Akut Solunum Yolu Enfeksiyonu Olan Hastalarda Etkenlerin Sendromik Panel ile Araştırılması

Öz

Amaç: Bu çalışmada, akut solunum yolu enfeksiyonu (ASYE) tanısı alan hastalarda sendromik panel yöntemiyle tespit edilen viral ve bakteriyel etkenlerin dağılımı, mevsimsel varyasyonları, ko-enfeksiyon paternleri ve yaş gruplarına göre farklılıklarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Şubat 2023-Ocak 2024 döneminde tek merkezde yürütülen retrospektif kesitsel çalışmada, ASYE şüphesiyle başvuran 453 hastanın nazofaringeal sürüntü örnekleri QIAstat-Dx Respiratory Panel (Qiagen®) kullanılarak analiz edilmiştir. Panel, 22 viral ve atipik bakteriyel etkeni yaklaşık olarak tespit etmektedir. İstatistiksel analizler SPSS 26.0 ile yapılmıştır. Bulgular: Hastaların %45,2'sinde en az bir etken saptanmış olup, pozitiflik pediatrik grupta (%62,7) erişkinlere göre (%33,2) anlamlı olarak yüksekti (p<0,001). Saptanan etkenlerin %99,1'i viral olup en sık rinovirüs/enterovirüs (%29,1), SARS-CoV-2 (%11,9), influenza B (%11,1) ve influenza A (%11,1) idi. Pozitiflik oranı kış ve ilkbaharda artarken yazın belirgin şekilde düştü (p<0,001). Vakaların %22,9'unda ko-enfeksiyon gözlendi; en sık adenovirüs+rinovirüs birlikteliği saptandı. Bakteriyel etkenler oldukça nadirdi (<%1). Sonuç: Sendromik panel testi, ASYE'lerde etken spektrumunun geniş ve baskın olarak viral olduğunu göstermiştir. Çocuklarda ve soğuk mevsimlerde pozitiflik oranı yüksektir. Testin hızlı ve doğru sonuçları, antibiyotik kullanımını azaltarak, uygun tedaviyi yönlendirmekte ve epidemiyolojik izleme için önemli bilgiler sunmaktadır.

Anahtar Kelimeler

• Akut solunum yolu enfeksiyonları
• Sendromik panel
• Multiplex PCR
• Viral etkenler
• Ko-enfeksiyon

Syndromic Panel for Investigation of Agents in Patients with Acute Respiratory Tract Infections

Öz

Aim: The aim of this study was to evaluate the distribution, seasonal variations, co-infection patterns and age group differences of viral and bacterial agents detected by syndromic panel method in patients with acute respiratory tract infection (ARTI). Material and Methods: In this retrospective cross-sectional study conducted in a single center between February 2023 and January 2024, nasopharyngeal swab samples of 453 patients with suspected ARTI were analyzed using QIAstat-Dx Respiratory Panel (Qiagen®). The panel detects 22 viral and atypical bacterial agents. Statistical analyses were performed with SPSS 26.0. Results: At least one agent was detected in 45.2% of patients and positivity was significantly higher in the pediatric group (62.7%) compared to adults (33.2%) (p<0.001). The most common agents were rhinovirus/enterovirus (29.1%), SARS-CoV-2 (11.9%), influenza B (11.1%) and influenza A (11.1%). The positivity rate increased in winter and spring and decreased significantly in summer (p<0.001). Co-infection was observed in 22.9% of cases; the most common co-infection was adenovirus+rhinovirus. Bacterial agents were very rare (<1%). Conclusion: Syndromic panel testing demonstrated that the spectrum of agents in ARTIs is broad and predominantly viral. The positivity rate is high in children and during cold seasons. The rapid and accurate results of the test, provide valuable information for epidemiological surveillance and support appropriate treatment selection; thus, it has the potential to reduce antibiotic use.

Anahtar Kelimeler

• Acute respiratory tract infections
• Syndromic panel
• Multiplex PCR
• Viral pathogens
• Co-infection

Kaynakça

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