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Konya’da Ekim 2008 - Şubat 2010 tarihleri arasındaki çocukluk çağında toplum kökenli pnömoni tanısı ile hastaneye yatırılan hastalarda bakteriyel ve viral etkenlerin insidansı ve klinik özellikleri

Year 2016, Volume: 73 Issue: 2, 101 - 110, 01.06.2016

Abstract

Amaç: Bu çalışmada; toplum kökenli pnömoni tanısı TKP ile hastaneye yatırılan hastalarda bakteriyel ve viral etkenlerin insidansı ve klinik özellikleri araştırılması amaçlanmıştır.Yöntem: 1 Ekim 2008-28 Şubat 2010 tarihleri arasında Selçuk Üniversitesi Meram Tıp Fakültesi Çocuk Poliklinikleri ve Çocuk Acil Servisine başvuran ve yatırılarak tedavi edilmesi gereken, başvurudan 48 saat öncesine kadar antibiyotik kullanmayan, klinik olarak TKP tanısı olan, yaşları 1 ay ile 16 yaş arasındaki toplam 91 hasta çalışma kapsamına alındı. Bu hastaların demografik ve klinik özellikleri kaydedildi. Hastane başvurusu esnasında tam kan sayımı, eritrosit sedimantasyon hızı, C-reaktif protein, prokalsitonin, kan kültürü için kan numuneleri ve viral etiyolojiyi gerçek zamanlı polimeraz zincir reaksiyonu RT-PCR ile saptamak amacıyla nazofaringeal aspirat numuneleri alındı. Tüm hastaların PA akciğer radyografileri kontrol edildi.Bulgular:Hastaların %24,2 22/91 ’sinde pnömoni etkeni saptanırken, %75,8 69/91 ’inde herhangi bir pnömoni etkeni saptanamadı. 91 hastanın 11 %12,1 ’inde viral enfeksiyon, dokuzunda %9,9 sadece bakteriyel enfeksiyon, üçünde %3.3 viral koenfeksiyon, ikisinde %2,2 hem virus hem de bakteri vardı. Virus tespit edilen 11 hastanın yedisinde Parainfluenza PIV 2, ikisinde PIV 3, birinde adenovirus, ikisinde hem PIV3 hem remains a leading cause of morbidity and mortality Childhood community-acquired pneumonia CAP adenovirus, birinde hem PIV2 hem de PIV3 tespit edildi. Hastaların hiçbirinde RSV, PIV1, hMPV saptanmadı. Bakteri tespit edilen 11 hastanın beşinde Stafilokokus epidermidis, ikisinde S. saprophyticus, birinde S. shominis, birinde S. capitis, birinde S. sobrinus ve birinde S. mitis tespit edildi. Hastaların ikisinde de viral-bakteriyel karma etken olduğu saptandı. Klinik olarak pnömoni tanısı alan 91 hastanın 59 %64,7 ’unda radyolojik olarak pnömoni varlığı belirlendi. Sonuç: Çalışmamız TKP’de viral etkenlerin etiyolojik etkisini gösterdi. Parainfluenza virus 2 tüm yaş gruplarında en sık tespit edilen viral etkendi. Viral enfeksiyonların etiyolojik tanılarının iyileştirilmesi ile gereksiz antibiyotik kullanımından kaçınılabilir. Sonuçlarımızı doğrulamak için daha kapsamlı ve randomize kontrollü çalışmalara gereksinim vardır

References

  • Chiang WC, Teoh OH, Chong CY, Goh A, Tang JP, Chay OM. Epidemiology, clinical characteristics and antimicrobial resistance patterns of community- acquired pneumonia in 1702 hospitalized children in Singapore. Respirology, 2007; 12: 254-61.
  • Mulholland K. Global burden of acute respiratory infections in children:implications for interventions. Pediatr Pulmonol, 2003; 36: 469-74.
  • Paisley JW, Lauer BA, McIntosh K, Glode MP, Schachter J, Rumack C. Pathogens associated with acute lower respiratory tract infection in young children. Pediatr Infect Dis, 1984; 3: 14–9.
  • Nohynek H, Eskola J, Laine E, Halonen P, Ruutu P, Saikku P, et al. The causes of hospital-treated acute lower respiratory tract infection in children. Am J Dis Child, 1991; 145: 618–22.
  • Gendrel D, Raymond J, Moulin F, Iniguez JL, Ravilly S, Habib F, et al. Etiology and response to antibiotic therapy of communityacquired pneumonia in French children. Eur J Clin Microbiol Infect Dis, ; 16: 388–91.
  • Juvén T, Mertsola J, Waris M, Leinonen M, Meurman O, Roivainen M, et al. Etiology of community- acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J, 2000; 19: 293–8.
  • Sinaniotis CA, Sinaniotis AC. Community-acquired pneumonia in children. Curr Opin Pulm Med, 2005; : 218-25.
  • Coiras MT, Pérez-Breña P, García ML, Casas I. Simultaneous detection of influenza A, B, and C viruses, respiratory syncytial virus, and adenoviruses in clinical samples by multiplex reverse transcription nested-PCR assay. J Med Virol, 2003; 69: 132-44.
  • Templeton KE, Scheltinga SA, Beersma MF, Kroes AC, Claas EC. Rapid and sensitive method using multiplex real-time PCR for diagnosis of infections by influenza A and influenza B viruses, respiratory syncytial virus, and parainfluenza viruses 1, 2, 3, and 4. J Clin Microbiol, 2004; 42: 1564-9.
  • McIntosh K. Community-acquired pneumonia in children. N Engl J Med, 2002; 346: 429-37.
  • World Health Organization. Technical bases for the WHO recommendation on the management of pneumonia in children at first level health facilities. World Health Organization, 1991, Geneva.
  • Heiskanen-Kosma T, Korppi M, Jokinen C, Kurki S, Heiskanen L, Juvonen H, et al. Etiology of childhood pneumonia: serologic results of a prospective, population-based study. Pediatr Infect Dis J, 1998; : 986-91.
  • Wubbel L, Muniz L, Ahmed A, Trujillo M, Carubelli C, McCoig C, et al. Etiology and treatment of community- acquired pneumonia in ambulatory children. Pediatr Infect Dis J, 1999; 18: 98-104.
  • Ceyhan M, Ozsurekci Y, Gürler N, Ozkan S, Sensoy G, Belet N, et al. Distribution of Streptococcus pneumoniae serotypes that cause parapneumonic empyema in Turkey. Clin Vaccine Immunol, 2013; : 972-6.
  • Herwaldt LA, Geiss M, Kao C, Pfaller MA. The positive predictive value of isolating coagulase- negative staphylococci from blood cultures. Clin Infect Dis, 1996; 22: 14–20.
  • Rogers KL, Fey PD, Rupp ME. Coagulase-negative staphylococcal infections. Infect Dis Clin North Am, 2009; 23: 73–98.
  • Seybold U, Reichardt C, Halvosa JS, Blumberg HM. Clonal diversity in episodes with multiple coagulase-negative staphylococcus bloodstream isolates suggesting frequent contamination. Infection, 2009; 37: 256–60.
  • Toldos CM, Yague G, Ortiz G, Segovia M. Assessment of multiple coagulase-negative staphylococci isolated in blood cultures using pulsed-field gel electrophoresis. Eur J Clin Microbiol Infect Dis, ; 16: 581–6.
  • Iwane MK, Edwards KM, Szilagyi PG, Walker FJ, Griffin MR, Weinberg GA, et al; New Vaccine Surveillance surveillance for hospitalizations associated with respiratory syncytial virus, influenza virus, and parainfluenza viruses among young children. Pediatrics, 2004; 113: 1758-64 Population-based
  • Nascimento-Carvalho CM, Rocha H, Benguigui Y. Effects of socioeconomic status on presentation with acute lower respiratory tract disease in children in Salvador, Northeast Brazil. Pediatr Pulmonol, 2002; 33: 244-8.
  • Juvén T, Ruuskanen O, Mertsola J. Symptoms and signs of community-acquired pneumonia in children. Scand J Prim Health Care, 2003; 21: 6.
  • British Thoracic Society. Guidelines for the management of community-acquired pneumonia in childhood. Thorax, 2002; 57: 1-24.
  • Cilla G, Oñate E, Perez-Yarza EG, Montes M, Vicente D, Perez-Trallero E. Viruses in community- acquired pneumonia in children aged less than 3 years old: High rate of viral coinfection. J Med Virol, 2008; 80: 1843-9.
  • Lu MP, Ma LY, Zheng Q, Dong LL, Chen ZM. Clinical characteristics of adenovirus associated lower respiratory tract infection in children. World J Pediatr, 2013; 9: 346-9.
  • Samransamruajkit R, Hiranrat T, Chieochansin T, Sritippayawan S, Deerojanawong J, Prapphal N, et al. Prevalence, clinical presentations and complications among hospitalized children with influenza pneumonia. Jpn J Infect Dis, 2008; 61: 9.
  • Wolf DG, Greenberg D, Kalkstein D, Shemer-Avni Y, Givon-Lavi N, Saleh N, et al. Comparison of human metapneumovirus, respiratory syncytial virus and influenza A virus lower respiratory tract infections in hospitalized young children. Pediatr Infect Dis J, ; 25: 320-4.
  • Michelow IC, Olsen K, Lozano J, Rollins N. Epidemiology and characteristics of community acquired pneumonia in hospitalized children. Pediatrics, 2004; 113: 701-7.
  • Moulin F, Raymond J, Lorrot M, Marc E, Coste J, Iniguez JL, et al. Procalcitonin in children admitted to hospital with community acquired pneumonia. Arch Dis Child, 2001; 84: 332–6.
  • Toikka P, Irjala K, Juven T, Virkki R, Mertsola J, Leinonen M, et al (2000) Serum procalcitonin, C-reactive distinguishing bacterial and viral pneumonia in children. Pediatr Infect Dis J, 19: 598–602. for
  • Don M, Valent F, Korppi M, Canciani M. Differentiation of bacterial and viral community- acquired pneumonia in children. Pediatr Int, 2009; : 91-6.
  • Isaacs D. Problems in determining the etiology of community acquired childhood pneumonia . Pediatr Infect Dis J, 1989; 8: 143-8.
  • Korppi M , Kiekara O , Heiskanen-Kosma T , Soimakallio S . Comparison of radiological findings and microbial aetiology of childhood pneumonia . Acta Paediatr, 1993 ; 82: 360-3 .
  • Virkki R, Juven T, Rikalainene H, Svedström E, Mertsola J, Ruuskanen O. Differentiation of bacterial and viral pneumonia in children . Thorax, ; 57: 438-41.

Clinical characteristics and incidence of bacterial and viral pathogens in patients hospitalized with community acquired pneumonia in childhood in Konya between October 2008 and February 2010

Year 2016, Volume: 73 Issue: 2, 101 - 110, 01.06.2016

Abstract

Objective: It was aimed to investigate clinical characteristics and incidence of bacterial and viral pathogens in patients who were hospitalized with the clinical diagnosis of community acquired pneumonia CAP .Method: In this study 91 patients at the ages between one month and six years who required hospitalization and were admitted to pediatrics clinics and pediatric emergency services of the Selçuk University Meram Medical Faculty, and also who did not use antibiotics for 48 hours before hospital admission and had the clinical diagnosis of CAP were investigated from October 2008 to February 2010. Demographic and clinic characteristics of the patients were recorded. Blood samples for complete blood count, erytrocyte sedimentation rate, C-reactive protein, procalcitonin, blood culture and nasopharyngeal aspirate samples for detection of the viral etiologies by real time polymerase chain reaction RT-PCR were taken at the time of hospital admission. Initial posteroanterior PA chest X-rays of all patients were checked.Results: The agents of pneumonia were detected in 24.2% 22/91 but not in 75.8% 69/91 of our patients. Of 91 patients, 11 12.1% were positive for viral infections, 9 9.9% were positive for only bacterial infections, 3 3.3% had viral coenfection, 2 2.2% were positive for both viral and bacterial infections. Out of 11 viral positive patients, 7, 2, 1, 2, and 1 patients adenovirus, birinde hem PIV2 hem de PIV3 tespit edildi. Hastaların hiçbirinde RSV, PIV1, hMPV saptanmadı. Bakteri tespit edilen 11 hastanın beşinde Stafilokokus epidermidis, ikisinde S. saprophyticus, birinde S. shominis, birinde S. capitis, birinde S. sobrinus ve birinde S. mitis tespit edildi. Hastaların ikisinde de viral-bakteriyel karma etken olduğu saptandı. Klinik olarak pnömoni tanısı alan 91 hastanın 59 %64,7 ’unda radyolojik olarak pnömoni varlığı belirlendi. Sonuç: Çalışmamız TKP’de viral etkenlerin etiyolojik etkisini gösterdi. Parainfluenza virus 2 tüm yaş gruplarında en sık tespit edilen viral etkendi. Viral enfeksiyonların etiyolojik tanılarının iyileştirilmesi ile gereksiz antibiyotik kullanımından kaçınılabilir. Sonuçlarımızı doğrulamak için daha kapsamlı ve randomize kontrollü çalışmalara gereksinim vardır

References

  • Chiang WC, Teoh OH, Chong CY, Goh A, Tang JP, Chay OM. Epidemiology, clinical characteristics and antimicrobial resistance patterns of community- acquired pneumonia in 1702 hospitalized children in Singapore. Respirology, 2007; 12: 254-61.
  • Mulholland K. Global burden of acute respiratory infections in children:implications for interventions. Pediatr Pulmonol, 2003; 36: 469-74.
  • Paisley JW, Lauer BA, McIntosh K, Glode MP, Schachter J, Rumack C. Pathogens associated with acute lower respiratory tract infection in young children. Pediatr Infect Dis, 1984; 3: 14–9.
  • Nohynek H, Eskola J, Laine E, Halonen P, Ruutu P, Saikku P, et al. The causes of hospital-treated acute lower respiratory tract infection in children. Am J Dis Child, 1991; 145: 618–22.
  • Gendrel D, Raymond J, Moulin F, Iniguez JL, Ravilly S, Habib F, et al. Etiology and response to antibiotic therapy of communityacquired pneumonia in French children. Eur J Clin Microbiol Infect Dis, ; 16: 388–91.
  • Juvén T, Mertsola J, Waris M, Leinonen M, Meurman O, Roivainen M, et al. Etiology of community- acquired pneumonia in 254 hospitalized children. Pediatr Infect Dis J, 2000; 19: 293–8.
  • Sinaniotis CA, Sinaniotis AC. Community-acquired pneumonia in children. Curr Opin Pulm Med, 2005; : 218-25.
  • Coiras MT, Pérez-Breña P, García ML, Casas I. Simultaneous detection of influenza A, B, and C viruses, respiratory syncytial virus, and adenoviruses in clinical samples by multiplex reverse transcription nested-PCR assay. J Med Virol, 2003; 69: 132-44.
  • Templeton KE, Scheltinga SA, Beersma MF, Kroes AC, Claas EC. Rapid and sensitive method using multiplex real-time PCR for diagnosis of infections by influenza A and influenza B viruses, respiratory syncytial virus, and parainfluenza viruses 1, 2, 3, and 4. J Clin Microbiol, 2004; 42: 1564-9.
  • McIntosh K. Community-acquired pneumonia in children. N Engl J Med, 2002; 346: 429-37.
  • World Health Organization. Technical bases for the WHO recommendation on the management of pneumonia in children at first level health facilities. World Health Organization, 1991, Geneva.
  • Heiskanen-Kosma T, Korppi M, Jokinen C, Kurki S, Heiskanen L, Juvonen H, et al. Etiology of childhood pneumonia: serologic results of a prospective, population-based study. Pediatr Infect Dis J, 1998; : 986-91.
  • Wubbel L, Muniz L, Ahmed A, Trujillo M, Carubelli C, McCoig C, et al. Etiology and treatment of community- acquired pneumonia in ambulatory children. Pediatr Infect Dis J, 1999; 18: 98-104.
  • Ceyhan M, Ozsurekci Y, Gürler N, Ozkan S, Sensoy G, Belet N, et al. Distribution of Streptococcus pneumoniae serotypes that cause parapneumonic empyema in Turkey. Clin Vaccine Immunol, 2013; : 972-6.
  • Herwaldt LA, Geiss M, Kao C, Pfaller MA. The positive predictive value of isolating coagulase- negative staphylococci from blood cultures. Clin Infect Dis, 1996; 22: 14–20.
  • Rogers KL, Fey PD, Rupp ME. Coagulase-negative staphylococcal infections. Infect Dis Clin North Am, 2009; 23: 73–98.
  • Seybold U, Reichardt C, Halvosa JS, Blumberg HM. Clonal diversity in episodes with multiple coagulase-negative staphylococcus bloodstream isolates suggesting frequent contamination. Infection, 2009; 37: 256–60.
  • Toldos CM, Yague G, Ortiz G, Segovia M. Assessment of multiple coagulase-negative staphylococci isolated in blood cultures using pulsed-field gel electrophoresis. Eur J Clin Microbiol Infect Dis, ; 16: 581–6.
  • Iwane MK, Edwards KM, Szilagyi PG, Walker FJ, Griffin MR, Weinberg GA, et al; New Vaccine Surveillance surveillance for hospitalizations associated with respiratory syncytial virus, influenza virus, and parainfluenza viruses among young children. Pediatrics, 2004; 113: 1758-64 Population-based
  • Nascimento-Carvalho CM, Rocha H, Benguigui Y. Effects of socioeconomic status on presentation with acute lower respiratory tract disease in children in Salvador, Northeast Brazil. Pediatr Pulmonol, 2002; 33: 244-8.
  • Juvén T, Ruuskanen O, Mertsola J. Symptoms and signs of community-acquired pneumonia in children. Scand J Prim Health Care, 2003; 21: 6.
  • British Thoracic Society. Guidelines for the management of community-acquired pneumonia in childhood. Thorax, 2002; 57: 1-24.
  • Cilla G, Oñate E, Perez-Yarza EG, Montes M, Vicente D, Perez-Trallero E. Viruses in community- acquired pneumonia in children aged less than 3 years old: High rate of viral coinfection. J Med Virol, 2008; 80: 1843-9.
  • Lu MP, Ma LY, Zheng Q, Dong LL, Chen ZM. Clinical characteristics of adenovirus associated lower respiratory tract infection in children. World J Pediatr, 2013; 9: 346-9.
  • Samransamruajkit R, Hiranrat T, Chieochansin T, Sritippayawan S, Deerojanawong J, Prapphal N, et al. Prevalence, clinical presentations and complications among hospitalized children with influenza pneumonia. Jpn J Infect Dis, 2008; 61: 9.
  • Wolf DG, Greenberg D, Kalkstein D, Shemer-Avni Y, Givon-Lavi N, Saleh N, et al. Comparison of human metapneumovirus, respiratory syncytial virus and influenza A virus lower respiratory tract infections in hospitalized young children. Pediatr Infect Dis J, ; 25: 320-4.
  • Michelow IC, Olsen K, Lozano J, Rollins N. Epidemiology and characteristics of community acquired pneumonia in hospitalized children. Pediatrics, 2004; 113: 701-7.
  • Moulin F, Raymond J, Lorrot M, Marc E, Coste J, Iniguez JL, et al. Procalcitonin in children admitted to hospital with community acquired pneumonia. Arch Dis Child, 2001; 84: 332–6.
  • Toikka P, Irjala K, Juven T, Virkki R, Mertsola J, Leinonen M, et al (2000) Serum procalcitonin, C-reactive distinguishing bacterial and viral pneumonia in children. Pediatr Infect Dis J, 19: 598–602. for
  • Don M, Valent F, Korppi M, Canciani M. Differentiation of bacterial and viral community- acquired pneumonia in children. Pediatr Int, 2009; : 91-6.
  • Isaacs D. Problems in determining the etiology of community acquired childhood pneumonia . Pediatr Infect Dis J, 1989; 8: 143-8.
  • Korppi M , Kiekara O , Heiskanen-Kosma T , Soimakallio S . Comparison of radiological findings and microbial aetiology of childhood pneumonia . Acta Paediatr, 1993 ; 82: 360-3 .
  • Virkki R, Juven T, Rikalainene H, Svedström E, Mertsola J, Ruuskanen O. Differentiation of bacterial and viral pneumonia in children . Thorax, ; 57: 438-41.
There are 33 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Sadiye Sert This is me

Melike Emiroğlu This is me

Uğur Arslan This is me

Osman Koç This is me

Rahmi Örs This is me

Publication Date June 1, 2016
Published in Issue Year 2016 Volume: 73 Issue: 2

Cite

APA Sert, S., Emiroğlu, M., Arslan, U., Koç, O., et al. (2016). Konya’da Ekim 2008 - Şubat 2010 tarihleri arasındaki çocukluk çağında toplum kökenli pnömoni tanısı ile hastaneye yatırılan hastalarda bakteriyel ve viral etkenlerin insidansı ve klinik özellikleri. Türk Hijyen Ve Deneysel Biyoloji Dergisi, 73(2), 101-110.
AMA Sert S, Emiroğlu M, Arslan U, Koç O, Örs R. Konya’da Ekim 2008 - Şubat 2010 tarihleri arasındaki çocukluk çağında toplum kökenli pnömoni tanısı ile hastaneye yatırılan hastalarda bakteriyel ve viral etkenlerin insidansı ve klinik özellikleri. Turk Hij Den Biyol Derg. June 2016;73(2):101-110.
Chicago Sert, Sadiye, Melike Emiroğlu, Uğur Arslan, Osman Koç, and Rahmi Örs. “Konya’da Ekim 2008 - Şubat 2010 Tarihleri arasındaki çocukluk çağında Toplum kökenli pnömoni tanısı Ile Hastaneye yatırılan Hastalarda Bakteriyel Ve Viral Etkenlerin Insidansı Ve Klinik özellikleri”. Türk Hijyen Ve Deneysel Biyoloji Dergisi 73, no. 2 (June 2016): 101-10.
EndNote Sert S, Emiroğlu M, Arslan U, Koç O, Örs R (June 1, 2016) Konya’da Ekim 2008 - Şubat 2010 tarihleri arasındaki çocukluk çağında toplum kökenli pnömoni tanısı ile hastaneye yatırılan hastalarda bakteriyel ve viral etkenlerin insidansı ve klinik özellikleri. Türk Hijyen ve Deneysel Biyoloji Dergisi 73 2 101–110.
IEEE S. Sert, M. Emiroğlu, U. Arslan, O. Koç, and R. Örs, “Konya’da Ekim 2008 - Şubat 2010 tarihleri arasındaki çocukluk çağında toplum kökenli pnömoni tanısı ile hastaneye yatırılan hastalarda bakteriyel ve viral etkenlerin insidansı ve klinik özellikleri”, Turk Hij Den Biyol Derg, vol. 73, no. 2, pp. 101–110, 2016.
ISNAD Sert, Sadiye et al. “Konya’da Ekim 2008 - Şubat 2010 Tarihleri arasındaki çocukluk çağında Toplum kökenli pnömoni tanısı Ile Hastaneye yatırılan Hastalarda Bakteriyel Ve Viral Etkenlerin Insidansı Ve Klinik özellikleri”. Türk Hijyen ve Deneysel Biyoloji Dergisi 73/2 (June 2016), 101-110.
JAMA Sert S, Emiroğlu M, Arslan U, Koç O, Örs R. Konya’da Ekim 2008 - Şubat 2010 tarihleri arasındaki çocukluk çağında toplum kökenli pnömoni tanısı ile hastaneye yatırılan hastalarda bakteriyel ve viral etkenlerin insidansı ve klinik özellikleri. Turk Hij Den Biyol Derg. 2016;73:101–110.
MLA Sert, Sadiye et al. “Konya’da Ekim 2008 - Şubat 2010 Tarihleri arasındaki çocukluk çağında Toplum kökenli pnömoni tanısı Ile Hastaneye yatırılan Hastalarda Bakteriyel Ve Viral Etkenlerin Insidansı Ve Klinik özellikleri”. Türk Hijyen Ve Deneysel Biyoloji Dergisi, vol. 73, no. 2, 2016, pp. 101-10.
Vancouver Sert S, Emiroğlu M, Arslan U, Koç O, Örs R. Konya’da Ekim 2008 - Şubat 2010 tarihleri arasındaki çocukluk çağında toplum kökenli pnömoni tanısı ile hastaneye yatırılan hastalarda bakteriyel ve viral etkenlerin insidansı ve klinik özellikleri. Turk Hij Den Biyol Derg. 2016;73(2):101-10.