Alt solunum yolu enfeksiyonunda nazofaringeal örneklerde polimeraz zincir reaksiyonu sonuçları

Amaç: Bu çalışmanın amacı; alt solunum yolu enfeksiyonu (ASYE) tanısıyla yatırılan hastalarda, polimeraz zincir yöntemi (PZR) ile nazofaringeal sürüntü örneklerinde viral etkenlerin yaşlara ve tanılara göre dağılımının belirlenmesidir. Gereç ve Yöntemler: Çalışmaya Şubat-Ağustos 2010 tarihleri arasında hastanemiz Çocuk Sağlığı ve Hastalıkları Servisi’nde bronşiolit, bronkopnömoni ve pnömoni tanılarıyla izlenmiş 87 olgu alındı. Hastaların yatış dosyaları geriye dönük olarak değerlendirildi. Yaş, cinsiyet, başvuru yakınmaları, fizik muayene bulguları, enfeksiyon belirteçlerine ait veriler ve akciğer grafileri değerlendirildi. Klinik tanı, uygulanan tedaviler, hastanede yatış süreleri ve PZR yöntemi ile nazofaringeal sürüntü örneğinde bakılan virüs taraması sonuçları kaydedildi. Bulgular: Akut bronşiolit, bronkopnömoni ve pnömoni tanılarıyla izlenen toplam 87 olgu çalışmaya alındı. Toplam 87 olgunun 59’unda (%67.8) PZR ile en az bir virüs saptanırken; 28 (%32.2) olguda viral etken bulunamadı. Olguların %58.6’sında tek viral etken, %9.2 sinde birden fazla viral etken saptandı. En sık saptanan viral etkenler sırasıyla rinovirüs, respiratuar sinsisyal virüs A-B ve human metapneumovirüs (%26.4, %10.3, %6.9) idi. Sonuç: Alt solunum yolu enfeksiyonlarında PZR ile viral etken saptanması gereksiz antibiyotik kullanımını önleyecektir. Polimeraz zincir reaksiyonu ile virüs taramasının hem hasta hem de ülke ekonomisinin yararına olacağı kanısındayız. (J Pediatr Inf 2012; 6: 84-9)

Results of polymerase chain reaction in nasopharyngeal swab specimens of patients with lower respiratory tract ınfection

Objective: In this study, we aimed to determine the distribution and frequency of viral agents isolated by the polymerase chain reaction (PCR) from nasopharyngeal swab specimens in patients who were hospitalized with the diagnosis of lower respiratoy tract infection. Material and Methods: Eighty-seven children who were diagnosed either as bronchiolitis, bronchopneumonia or pneumonia between February to August 2010 were enrolled in the study. Data regarding age, sex, symptoms at presentation, physical findings, markers of infection and chest radiography were obtained retrospectively from medical records of patients. Clinical diagnosis, medication and duration of hospitalization were noted. Results of a virus scan by the PCR method in nasopharyngeal swab specimens of study population were evaluated. Results: A total of 87 cases were followed up with the diagnosis of bronchiolitis, bronchopneumonia or pneumonia. At least one virus was isolated in 59 of 87 cases (67.8%) by PCR, while no viral agent was detected in 28 (32.2%). In 58.6% of the patients, a single viral agent was estabished and multiple agents were isolated in 9.2%. The most common viral agents were rhinovirus, respiratory syncytial virus and human metapneumovirus (26.4%, 10.3% and 6.9%, respectively). Conclusion: Isolation of a viral agent by PCR in the diagnosis of lower respiratory tract infection will prevent unnecessary use of antibiotics. We are of the opinion that a virus scan by PCR will be beneficial for both patients and the national economy. (J Pediatr Inf 2012; 6: 84-9)

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