Real-Time Polymerase Chain Reaction ile Tespit Edilen Viral Akut Alt Solunum Yolu Enfeksiyonlarının Değerlendirilmesi

Yıl 2021, Cilt: 15 Sayı: 2, 129 - 136, 30.03.2021

Emine Polat Hüsniye Yücel

https://doi.org/10.12956/tchd.827700

Öz

Objective: Acute lower respiratory tract infection (ALRTI) is the most frequent cause of hospitalization in infantsyounger than 5 years. In the main, alveolar and bronchial infections are responsible for 90% of deaths from respiratory disease.The aim of this study was to investigate the epidemiology, clinical findings, and treatment modalities of respiratory viruses detected with real-time polymerase chain reaction (PCR).

Material and Methods: A total of 235 children between the age of 1 and 24 months who were hospitalized due to ALRTI between January 2014 and December 2018 and who had positive PCR results for respiratory viruses were included in the study. Demographics, clinical findings, laboratory tests, treatment modalities, need for the high-frequency nasal cannula (HFNC) or mechanical ventilation, length of hospital stay, and the requirement for treatment within a pediatric intensive care unit (PICU) were recorded.

Results: In total, 55.5% of the children were male with a mean age of 6.1±6 months. Respiratory syncytial virus (RSV) was present in 106, rhinovirus in 35, influenza in 23, and other viruses in the remaining 71. There was a significant seasonal difference among the various etiologies. Fever was present in patients with influenza, multiple viral infections, adenovirus, and human metapneumovirus (HMPV). There was no significant difference in the physical examination among patients presenting with a pertussis-like cough, feeding difficulty, or lethargy. The white blood cell (WBC) count increased due to adenovirus and HMPV infection; however, differences in C-reaktif protein(CRP), mean platelet volume (MPV), and eosinophilia were not significant. There was no significant difference between the chest X-ray findings and medical treatment based on the viral etiology. Fifty-four patients were followed up in the PICU. Although influenza was only the third most common etiology, it was the most common cause of PICU admission.

Conclusion: RSV continues to be an important viral etiology for hospitalization in children below 2 years old. Influenza was the most frequent virus requiring admission to the PICU. Widespread immunization against influenza has been related to the decline of the LRTI in children.

Anahtar Kelimeler

Acute lower respiratory tract infection, Children, Viruses

Evaluation of Viral Acute Lower Respiratory Tract Infections Detected with Real-Time Pcr

Öz

Amaç: Akut alt solunum yolu enfeksiyonu (ALRTI), 5 yaşından küçük bebeklerde en sık hastaneye yatış nedenidir. Çoğunlukla, alveolar ve bronşiyal enfeksiyonlar, solunum hastalıklarından kaynaklanan ölümlerin %90'ından sorumludur. Bu çalışmanın amacı, real-time PCR ile saptanan solunum yolu virüslerinin epidemiyolojisini, klinik bulgularını ve tedavi yöntemlerini incelemektir.

Gereç ve Yöntemler: Ocak 2014 - Aralık 2018 tarihleri arasında ALRTI nedeniyle hastaneye yatırılan ve solunum yolu virüsleri için pozitif PCR sonuçları olan 1-24 aylık toplam 235 çocuk çalışmaya dahil edildi. Demografik veriler, klinik bulgular, laboratuvar testleri, tedavi modaliteleri, yüksek frekanslı nazal kanül (HFNC) veya mekanik ventilasyon ihtiyacı, hastanede kalış süresi ve çocuk yoğun bakım ünitesinde (ÇYBB) tedavi gereksinimi kaydedildi.

Bulgular: Toplamda çocukların% 55.5'i erkekti ve yaş ortalaması 6.1±6 aydı. Respiratuvar sinsityal virüs (RSV) 106'da, rinovirüs 35'te, influenza 23'te ve diğer virüsler kalan 71'de mevcuttu. Çeşitli etiyolojiler arasında önemli bir mevsimsel farklılık vardı. Ateş influenza, çoklu viral enfeksiyonlar, adenovirüs ve human metapnömovirüs (HMPV) hastalarında vardı. Boğmaca benzeri öksürük, beslenme güçlüğü veya letarji ile başvuran hastalar arasında fizik muayenede anlamlı fark yoktu. Adenovirüs ve HMPV enfeksiyonu nedeniyle WBC sayısı arttı; ancak CRP, MPV ve eozinofilideki farklılıklar anlamlı değildi. Viral etiyolojiye göre akciğer grafisi bulguları ile medikal tedavi arasında anlamlı bir fark yoktu. ÇYBB'de elli dört hasta izlendi. İnfluenza sadece üçüncü en yaygın etiyoloji olmasına rağmen, ÇYBB'ye kabulün en yaygın nedeniydi.

Sonuç: RSV iki yaşın altındaki çocuklarda hastaneye yatış için önemli bir viral etiyoloji olmaya devam etmektedir. İnfluenza, ÇYBB'de izlenmeyi gerektiren en sık görülen virüstür. İnfluenzaya karşı yaygın aşılama, çocuklarda ASYE'nin azalmasıyla ilişkilidir.

Anahtar Kelimeler

Alt solunum yolu enfeksiyonu, Çocuk, Virüsler

Kaynakça

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