Hayati BEKA, Ali AĞAÇFİDAN, Ayper SOMER, İlker YILMAZ, Nuran SALMAN, Murat SÜTÇÜ, Manolya ACAR, Metin UYSALOL
Akut Gastroenteritli Çocuklarda Norovirüs, Rotavirüs ve Adenovirüs Sıklığı
Amaç: Acil çocuk polikliniğine başvuran akut ishalli çocuklarda rotavirüs, nörovirüs ve adenovirüs sıklığı araştırıldı.Gereç ve Yöntem: Ekim 2012-Ocak 2013 döneminde, Çocuk Acil Polikliniğine ishalle başvuran, 164 hastadan dışkı örneği alınabilen 126 hasta çalışma grubunu oluşturdu. ELISA yöntemiyle üç virüs tipinin belirlenmesi çalışıldı. Hastaların ishal sayısı ve süresi, kusma sayısı ve süresi ateş düzeyi, ishal etkenlerinin düzeyi ve yaş ile klinik ağırlık arasındaki ilişki değerlendirildi.Bulgular: Hastaların 23’ünde %18,2 rotavirüs, 13’ünde %10,3 adenovirüs, 11’inde %8,7 ise norovirüs pozitif saptandı. Üç ishal etkeninin de en çok görüldüğü yaş dilimi 1-5’ti. Norovirüs daha küçük yaş grubunda tespit edildi. Rotavirüs enfeksiyonu ocak ayında en fazla görülürken adenovirüs ve norovirüs hem aralık hem de ocak ayında saptandı. Üç ishal etkeninin de klinik ağırlık skorlamasında istatistiksel olarak anlamlı farklılık saptanmadı. Buna karşın adenovirüsün klinik skorlaması daha yüksekti.Sonuç: Ülkemizde rotavirüs, adenovirüs antijen taramaları kolaylıkla yapılırken norovirüs için hızlı güvenilir tanı tekniklerinin yaygınlaşması gerekmektedir. Rotavirüs aşısının uygulanabilirliğini artırmaya ve aşısının etkinliğine yönelik çalışmalar yapılmalıdır
Anahtar Kelimeler:
Akut viral gastroenterit, norovirüs, rotavirüs ve adenovirüs
The Incidence of Norovirus, Rotavirus and Adenovirus in Children with Acute Gastroenteritis
Objective: To investigate the incidence of norovirus, rotavirus and adenovirus in children who presented to the pediatric emergency service with acute diarrhea.Material and Method: One hundred and twenty-six children among 164 patients who presented to our pediatric emergency department with diarrhea, and gave stool samples between October 2012 and February 2013 were enrolled in the study. Stool samples were analysed for norovirus, rotavirus and adenovirus. The association among frequency, duration of diarrhea, and vomiting, body temperature, age, causative factors of diarrhea, and clinical severity of the disease was evaluated.Results: Rotavirus, adenovirus, and norovirus were identified in 18.2% n=23 , 103 n=13 , and 8.7 % n=11 of the patients, respectively. These three causative agent of diarrhea were most frequently seen in children between 1-5 years of age. Norovirus was more frequent in younger children. Rotavirus infection was more common in January, whereas adenovirus and norovirus were detected in December and January. Any statistically significant difference was not found among three agents of diarrhea in terms of disease severity. However, patients with adenovirus related diarrhea had a higher clinical disease severity score. Conclusion: In our country rotavirus, adenovirus antijen screening tests are easily performed, however rapid and reliable diagnostic tests for norovirus should be used prevalently. Studies aiming at applicability, and effectiveness of rotavirus vaccination should be conducted
Keywords:
Acute viral gastroenteritis, norovirus, rotavirus and adenovirus,
___
- Scallan E, Grfifin PM, Angulo fJ, tauxe rV, Hoekstra rM. Foodborne illness acquired in the United States-unspecified agents. Emerg Infect Dis 2011;17:16-22. http://dx.doi.org/10.3201/eid1701.P21101
- Jones tf, McMillian MB, Scallan E, frenzen Pd, cronquist AB, thomas S, et al. A population-based estimate of the substantial burden of diarrhoeal disease in the United States; FoodNet, 1996-2003. Epidemiol Infect 2007;135:293-301. http://dx.doi.org/10.1017/S0950268806006765
- Scallan E, Hoekstra rM, Angulo fJ, tauxe rV, Widdowson MA, roy SL, et al. Foodborne illness acquired in the United States-major pathogens. Emerg Infect Dis 2011;17:7-15. http://dx.doi.org/10.3201/eid1701.P11101
- Glass rI, Parashar ud, Estes MK. Norovirus gastro- enteritis. N Engl J Med 2009;361:1776-85. http://dx.doi.org/10.1056/NEJMra0804575
- ramani S, Kang G. Viruses causing childhood diarr- hoea in the developing world. Curr Opin Infect Dis 2009;13:477-82. http://dx.doi.org/10.1097/QCO.0b013e328330662f
- farkas t, Jiang XI. Rotaviruses, Caliciviruses, astro- viruses, enteric adenoviruses and other diarrheic viru- ses. In manual of clinical micriobiology. 9th edition. Edited by Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MA. Washington DC ASM Press; 2007: 1453-69.
- ruuska t, Vesicari t. Rotavirus disease in Finnish children: use of numerical scores for clinical severity of diarrheal episodes. Scand J Infect Dis 1990:22:259-67. http://dx.doi.org/10.3109/00365549009027046
- chen S, ni Y, chen H, chang M. Microbial etiology of acute gastroenteritis in hospitalized children in Taiwan. J Formos Med Assoc 2006;105:964-70.
- Wiegering V, Kaiser J, tappe d, Weißbrich B, Morbach H,Girschick H. Gastroenteritis in childho- od: a retrospective study of 650 hospitalized pediatric patients Int. J Infectious Diseases 2011;15:401-7. http://dx.doi.org/10.1016/j.ijid.2011.02.006
- nakanishia K, tsugawab t, Honmaa S, nakatac S, Yotoa Y, tsutsumia H. Detection of enteric viruses in rectal swabs from children with acute gastroenteritis attending the pediatric outpatient clinics in Sapporo, Japan. J Clin Virology 2009;46:94-7. http://dx.doi.org/10.1016/j.jcv.2009.06.014
- Sdiri-Loulizi K,Garbi-Kehelifi H, de rougemont A. Acute İnfantile Gastroenteritis associated with human enteric viruses in Tunisia. J Clin Microbiol 2008; 1349- 55. http://dx.doi.org/10.1128/JCM.02438-07
- Akıncı n, Ercan t, Yalman n, Eren A, Severge B, Ercan G. Akut gastroenteritli çocuklarda rotavirüs ve adenovirüs. Çocuk Enf Derg 2007;1:98-101.
- Gültepe B,Yaman G, Aytekin çıkman A, Güdü- cüoğlu H. Çocukluk yaş grubu gastroenteritlerde rota- virus ve adenovirus sıklığı. Türk Mikrobiyol Cem Derg 2012; 42:16-20.
- Altındiş M, Bányai K, Kalaycı r, Gulamber c, Koken r, Yoldaş Y, et al. Frequency of norovirus in stool samples from hospitalized children due to acute gastroenteritis in Anatolia, Turkey, 2006-2007. Scand J Infect Dis 2009;41:685-8. http://dx.doi.org/10.1080/00365540903071342
- Huh J, Kima W, Moona S, Leea J, Limb Y. Viral etiology and incidence associated with acute gastroen- teritis in a 5-year survey in Gyeonggi province, South Korea. J Clin Virology 2009;44:152-6.
- Gül M, Garipardıç M, çıragil P, Aral M, Karabiber H,Güler Ý. 0-5 yaş arası gastroenteritli çocuklarda rotavirüs ve adenovirüs tip 40/41 araştırılması. ANKEM Derg 2005;19:64-7.
- WHo. Meeting of the immunization strategic advisory group of experts, April 2009 - conclusions and recom- mendations. Weekly Epidemiological Record 2009; 213-26.
- ISSN: 1302-9940
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 2000
- Yayıncı: İstanbul Üniversitesi