Bruselloz ve atipik pnömoni şüpheli hastalarda Coxiella burnetii antikor varlığının ELISA ve IFA yöntemleri ile araştırılması

Amaç: Query (Q) ateşi, Coxiella burnetii’nin nedenolduğu zoonotik bir hastalıktır. Bulaş yolları ve klinikbulguları açısından Bruselloz ile oldukça benzerlikgöstermektedir. Ayrıca, C. burnetii önemli bir atipikpnömoni etkenidir. Bu çalışmada, atipik pnömonive bruselloz şüpheli klinik bulguları olan hastalardaC. burnetii antikorlarının ELISA ve IFA yöntemleri ilearaştırılması amaçlanmıştır.Yöntem: Çalışmaya, Dokuz Eylül Üniversitesi TıpFakültesi Hastanesi Mikrobiyoloji Laboratuvarı’nda RoseBengal testi ile Brucella spp. yönünden, ELISA ve IFAyöntemleri ile C. burnetii dışındaki diğer önemli atipikpnömoni etkenleri olan Mycoplasma pneumoniae veChlamydia pneumoniae yönünden negatif saptanan hastaserumları alındı. Dosyaları incelenen ve Q ateşi açısındanklinik ve laboratuvar bulguları olan hastalara ait serumörneklerinde C. burnetii faz I ve faz II antikorları ELISA veIFA yöntemleri ile araştırıldı. Q ateşinin en sık rastlananklinik belirtileri olan ateş, baş ağrısı, myalji, artralji, gripbenzeri hastalık bulguları, öksürük, göğüs ağrısı, solunumsıkıntısı gibi belirtileri ve eritrosit sedimantasyon hızında(ESR) ve transaminazlarda (AST, ALT) yükseklik olan 84hasta serumu çalışmaya dâhil edildi. Çalışma grubu 46(%54.8) kadın (ortanca/min-max=38.0/3-67 yaş) ve 38(%45.2) erkek hastadan (ortanca/min-max=35.0/1-65yaş) oluşmaktadır.Bulgular: C. burnetii’ye karşı %13.1 oranındaseropozitiflik saptanmış olup bu pozitiflikler %9.5oranında geçirilmiş enfeksiyon, %1.2 oranında akut Qateşi ve %2.4 oranında C. burnetii IgM antikoru pozitifliğişeklindeydi. C. burnetii IgG antikoru çocuk hastalardasaptanmazken erişkinlerde %16.1 oranında ve en fazla41-60 yaş arasındaki hastalarda (%19.2) saptanmıştır.Sonuç: Ateşli olgularda, influenza benzerihastalıklarda, atipik pnömonide ve bruselloz şüpheliklinik bulguları olanlarda, Q ateşinin ayırıcı tanıdaakılda tutulması gerektiğini düşünmekteyiz.

Detection of Coxiella burnetii antibodies in patients with suspicion of brucellosis and atypical pneumonia by ELISA and IFA methods

Objective: Query (Q) fever is a zoonotic disease caused by Coxiella burnetii. The transmission routes and clinical manifestations of C. burnetii are similar with brucellosis. C. burnetii is important agent of atypical pneumonia. In this study, C. burnetii antibodies were investigated by ELISA and IFA methods in patients whose clinical findings suspected with atypical pneumonia and brucellosis. Methods: In this study, the sera of patients were chosen who were determined to be negative for Brucella spp. by Rose Bengal test and for Mycoplasma pneumoniae and Chlamydia pneumoniae infections by ELISA and IFA in Microbiology Laboratory of Dokuz Eylul University Hospital. C. burnetii phase I and phase II antibodies were investigated by ELISA and IFA methods in serum samples of patients whose clinical and laboratory data were compatible with Q fever. Eighty four patients were included in the study who had symptoms and findings such as fever, headache, myalgia, arthralgia, flu-like syndrome symptoms, cough, chest pain, respiratory distress, elevation of ESR, ALT, AST. The study group consisted of 46 (54.8%) women (median / min-max = 38.0 / 3-67 years) and 38 (45.2%) male patients (median / min-max = 35.0 / 1-65 years). Results: Seropositivity of C. burnetii was detected in 13.1% of the study group, and 9.5% of theme was past infection, 1.2% was acute Q fever and 2.4% was C. burnetii IgM antibody positivity. While C. burnetii IgG antibodies were not observed in paediatric patients, positivity rate was 16.1% in adult patients and IgG positivity was highest between 41-60 years of age (19.2%). Conclusion: Q fever should be taken into consideration in the differential diagnosis of a febrile diseases, influenza-like illness, atypical pneumoniae, patients with symptoms suggestive of brucellosis.

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