The ıncidence of cryptosporidium ınfection in children with diarrhea

Amaç: Bu çalışma hastanemiz çocuk polikliniğine başvuran ishalli çocuklarda Cryptosporidium’un sıklığını belirlemek amacıyla yapılmıştır. Gereç ve Yöntemler: Çalışmada 240 ishalli çocuğun dışkı örnekleri Kinyoun’un asidorezistan boyama yöntemi ile incelendi. Olguların yaşı, cinsiyeti, ateş, kusma, karın ağrısı, dışkı sayısı gibi semptomları, anne sütü alma, hayvanlarla temas öyküleri, boy, kilo ve hidrasyon durumları anket formlarına kaydedildi. Bulgular: Daha önceden bilinen hastalığı olmayan 229 ishalli çocuğun 13’ünde (%5,6), 11 immün yetmezlikli hastanın üçünde (%27) Cryptosporidium ookisti saptandı. Olguların ortanca yaşı 3,5 (0,1-19) yıl, Cryptosporidium saptanan olgularda 3,75 (0,8-11) yıl ve saptanamayan olgularda ise 3,5 (1,1-19) yıl idi. Yaş, cinsiyet, anne sütü alma öyküsünün Cryptosporidiosisle belirgin ilişkisi bulunmadı. Hayvanlarla temas ve malnutrisyonun Cryptosporidium riskini arttırdığı görüldü. İmmün yetmezlikli iki hastada Cryptosporidium ishali çok şiddetli seyretti ve bu iki hasta ağır sepsisle kaybedildi. Sonuç: Çalışmamız özellikle hayvan maruziyeti, malnutrisyon, primer immün yetmezlik gibi risk gruplarında ağır sulu diyarelerin etyolojik faktörlerinden Cryptosporidium spp’un önemini ve fatal seyrini göstermiştir.

İshalli çocuklarda crptosporidium sıklığı

Objective: The aim of our study was to determine the the incidence of Cryptosporidium infection in patients who suffered from diarrhea. Material and Methods: Fecal samples of 240 chil- dren with diarrhea were examined with Kinyoun’s acidoresistant staining method. Age, gender, clinical symptoms including height, weight, hydration status, fever, vomiting, abdominal pain, number of stools per day, the past medical history of breastfeeding and animal contact, were recorded in the questionaire. Results: Cryptosporidium oocytes were determined in both 13 of 229 (5.6%) children with diarrhea whohad no known disease previously and 3 of 11 (27%) patients with immunodeficiency disease. The median age of 3.5 (0.1 to 19) years Cryptosporidium wasdetected in patients 3.75 (0.8 to 11) years and unde-tectable in patients 3.5 (1.1 to 19) years. The clinical features of patients such as age, gender, and breestfeeding were not significantly associated with Cryptosporidium infection. However, animal contact and malnutrition appeared to increase the risk for Cryptosporidium infection. The severity of Cryptosporidium diarrhea increased in two immuno- deficient patients and they died due to sepsis during the following up period. Conclusion: Our results revealed that some risk fac- tors including exposure to farm animals, malnutrition, primary immunodeficiencies could have importance for the prognosis of Cryptosporidium infection. Therefore, children with severe watery diarrhea should be followed up closely by physicians due to the fatal course of disease.

Kaynakça

1. Dennehy PH. Acute diarrheal disease in children: epidemiology, prevention and treatment. İnfect Dis Clin North Am 2005; 19: 585-602. [CrossRef]

2. Gestanaduy AS, Begue RE. Acute gastroenteritis. Clin Pediatr 1999; 38: 1-12. [CrossRef]

3. Shirley DA, Moonah SN, Kotloff KL. Burden of disease from Cryptosporidiosis. Curr Opin Infect Dis 2012; 25: 555-63. [CrossRef]

4. Yoder JS, Wallace RM, Collier SA, Beach MJ, Hlavsa MC; Centers for Disease Control and Prevention (CDC). Cryptosporidiosis surveillance- United States, 2009-2010. MMWR Surveill Summ 2012; 6: 1-12.

5. Mac Kenzie WR, Hoxie MS, Proctor ME ve et al. A massive outb- reak in Milwaukee of Cryptosporidium infection transmitted through the public water supply. N Engl J Med 1994; 331: 161-7. [CrossRef]

6. Sorvillo FJ, Fujioka K, Nahlen B, Tormey MP, Kebabjian R, Mascola L. Swimming-associated Cryptosporidiosis. Am J Public Health 1992; 82: 742-4. [CrossRef]

7. Current WL, Garcia LS. Cryptosporidiosis. Clin Microbiol Rev 1991; 4: 325-358.

8. Chieffi PP, Paschoalotti MA, Vergueiro CS, Chiattone C. Infection by Cryptosporidium sp. in immunocomprimised haemotological patients. Rev Inst Med Trop S Paulo 2005; 47: 301-2. [CrossRef]

9. Krause I, Amir J, Cleper R ve et al. Cryptosporidiosis in children following solid organ transplantation. Pediatr Infect Dis J 2012; 31: 1135-8. [CrossRef]

10. Petersen C. Cryptosporidiosis in patients infected with the human immunodeficiency virus. Clin Infect Dis 1992; 15: 903-9. [CrossRef]

11. Ratnam S, Paddock J, McDonald, Whitty D, Jong M, Cooper R. Occurrence of Cryptosporidium oocysts in fecal samples sub- mitted for routine microbiological examination. J Clin Microbiol 1985; 22: 402-4.

12. Iqbal J, Hira PR, Al-Ali F, Philip R. Criptosporidiosis in Kuwaiti chiildren: seasonality and endemicity. Clin Microbiol İnfect 2001; 7: 261-6. [CrossRef]

13. Molbak K, Aaby P, Hojlyng N,Silva AP. Risk factors for cryptos- poridium diarrhea in early childood: A case- control study from Guinea- Bissau, West Africa. Am J Epidemiol 1994; 139: 734-40.

14. Nahrevanian H, Assmar M, Samin MG. Cryptosporidiosis among immunocompetent patients with gastroenteritis in Iran: a compa- rison with other enteropathojenic parasites. J Microbiol İmmunol İnfect 2007; 40: 154-6.

15. Homedi Y, Safa O, Haidari M. Cryptosporidium infection in diar- reheic children in Southeastern Iran. Pediatr Infect Dis J 2005; 24: 86-8. [CrossRef]

16. Abdel-Messih IA, Wierzba TF, Abu-Elyazeed R, Ibrahim AF, Ahmed SF, Kamal K, Sanders J, Frenck R. Diarrhea associated with Cryptosporidium parvum among young children of the Nile River Delta İn Egypt. J Trop Pediatr 2005; 51: 154-9. [CrossRef]

17. Koturoglu G, Bayram S, Kurugöl Z, Turgay N, Mutlubaş F. Akut ishalli çocuklarda Cryptosporidium sıklığı ve risk faktörleri. T Klin J Pediatr 2004; 13: 16-9.

18. Aksoy U, Akıcısu C, Sahin S, Usluca S, Yalcin G, Kuralay F, Oral AM. First reported waterborne outbreak of Cryptosporidiosis with Cyclospora co-infection in Turkey. Euro Surveill 2007; 12: E070215.4

19. Akyön Y, Ergüven S, Arıkan S, Yurdakök K, Günalp A. Cryptosporidium parvum prevalence in a group of Turkish child- ren. Turk J Pediatr 1999; 41: 189-96.

20. Khan WA, Rogers KA, Karım MM ve et al. Cryptosporidiosis among Bangladeshi children with diarrhea: A prospective, matched, case- control study of clinical features, epidemiology and systemic anti- body responses. Am J Trop Med Hyg 2004; 71: 412-9.

21. Bhattacharya MK, Teka T, Faruque AS, Fuschs GJ. Cryptosporidium infection in children in urban Bangladesh. J Trop Pediatr 1997; 43: 282-6. [CrossRef]

22. Russell T, Lynch J, Ottoloni MG. Eradication of Cryptosporidium in a child undergoing maintenance chemotherapy for leukemia using high dose azithromycin therapy. J Pediatr Hematol Oncol 1998; 20: 83-5. [CrossRef]

23. Leitch GJ, He Q. Cryptosporidiosis-an overview. J Biomed Res 2012; 25: 1-16. [CrossRef]

24. Trad O, Jumaa P, Uduman S, Nawaz A. Eradication of Cryptosporidium in four children with acute lymphoblastic leuke- mia. J Trop Pediatr 2003; 49: 128-30. [CrossRef]

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