Çocuk Acil Kliniğimizde Takip Edilen Hastalarda Solunum Yolu Viral Etkenlerin Dağılımı

Yıl 2019, , 94 - 104, 31.03.2019

Esra Türe , Abdullah Yazar

https://doi.org/10.26453/otjhs.495639

Öz

Solunum yolu enfeksiyonu bulguları ile
çocuk acil polikliniğine başvuran ve çocuk acil yataklı ünitesinde takip edilen
5 yaş altı hastaların nazofaringeal sürüntü örneklerinde saptanan solunum yolu
virüslerinin görülme sıklığının, mevsim, yaş ve klinik bulgulara göre
dağılımının saptanması amaçlandı. Hastaların kayıtları retrospektif olarak
incelendi ve yaş, cinsiyet, başvuru şikayeti, fizik muayene bulguları,
başvurduğu mevsim, non-invaziv ventilasyon gereksinimi, hastanede yatış süresi,
nazofaringeal sürüntü viral polimeraz zincir reaksiyonu (PCR) inceleme
sonuçları kaydedildi. Nazofaringeal sürüntü viral PCR sonuçları incelendiğinde
hastaların 43’ünde (%26,5) herhangi bir virüs izole edilemediği, 119’unda
(%73,5) ise en az bir ya da birden fazla virüs izole edildiği görüldü. Bu 119
hastanın 82’sinde (%68,9) tek bir virüs, 37’sinde (%31,1) iki veya daha fazla
virüs izole edildi. Hastaların aldıkları tedavileri incelendiğinde 87’sinin
(%53,7) hiçbir antibiyotik almadığı, 75’inin (%46,3) ise bir ya da birden çok
antbiyotik tedavisi aldığı görüldü. Viral patojenlerin erken dönemde saptanması
ile gereksiz antibiyotik kullanımının 
önlenebileceği, antibiyotik direncinin kontrol altına alınabileceği,
hastanede yatış süresinin kısalacağı ve tedavi maliyetlerinin azalacağı
düşünülmektedir.

Anahtar Kelimeler

Solunum yolu enfeksiyonu, nazofaringeal sürüntü, viral PCR, çocuk acil, çocuk

Distribution of Respiratory Viral Agents in Patients Being Followed-Up in Our Pediatric Emergency Department

Öz

We aimed to determine the  distribution of frequency of respiratory
viruses detected in nasopharyngeal swab samples of patients under 5 years of
age, who were hospitalized in the inpatient unit of pediatric emergency
department during last year, by seasons, age and clinical findings.
Hospitalization files of the patients were examined retrospectively.  Patients’ age, gender, admission complaint,
physical examination findings, season they admitted, need for non-invasive
mechanical ventilation, duration of hospital stay and result of nasopharyngeal
swab viral polymerase chain reaction (PCR) were recorded. When results of the
nasopharyngeal swab viral PCR of the patients were examined, it was determined
that no virus was isolated in 43 (26.5%) patients and in 119 (73.5%), however,
at least one virus was isolated. Of these 119 patients; only one virus was
detected in 82 (68.9%) and two or more viruses in 37 (31.1%). It was observed
that 87 (53.7%) did not receive any antibiotics and 75 (46.3%) patients were
treated with one or more antibiotics. Early detection of viral pathogens is
thought to prevent unnecessary antibiotic use, control of antibiotic
resistance, shorten hospital stay and decrease treatment costs.

Anahtar Kelimeler

Respiratory tract infection, nasopharyngeal swab, viral PCR, child emergency, child

Kaynakça

• 1. Bangladesh D. National Institute of Population Research and Training (NIPORT), Mitra and Associates, and Macro International.(2009). Calverton, Maryland: Bangladesh Demographic and Health Survey. 2007
• 2. Gwatkin DR. How many die? A set of demographic estimates of the annual number of infant and child deaths in the world. Am J Public Health. 1980;70(12):1286-1289.
• 3. Kistler A, Avila PC, Rouskin S, et al. Pan-viral screening of respiratory tract infections in adults with and without asthma reveals unexpected human coronavirus and human rhinovirus diversity. J Infect Dis. 2007;196(6):817-825.
• 4. van den Hoogen BG, de Jong JC, Groen J, et al. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med. 2001;7(6):719-724.
• 5. Mahony JB. Detection of respiratory viruses by molecular methods. Clin Microbiol Rev. 2008;21(4):716-747. doi: 10.1128/CMR.00037-07.
• 6. Alto WA. Human metapneumovirus: a newly described respiratory tract pathogen. J Am Board Fam Pract. 2004;17(6):466-469.
• 7. Iwane MK, Edwards KM, Szilagyi PG, et al. Population based surveillance for hospitalizations associated with respiratory syncytial virus, influenza virus, and parainfluenza viruses among young children. Pediatrics. 2004;113(6):1758-1764.
• 8. Tregoning JS, Schwarze J. Respiratory viral infections in infants: causes, clinical symptoms, virology, and immunology. Clin Microbiol Rev. 2010;23(1):74-98. doi: 10.1128/CMR.00032-09.
• 9. Kesson AM. Respiratory virus infections. Paediatr Respir Rev. 2007;8(3):240-248.
• 10. Advani S, Sengupta A, Forman M, Valsamakis A, Milstone AM. Detecting respiratory viruses in asymptomatic children. Pediatr Infect Dis J. 2012;31(12):1221-1226. doi:10.1097/INF.0b013e318265a804.
• 11. Goka EA, Vallely PJ, Mutton KJ, Klapper PE. Single and multiple respiratory virus infections and severity of respiratory disease: a systematic review. Paediatr Respir Rev. 2014;15(4):363-370. doi: 10.1016/j.prrv.2013.11.001.
• 12. Leekha S, Irish CL, Schneider SK, et al. Viral detection using a multiplex polymerase chain reaction-based assay in outpatients with upper respiratory infection. Diagn Microbiol Infect Dis. 2013;75(2):169-173. doi:10.1016/j.diagmicrobio.2012.10.016.
• 13. Çiçek C, Arslan A, Karakuş HS, et al. [Prevalence and seasonal distribution of respiratory viruses in patients with acute respiratory tract infections, 2002-2014]. Mikrobiyol Bul. 2015;49(2):188-200.
• 14. Akçalı S, Yılmaz N, Güler Ö, Şanlidağ T, Anıl M. Alt solunum yolu enfeksiyonu olan çocuklarda solunum yolu viral etkenlerinin sıklığı. Turk Arch Ped 2013;48(3):215-220
• 15. Ünüvar E, Yildiz I, Kiliç A, et al. Viral etiology and symptoms of acute upper respiratory tract infections in children. Turk J Med Sci. 2009;39(1):29-35.
• 16. Zhang D, He Z, Xu L, et al. Epidemiology characteristics of respiratory viruses found in children and adults with respiratory tract infections in southern China. Int J Infect Dis. 2014;25:159-164. doi: 10.1016/j.ijid.2014.02.019.
• 17. Tsai HP, Kuo PH, Liu CC, Wang JR. Respiratory viral infections among pediatric inpatients and outpatients in Taiwan from 1997 to 1999. J Clin Microbiol. 2001;39(1):111-118.
• 18. Eccles R. An explanation for the seasonality of acute upper respiratory tract viral infections. Acta Otolaryngol. 2002;122(2):183-191.
• 19. Lim FJ, de Klerk N, Blyth CC, Fathima P, Moore HC. Systematic review and meta-analysis of respiratory viral coinfections in children. Respirology. 2016;21(4):648-655. doi: 10.1111/resp.12741.
• 20. Hall CB, Weinberg GA, Iwane MK, et al. The burden of respiratory syncytial virus infection in young children. N Engl J Med. 2009;360(6):588-598. doi: 10.1056/NEJMoa0804877.
• 21. Templeton KE. Why diagnose respiratory viral infection? J Clin Virol. 2007;40(1):2-4. doi: 10.1016/S1386-6532(07)70002-1.
• 22. Yalçın A, Tosun E, Topaloğlu O. Solunum yolu enfeksiyonları: antibiyotik kullanım oranı ve tedavi maliyeti. Türk Aile Hek Derg. 2008;12(1):25-30.