Biyogüvenlik için otopsi öncesi alınan kanların mikrobiyolojik tarama testleri açısından değerlendirilmesi

Öz

AMAÇ: Adli Tıp Kurumu İstanbul Morg İhtisas Dairesinde yapılan otopsi işlemlerinde görevli sağlık çalışanlarının insan immün yetmezlik virüsü HIV , Hepatit B HBV ve Hepatit C HCV virüsleri açısından ne kadar risk altında olduklarını PCR incelemesi ile belirlemek ve bu tür kanla bulaşan enfeksiyonlardan korunma amaçlı gerekli tedbirlerin literatür eşliğinde tartışılması amaçlanmıştır. YÖNTEM: Otopsi işlemi yapılmak üzere Adli Tıp Kurumuna gönderilen ölenlerden rastgele seçilen 158 olgu çalışmaya dahil edildi. Otopsi işlemi sırasında cesetlerden alınan kan örneklerinde PCR incelemesi ile HBV, HCV ve HIV değerlendirildi. BULGULAR: Yapılan inceleme sonucunda 158 olgunun 17’si %10,7 bu etkenlerden en az biri açısından pozitif, 13’ü %8,2 HBV pozitif, 4’ü %2,5 HCV pozitif, 1’i %0,6 HIV pozitif, 1’i %0,6 ise hem HBV hem HCV pozitif olduğu tespit edilmiştir. SONUÇ: Araştırdığımız kadarıyla bu çalışma ülkemizde adli otopsi yapılan olgularda bu enfeksiyon etkenlerinin birlikte değerlendirildiği ilk PCR çalışması olma özelliğini taşımaktadır. Bu çalışma ve diğer yapılan serolojik çalışmalar birlikte değerlendirildiğinde otopsi işleminde görevli sağlık çalışanlarının Hepatit B, Hepatit C ve AIDS hastalıkları açısından yüksek derecede risk altında oldukları anlaşıldı. Otopsi işleminden önce her olgu için risk değerlendirilmesi yapılmalıdır. Ortaya çıkan riske göre koruyucu tedbirler alınmalı ve biyogüvenlik seviyesi belirlenmelidir.

Anahtar Kelimeler

• Otopsi
• enfeksiyon
• risk analizi
• biyogüvenlik

Evaluation of blood specimens collected before the autopsy for microbiological screening tests in terms of biosafety

Öz

INTRODUCTION: The aim of this study was to determine the risks of seropositivity of autopsy cases for human immunodeficiency virus HIV , hepatitis B HBV , and hepatitis C HCV viruses by PCR and to discuss the measures recommended in the literature for the prevention of such blood-borne infections. METHODS: One hundred fifty-eight cases were randomly selected from the autopsy cases of the Council of Forensic Medicine. Blood samples collected during autopsy were tested by PCR for HBV, HCV, and HIV. RESULTS: As a result of the analyses, 17 10.7% of 158 bodies were positive for at least one of these markers, 13 8.2% were HBV-positive, four 2.5% were HCV-positive, one 0.6% was HIV-positive, and one 0.6% was positive for both HBV and HCV. CONCLUSION: As far as we know, this study is the first PCR study in which these infection factors were evaluated in forensic autopsy cases in Turkey. This study and other serological studies show that health workers involved in the autopsy process are at high risk of exposure to hepatitis B, hepatitis C, and AIDS diseases. Risk assessment should be performed for each case before the autopsy process. According to the resulting risk assessment, protective measures should be taken and the biosafety level should be determined before the autopsy.

Anahtar Kelimeler

• Autopsy
• infection
• risk analysis
• biosafety

Kaynakça

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