Dilek YAĞCI ÇAĞLAYIK, Nurhan ALBAYRAK, Mustafa ERTEK, Gülay KORUKLUOĞLU, Ayşe BAŞAK ALTAŞ

Refik Saydam Hıfzıssıhha Merkezi Başkanlığı, Viroloji Referans ve Araştırma Laboratuvarı, 2009 yılı akut viral gastroenterit verilerinin değerlendirilmesi

Amaç: Norovirüs, rotavirüs, adenovirüs ve astrovirüs; akut gastroenteritlerin en sık bakteriyel olmayan etkenlerindendir. Bu viral gastroenterit etkenlerinin Türkiye’deki insidansı bilinmemektedir. Bu çalışmada; Refik Saydam Hıfzıssıhha Merkezi Başkanlığı (RSHMB), Salgın Hastalıklar Araştırma Müdürlüğü (SHAM), Viroloji Referans ve Araştırma Laboratuvarı’nda 2009 yılında akut gastroenterit nedeniyle incelenen örneklerin viral etkenler açısından dağılımının irdelenmesi amaçlanmıştır. Yöntem: RSHMB, SHAM, Viroloji Referans ve Araştırma Laboratuvarı’na 2009 yılı içerisinde 11 ayrı ilimizden toplam 147 dışkı örneği gönderilmiştir. Örnekler; yılın farklı dönemlerinde akut gastroenterit nedeniyle başvuran hastalardan hastalık ile ilgili bulguları olan vakalardan il sağlık müdürlükleri aracılığı ile toplanmış ve laboratuvarımıza gönderilmiştir. Örnekler laboratuvarda ticari multipleks real time PCR kiti ile norovirüs Genotip I, norovirüs Genotip II, rotavirüs, adenovirüs ve astrovirüs açısından incelenmiştir. Bulgular: 65 (% 44,2) örnek en az bir viral etken açısından, 10 (% 6,8) örnek ise birden fazla viral etken açısından pozitif olarak tespit edilmiştir. Bir yıllık süreç içerisinde, araştırılan viral gastroenterit etkenlerinden norovirüs (özellikle genotip II) en sık olarak tespit edilen etken olmuştur. Rotavirüs enfeksiyonları norovirüs enfeksiyonlarından sonra ise ikinci sıklıkta görülmüştür. Adenovirüs enfeksiyonları laboratuvarımızda incelenen ve en az sıklıkta rastlanan viral gastroenterit etkeni olmuştur.Sonuç: Bu çalışma sonucunda, laboratuvarımızda incelenen örnekler içerisinde norovirüs Genotip II’nin diyarenin yaygın etkenlerinden olduğu ve yılın her döneminde tespit edilebildiği görülmüş olup çalışılan tüm bu viral etkenlerin her sezonda görülebileceği belirlenmiştir. Sonuç olarak; akut gastroenteritlere azımsanmayacak sıklıkta viral etkenlerin de neden olabileceği ayrıca koenfeksiyon şeklinde karşımıza çıkabileceğinin akıldan çıkarılmaması gereken bir husus olduğu ortaya konulmuştur.

Evaluation of the Results of Acute Viral Gastroenteritis Data in Refik Saydam National Public Health Agency, Virology Reference and Research Laboratory in 2009

Objective: Norovirus, Rotavirus, Adenovirus and Astrovirus are responsible for most non-bacterial acute gastroenteritis. The incidence of these viral agents in Turkey is not well known. In this study, it was aimed to document the viral etiology of the stool samples which were send to Refik Saydam National Public Health Agency (RSNPHA), Virology Reference and Research Laboratory for investigation of viral acute gastroenteritis agents. Method: A total of 147 stool samples from 11 different provinces were send to the Virology Laboratory for Reference and Research of RSNPHA in 2009. Samples were collected from patients admitted because of acute gastroenteritis and from the cases with the signs of illness at different times of the year and sent by the Provincial Health Directorates to our laboratory. The samples were examined in the laboratory using the commercial multiplex real-time PCR kit for norovirus genotype I, norovirus genotype II, rotavirus, adenovirus and astrovirus. Results: 65 (44.2 %) samples were found to be positive at least for one viral agent and 10 (6.8 %) samples for more than one viral agent. Norovirus (particularly genotype II) infections were detected as the most prevalent viral agent in acute gastroenteritis patients in this period. Rotavirus infections were determined as the second most common infection after norovirus infections. Adenovirus infections have been found to be the least prevalent agent in the laboratory.Conclusion: Results of this study showed that norovirus genotype II has been more commonly responsible for acute diarrhea than the other viral pathogens. The viral agents we have studied should be considered as pathogens that can be seen in all seasons. Viral factors should not be underestimated as the cause of acute gastroenteritis; additionally it should be noted that acute gastroenteritis could be caused by coinfection of viral agents.

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