Pediatrik yoğun bakımda viral solunum yolu enfeksiyonlarının epidemiyolojisi: Türkiye'den tek merkezli bir çalışma

Abstract

Amaç: Bu çalışma, Malatya Eğitim ve Araştırma Hastanesi Çocuk Yoğun Bakım Ünitesi'nde (ÇYBÜ) 2024 yılı boyunca solunum yolu enfeksiyonu tanısıyla izlenen çocuk hastalarda viral etkenlerin dağılımını ve bu etkenlerin klinik parametrelerle ilişkisini değerlendirmeyi amaçlamaktadır. Yöntem: Retrospektif olarak planlanan bu gözlemsel çalışmaya 1 Ocak – 31 Aralık 2024 tarihleri arasında solunum yolu enfeksiyonu ön tanısı ile ÇYBÜ’ne yatırılan 257 hasta dahil edilmiştir. Hastalardan elde edilen nazofaringeal sürüntü örnekleri multiplex PCR yöntemi ile analiz edilmiştir. Hastaların demografik bilgileri, laboratuvar verileri ve klinik seyri kayıt altına alınarak istatistiksel analizler yapılmıştır. Bulgular: En sık saptanan viral etkenler rinovirüs/enterovirüs (%36,6) ve RSV (%31,5) olmuştur. Komorbidite oranı %38,1 olarak tespit edilmiştir. RSV enfeksiyonları, rinovirüse kıyasla anlamlı olarak daha uzun yoğun bakım yatışı ile ilişkilendirilmiştir (ortalama 6,8 gün iken rinovirüs grubunda 4,3 gündü, p=0.008). Çoklu regresyon analizine göre yaş, CRP düzeyi ve komorbidite varlığı yatış süresini anlamlı derecede etkileyen faktörler olarak belirlendi (p<0.05). Sonuç: Rinovirüs/enterovirüs ve RSV, ÇYBÜ hastalarında en yaygın viral solunum yolu etkenleridir. RSV enfeksiyonu daha uzun yatış süresi ile ilişkilidir. CRP yüksekliği ve komorbid hastalık varlığı da klinik seyri olumsuz yönde etkilemektedir. Bu bulgular, pediatrik yoğun bakım yönetiminde hızlı tanı ve risk faktörlerinin göz önünde bulundurulmasının önemini vurgulamaktadır.

Keywords

• Çocuk yoğun bakım
• viral etkenler
• rinovirüs
• respiratuvar sinsityal virüs
• komorbidite

Epidemiology of viral respiratory tract infections in pediatric ICU: a single-center study in Turkiye

Abstract

Aims: This study aims to evaluate the distribution of viral agents and their relationship with clinical parameters in pediatric patients with respiratory tract infections in the pediatric intensive care unit (PICU) of MALATYA Training and Research Hospital during 2024. Methods: This retrospective observational study included 257 patients admitted to the PICU with a prediagnosis of respiratory tract infection between January 1 and December 31, 2024. Nasopharyngeal swab samples obtained from the patients were analyzed by multiplex PCR method. Demographic data, laboratory data and clinical course of the patients were recorded and statistical analysis was performed. Results: The most common viral agents were rhinovirus/enterovirus (36.6%) and respiratory syncytial virus (RSV) (31.5%). The comorbidity rate was 38.1%. RSV infections were associated with significantly longer ICU stay compared to rhinovirus (mean 6.8 days vs. 4.3 days in the rhinovirus group, p=0.008). According to multiple regression analysis, age, CRP level and presence of comorbidities were determined as factors that significantly affected the length of stay (p<0.05). Conclusion: Rhinovirus/enterovirus and RSV are the most common viral respiratory tract agents in PICU patients. RSV infection is associated with longer hospitalization. Elevated CRP and the presence of comorbid diseases also negatively affect the clinical course. These findings emphasize the importance of rapid diagnosis and consideration of risk factors in pediatric intensive care management.

Keywords

• Pediatric intensive care
• viral agents
• rhinovirus
• respiratory syncytial virus
• comorbidity
• PCR

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