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KOAH ATAKLARINDA VİRAL VE ATİPİK ETKENLERİN ROLÜ

Yıl 2005, Cilt: 19 Sayı: 2, 45 - 50, 01.10.2005

Öz

KOAH akut alevlenmelerinin %80'inden enfeksiyonlar sorumludur. Bunların %47'sinde bakteriler, %30'unda virüsler, %5-10'unda atipik ajanlar etkendir. Amacımız; KOAH akut ataklarında atipik ajanların ve virüslerin yerini araştırmaktı. Çalışmamızda prospektif olarak 6 aylık süreç içinde KOAH akut atakla başvuran 86 olguda iki viral ve üç atipik ajana ait çift serum örneklerinde Enzyme İmmune Assay (EIA) yöntemiyle antikor titrelerini inceledik. Toplam 86 olgunun %29'unda Respiratuar Sinsityal Virüs (RSV), %15'inde mikoplazma, %7'sinde adenovirüs, %3 klamidya, %2.5 legionella, %5 RSV+mikoplazma ve %2.5 oranında da RSV+klamidya birlikteliği izlendi. Olguların %36'sında etken saptanmadı. 20 adet sağlklı kontrol grubunun %5'inde RSV, %5'inde de adenovirüs bulundu. İki grup arasında RSV ve adenovirüs açısından anlamlı fark izlendi (p≤0.066). Sonuç olarak, KOAH akut ataklarında özellikle virüslerin önemini vurgulamak istedik.

Kaynakça

  • 1. Seemungal TAR, Donaldson GC, Paul EA ve ark. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1988; 157: 1418-22.
  • 2. Kocabafl A. Kronik obstrüktif akci¤er hastal›¤›nda alevlenme: ‹nfeksiyonlar›n rolü. Ekim N, Uçan ES ve ark, eds. Solunum sistemi infeksiyonlar›. Ankara. Turgut Yay›nc›l›k 2001; 377-412.
  • 3. Fagon JY, Chastre J, Gibert C. Acute respiratory failure in chronic obstructive pulmonary disease. In: Dereme JP, Whitelaw WA, Simillawski T, eds. Acute respiratory failure in chronic obstructive pulmonary diseaseVol: 92. New York: Marcel Dekker; 1996; 337.
  • 4. Voelkel N, Tuder R. COPD, exacerbation. Chest 2000; 117(2): 376-8.
  • 5. Schelhamer JH, Gill VJ, Quinn TC, et al. The laboratory evaluation of opportunistic pulmonary infections. Ann Int Med 1996; 124: 585-8.
  • 6. Toraks Derne¤i Kronik Obstrüktif Akci¤er Hastal›¤› Tan› ve Tedavi Rehberi. Toraks Dergisi 2000: 1.
  • 7. Greenberg S. Viral respiratory infections in elderly patients and patients with chronic obstructive pulmonary disease. Am J Med 2002; 112(6A): 28-32.
  • 8. Arseven O. Kronik obstrüktif akci¤er hastal›¤›nda antibiyotik kullan›m› ve afl›lar. Toraks Derne¤i yay›nlar›, Turgut Yay›nc›l›k, ‹stanbul 2000; 2: 113-6.
  • 9. Sethi S. Infectious etiology of acute exacerbations of chronic bronchitis. Chest 2000; 117 (Suppl 2): 380-4.
  • 10. Seemungal TAR, Harper –Owen R, Bhowemic A, et al. Respiratory viruses, symptoms and inflamatory markers in acute exacerbations and stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001; 164: 1618-23.
  • 11. Walsh EE, Falsey AR, Hennessey PA. Respiratory syncytial and other virus infection in persons with chronic ca rdiopulmonary disease. Am J Respir Crit Care Med 1999; 160: 791-5.
  • 12. Wark PAB, Johnston SL, Moric I, et al. Neutrophil degranulation and cell lysis is associated with clinical severity in virusinduced astma. Eur Respir J 2002, 19: 68-75.
  • 13. Matsuse T, Hahashi S, Kuwana K, et al. Latent adenoviral infections in the pathogenesis of chronic airway obstruction. Am Rev Respir Dis 1992; 146: 177-84.
  • 14. Blasi F, Legnani D, Lambarda UM, et al. Chlamidia pneumonia infection in acute exacerbations of COPD. Eur Respir J 1993; 6: 19-22.
  • 15. Mogulkoç N, Karakurt S, Isalska B, et al. Acute purulent exacerbations of chronic obstructive pulmonary disease and Chlamydia pneumoniae infection. Am J Respir Crit Care Med 1999; 160: 349-53.
  • 16. Beaty CD, Gynaston JT, Wang SP, et al. Chlamydia pneumoniae, strain TWAR, infection in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 1991; 144: 1408-13.
  • 17. Torres A, Dorca J, Zalacain R, et al. Community-acquired pneumonia in chronic obstructive pulmonary disease: a Spanish multicenter study. Am J Respir Crit Care Med. 1996; 154(5): 1456-61.
  • 18. Taflbakan S, Baflo¤lu ÖK, Say›ner AA ve ark. KOAH alevlenmelerinde etken patojenler. Toraks Ulusal Akci¤er ve Sa¤l›¤› 3. Kongre kitap盤›, Antalya 2000; 191.
  • 19. Uzun K, Özbay B, Buzgan T ve ark. KOAH akut ata¤›nda Chlamydiae pneumoniae, Mycoplasma pneumoniae, Legionella spp ve ‹nfluenza A s›kl›¤›. Toraks Dergisi, 2002; 3121: 146-50.
  • 20. Buscha RO, Saxtan D, Shultz PS, et al. Infections with viruses and Mycoplasma pneumoniae during exacerbations of chronic bronchitis. J Infect Dis 1978; 137: 377-81.
  • 21. Lieberman D, Ben-Yaakov M, Lazarovich Z, et al. Infectious etiologies in acute exacer bation of COPD. Diagn Microbial Infect Dis 2001; 40: 95-102.
  • 22. Gah SK, Johan A, Cheang JH, Wang YE. A prospective study of infections with atypical pneumonia organisms in acute exacerbations of chronic bronchitis. Ann Acad Med Singapore 1999; 28: 476-80 (Abstract).

THE ROLE OF VIRUSES AND ATYPICAL AGENTS IN ACUTE EXACERBATIONS OF COPD

Yıl 2005, Cilt: 19 Sayı: 2, 45 - 50, 01.10.2005

Öz

Infections are responsible for 80% of COPD acute exacerbations. Bacteries are responsible for 47%, viruses are found in 30% and atypical agents are responsible in 5-10%. Our aim is, to research the role of viruses and atypical agents in acute exacerbations of COPD. In our study we studied prospectively the antibody titres of 86 patients who admitted with COPD acute exacerbation in a six month period. Antibody titres were measured by using Enzyme Immune Assay method with double serum samples for two viral and three atypical agents. Among 86 patients, 29% had Respiratory Syncitial Virus (RSV), 15% had mycoplasma, 7% had adenovirus, 3% had chlamydia, 2.5% had Legionella, 5% had RSV + mycoplasma and 2.5% had RSV + chlamydia combination Agent could not be determined in 36%. Among 20 healthy control group, 5% had RSV and 5% had adenovirus. There was a statistical difference when compared with the control group (p≤0.066). In conclusion,we would like to impress the importance of viruses in acute exacerbations of COPD.

Kaynakça

  • 1. Seemungal TAR, Donaldson GC, Paul EA ve ark. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1988; 157: 1418-22.
  • 2. Kocabafl A. Kronik obstrüktif akci¤er hastal›¤›nda alevlenme: ‹nfeksiyonlar›n rolü. Ekim N, Uçan ES ve ark, eds. Solunum sistemi infeksiyonlar›. Ankara. Turgut Yay›nc›l›k 2001; 377-412.
  • 3. Fagon JY, Chastre J, Gibert C. Acute respiratory failure in chronic obstructive pulmonary disease. In: Dereme JP, Whitelaw WA, Simillawski T, eds. Acute respiratory failure in chronic obstructive pulmonary diseaseVol: 92. New York: Marcel Dekker; 1996; 337.
  • 4. Voelkel N, Tuder R. COPD, exacerbation. Chest 2000; 117(2): 376-8.
  • 5. Schelhamer JH, Gill VJ, Quinn TC, et al. The laboratory evaluation of opportunistic pulmonary infections. Ann Int Med 1996; 124: 585-8.
  • 6. Toraks Derne¤i Kronik Obstrüktif Akci¤er Hastal›¤› Tan› ve Tedavi Rehberi. Toraks Dergisi 2000: 1.
  • 7. Greenberg S. Viral respiratory infections in elderly patients and patients with chronic obstructive pulmonary disease. Am J Med 2002; 112(6A): 28-32.
  • 8. Arseven O. Kronik obstrüktif akci¤er hastal›¤›nda antibiyotik kullan›m› ve afl›lar. Toraks Derne¤i yay›nlar›, Turgut Yay›nc›l›k, ‹stanbul 2000; 2: 113-6.
  • 9. Sethi S. Infectious etiology of acute exacerbations of chronic bronchitis. Chest 2000; 117 (Suppl 2): 380-4.
  • 10. Seemungal TAR, Harper –Owen R, Bhowemic A, et al. Respiratory viruses, symptoms and inflamatory markers in acute exacerbations and stable chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001; 164: 1618-23.
  • 11. Walsh EE, Falsey AR, Hennessey PA. Respiratory syncytial and other virus infection in persons with chronic ca rdiopulmonary disease. Am J Respir Crit Care Med 1999; 160: 791-5.
  • 12. Wark PAB, Johnston SL, Moric I, et al. Neutrophil degranulation and cell lysis is associated with clinical severity in virusinduced astma. Eur Respir J 2002, 19: 68-75.
  • 13. Matsuse T, Hahashi S, Kuwana K, et al. Latent adenoviral infections in the pathogenesis of chronic airway obstruction. Am Rev Respir Dis 1992; 146: 177-84.
  • 14. Blasi F, Legnani D, Lambarda UM, et al. Chlamidia pneumonia infection in acute exacerbations of COPD. Eur Respir J 1993; 6: 19-22.
  • 15. Mogulkoç N, Karakurt S, Isalska B, et al. Acute purulent exacerbations of chronic obstructive pulmonary disease and Chlamydia pneumoniae infection. Am J Respir Crit Care Med 1999; 160: 349-53.
  • 16. Beaty CD, Gynaston JT, Wang SP, et al. Chlamydia pneumoniae, strain TWAR, infection in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 1991; 144: 1408-13.
  • 17. Torres A, Dorca J, Zalacain R, et al. Community-acquired pneumonia in chronic obstructive pulmonary disease: a Spanish multicenter study. Am J Respir Crit Care Med. 1996; 154(5): 1456-61.
  • 18. Taflbakan S, Baflo¤lu ÖK, Say›ner AA ve ark. KOAH alevlenmelerinde etken patojenler. Toraks Ulusal Akci¤er ve Sa¤l›¤› 3. Kongre kitap盤›, Antalya 2000; 191.
  • 19. Uzun K, Özbay B, Buzgan T ve ark. KOAH akut ata¤›nda Chlamydiae pneumoniae, Mycoplasma pneumoniae, Legionella spp ve ‹nfluenza A s›kl›¤›. Toraks Dergisi, 2002; 3121: 146-50.
  • 20. Buscha RO, Saxtan D, Shultz PS, et al. Infections with viruses and Mycoplasma pneumoniae during exacerbations of chronic bronchitis. J Infect Dis 1978; 137: 377-81.
  • 21. Lieberman D, Ben-Yaakov M, Lazarovich Z, et al. Infectious etiologies in acute exacer bation of COPD. Diagn Microbial Infect Dis 2001; 40: 95-102.
  • 22. Gah SK, Johan A, Cheang JH, Wang YE. A prospective study of infections with atypical pneumonia organisms in acute exacerbations of chronic bronchitis. Ann Acad Med Singapore 1999; 28: 476-80 (Abstract).
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Diğer ID JA32PK94AS
Bölüm Araştırma Makalesi
Yazarlar

Filiz Güldaval Bu kişi benim

İlke Evciler Bu kişi benim

Güneş Şenol Bu kişi benim

Rıfat Özacar Bu kişi benim

Yayımlanma Tarihi 1 Ekim 2005
Yayımlandığı Sayı Yıl 2005 Cilt: 19 Sayı: 2

Kaynak Göster

APA Güldaval, F., Evciler, İ., Şenol, G., Özacar, R. (2005). KOAH ATAKLARINDA VİRAL VE ATİPİK ETKENLERİN ROLÜ. İzmir Göğüs Hastanesi Dergisi, 19(2), 45-50.