Duygu GÜR, Müjgan SIDAL, Olca TAŞYÜREK, Ahmet BIÇAKÇI, Özel Meltem KARATAŞ, Nezahat GÜRLER

Hastane içi ve hastane dışı gündüz bakımevlerine devam eden çocuklarda faringeal Haemophilus influenzae tip B kolonizasyonu ve risk faktörlerinin araştırılması

Amaç: Önemli hastalıklara neden olabilen ve aşıyla korunulabilen Haemophilus influenzae tip b (Hib)'nin hastane içi ve hastane dışı gündüz bakımevlerine devam eden çocuklarda kolonizasyonu ve risk faktörlerini belirlemek. Yöntem: 3 aylık dönemde farklı gündüz bakımevlerinden, aileleri izin veren 0-5 yaş arası toplam 288 çocuk çalışmaya alındı. Her çocuk için ailelerinin iznini içeren onam formu ve anket formu dolduruldu ve boğaz kültürleri alındı. Bulgular: 141 kız (% 49), 147 erkek (% 51) toplam 288 çocuk çalışmaya alındı. 137 çocuk (% 47.6) hastane içi, 151 çocuk (% 52.4) hastane dışı gündüz bakımevine devam etmekteydi. Gündüz bakımevlerine giden çocuklarda faringeal Hib kolonizasyonu % 1.39 saptandı. Sonuç: Hib kolonizasyonu için risk faktörü olabileceğini düşündüğümüz cinsiyet, anne sütü alım süresi, pasif sigara içiciliği, kardeş varlığı, gündüz bakımevine devam süreleri ve aşılama durumlarının Hib kolonizasyonuna etkisinin olmadığı görüldü. Anne babanın sağlık personeli olmasının kolonizasyona etkisi saptanmadı.

Anahtar Kelimeler:

Çocuk gündüz bakım merkezleri, Anketler, Risk faktörleri, Haemophilus influenzae tip b

Colonization and risk factors of Haemophilus influenzae type b among children attending to hospital based and non-hospital based day care centers

Aim: To find out colonization and risk factors of vaccine preventable Haemophilus influenzae type b which is a potential cause of serious diseases among children attending to hospital vs non-hospital based day care centers. Methods: 288 children, between the ages of 0-5, who were attending different day care centres were included in the study with the permission of their families. The study period was three (3) months and an informed consent and questionnaire were applied for each child and pharyngeal swabs were taken. Results: 141 (49 %) girls, 147 (51 %) boys, a total of 288 children were included in the study. 137 (47.6 %) of the children were attending to hospital based day care centers and 151 (52.4 %) to non-hospital based. Pharyngeal colonisation of Hib was found to be 1.39 % among infants attending to day care centers. Conclusıon: We have concluded that sex, duration of breastfeeding, passive smoking, presence of a sibling, duration of attending to day care center and vaccination which are thought to be the risk factors for colonisation of Hib did not affect colonisation. Additionally having a parent working in the hospital did not affect the colonisation.

Keywords:

Child Day Care Centers, Questionnaires, Risk Factors, Haemophilus influenzae type b,

___

1.Bakır M, Yağcı A, Ülger N, et al. Pharyngeal colonization with Haemophilus influenzae type b among healthy Turkish infants and children. Pediatr International 2002; 44:381-6.
2.Akcakaya N, Torun MM, Söylemez Y, et al. Incidence of H.influenzae in a day-care center. Turk J Pediatr 1996; 38:289-93.
3.Akcakaya N, Camcioğlu Y, Belbek Ş, Eşkazan G, Çokuğ- raş H. Haemophilus influenzae type b colonization in children in a hospital-based day-care center. Europ J Epid 2001; 17:313-6.
4.Önlen Y, Dinç E, Ağaç E, Çetmeli G, Özgüneş N. 0-5 yaş çocukların boğaz kültürlerinde Haemophilus influenzae sıklığı Klimik Dergisi 2000; 13:53-4.
5.Gessner, BD, Sutanto A, Steinhoff M, et al. A population-based survey of Haemophilus influenzae type b nasophary-ngeal carriage prevalence in Lombok Island, Indonesia. Ped Infect DisJ 1998; 17:179-82.
6.Howard AJ, Dunkin KT, Millar GW. Nasopharyngeal carriage and antibiotic resistance of Haemophilus influenzae in healty children. Epidemiol Infect 1988; 100:193-203.
7.Das BK, Arora NK, Mathur P, et al. Nasopharyngeal carriage of Haemophilus influenzae. Indian J Pediatr 2002; 69:775-7.
8.Hussey GD, Coetzee G, Hitchcock J, van Schalkwyk E, van Wyk H, Kibel M. Carriage of Haemophilus influenzae in Cape Town children. S Afr Med J 1994; 84:135-7.
9.Peerbooms PGH, Engelen MN, Stokman DAJ, et al. Nasopharyngeal carriage of potential pathogens related today care attendance, with special reference to the molecular epidemiology of Haemophilus influenzae. J Clin Microbiol 2002; 40:2832-6.
10.Vives M, Garcia ME, Saenz P, et al. Nasopharyngeal colonization in Costa Rican children during the first year of life. Pediatr Infect Dis J 1997; 16:852-8.
11.Zielinski A, Kwon CB, Tomaszunas-BIaszczyk J, Magdzik W, Bennett JV. Risk of Haemophilus influenzae type b me-ningitisin Polish children varies directly with number of siblings: possible implications for vaccination strategies. Eur J Epidemiol 2003; 18:917-22.
12.Gomez E, Moore A, Sanchez J, et al. The epidemiology of Haemophilus influenzae type b carriage among infants and young children in Santo Domingo, Dominican Republic. Pediatr Infect Dis 1998; 17:782-6.
13.Silfverdal SA, Bodin L, Olcen P. Protective effect of breastfeeding: an ecologic study of Haemophilus influenzae meningitis and breastfeeding in a Swedish population. Int J Epidemiol 1999; 28:152-6.
14.Principi N, Marchisio P, Schito GC, Mannelli S, and The Ascanius Project Collaborative Group. Risk factors for carriage of respiratory pathogens in the nasopharynx of healthy children. Pediatr Infect Dis J 1999; 18:517-23.
15.Harabuchi Y, Faden H, Yamanaka N, Duffy L, Wolf J, Krystofik D. Human milk secretory IgA antibody to nontype-able Haemophilus influenzae: possible protective effects against nasopharyngeal colonization. J Pediatr 1994; 124:193-8.
16.Vadheim CM, Greenberg DP, Bordenave N, et al. Risk factors for invasive Haemophilus influenzae type b in Los Angeles County children 18-60 months of age. Am J Epidemiol 1992; 136:221-35.
17.Pereiro I, Diez-Domingo J, Segarra L, Ballester A, Albert A, Morant A. Risk factors for invasive disease among children in Spain. J Infect 2004; 48:320-9.
18.Takala AK, Eskola J, Palmgren J, et al. Risk factors for invasive Haemophilus influenzae type b disease among children in Finland. J Pediatr 1989; 115:694-701.
19.Black SB, Shinefield HR, Fireman B, Hiatt B, Polen M, Vittinghoff E. Efficacy in infancy of oligosaccharide conjugate Haemophilus influenzae type b (HbOC) vaccine in a United States population of 61.080 children. The Northern California Kaiser Permanente Vaccine Study Center Pediatrics Group. Pediatr Infect Dis J 1991; 10:97-104.
20.Vadheim CM, Greenberg DP, Eriksen E, et al. Eradication of Haemophilus influenzae type b disease in southern California.Kaiser-UCLA Vaccine Study Group. Arch Pediatr AdolescMed 1994; 148:51-6.
21.Murphy TV, Pastor P, Medley F, Osterholm MT, Granoff DM. Decreased Haemophilus colonization in children vaccinated with Haemophilus influenza type b conjugate vaccine. J Pediatr 1993; 122:517-23.