Investigation of Viruses Causing Gastroenteritis by Immunochromatographic Tests and Multiplex PZR Method

Abstract

Aim: Acute gastroenteritis (AGE) is a common infection all over the world, which can progress with high morbidity and mortality, especially in children, if not treated early and correctly. Rotaviruses, Adenoviruses, Noroviruses most commonly cause AGEs in childhood. While immunochromatographic (ICT) or ELISA-based methods are preferred for rapid diagnosis of viral infections, multiplex polymerase chain reaction (PCR) tests have also been used in laboratories in recent years. In this study, it is aimed to compare the results obtained by immunochromatographic and real-time PCR methods in the diagnosis of Rotavirus, Adenovirus and Norovirus.

Material and Methods: The study included 67 stool samples of a patient diagnosed with AGE who were positive for Rotavirus and/or Adenovirus by the ICT method, and 17 stool samples that were found to be negative in terms of viral, bacterial and parasitic agents by the ICT method. Rotavirus, Norovirus RNA and Adenovirus DNA were investigated in all samples using multiplex real-time PCR kit.

Results: At least one of Rota/Adeno was found to be positive in 67 of the stool samples of 84 patients included in the study. While 62 (73.8%) of the samples were Rotavirus positive with the ICT method, 49 (58.5%) were positive with the real-time PCR method. While 5 (5.9%) of the samples were found to be Adenovirus positive with the ICT method, 40 (47.6%) of them were found positive with the real-time PZR method. Norovirus was positive in 11 (13%) of the samples.

Conclusion: ICT is widely used for the diagnosis of the most common viral gastroenteritis agents Rotavirus and Adenovirus. However, as can be seen in our study; In such cases, it should not be ignored that other gastroenteritis-causing viruses, such as other Norovirus, may be responsible for the clinical picture. A significant but low level correlation was found between ICT and PCR methods in the identification of Rotavirus and Adenovirus.

Keywords

• Gastroenterit
• Rotavirus
• Adenovirus
• Norovirus
• PCR

Gastroenterit Etkeni Virüslerin İmmünokromatografik Yöntem ve Multipleks PZR Yöntemiyle Araştırılması

Abstract

Amaç: Akut gastroenterit (AGE), erken ve doğru tedavi edilmediğinde özellikle çocuklarda yüksek morbidite ve mortalite ile seyredebilen ve tüm dünyada sık görülen bir enfeksiyondur. Çocukluk döneminde en sık Rotavirüsler, Adenovirüsler, Norovirüsler AGE’lere neden olmaktadır. Viral enfeksiyonların hızlı tanısında, immünokromatografik (ICT) veya ELISA temelli yöntemler tercih edilmekte iken, son yıllarda multipleks polimeraz zincir reaksiyonu (PZR) testleri de laboratuvarlarda kullanılmaya başlanmıştır. Bu çalışmada Rotavirus, Adenovirus ve Norovirus tanısında immünokromatografik yöntem ve PZR yöntemi ile elde edilen sonuçların karşılaştırılması amaçlanmıştır.

Gereç ve Yöntemler: Çalışmaya AGE tanılı hastaların ICT yöntemi ile Rotavirus ve/veya Adenovirus pozitif olarak saptanan 67 gaita örneği ve ICT yöntemi ile viral, bakteriyel, paraziter etkenler açısından negatif bulunan 17 gaita örneği dâhil edildi. Bu örneklerde Rotavirus, Norovirus RNA’sı ile Adenovirus DNA’sı multipleks PZR kiti kullanılarak araştırıldı.

Bulgular: ICT yöntemi ile örneklerin 62’sinde (%73,8) Rotavirus pozitif iken, gerçek zamanlı PZR yöntemi ile 49’unda (%58,5) Rotavirus pozitif bulundu. ICT yöntemi ile örneklerin beşinde (%5,9) Adenovirus pozitif bulunurken, multipleks gerçek zamanlı PZR yöntemi ile 40’ında (%47,6) Adenovirus pozitif tespit edildi. Örneklerin 11’inde (%13) Norovirus pozitif saptandı.

Sonuç: En sık karşılaşılan viral gastroenterit etkenleri olan Rotavirus ve Adenovirus tanısı için çok yaygın olarak ICT kullanılmaktadır. Ancak çalışmamızda da görüldüğü üzere; bu tür olgularda Norovirüs gibi diğer gastroenterit etkeni virüslerin de klinik tablodan sorumlu olabileceği göz ardı edilmemelidir. Rotavirus ve Adenovirus tanımlamasında ICT ve PZR yöntemleri arasında anlamlı ancak düşük düzeyde korelasyon saptandı.

Keywords

• Gastroenterit
• Rotavirus
• Adenovirus
• Norovirus
• PZR.

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