Yıldız Camcıoğlu, Muhammet Köşker, Fatih Varol, Haluk Çokuğraş, Dicle Şener, Mert Kuşkucu, Deniz Aygün, Kenan Midilli, Firuze Erbek

Alt solunum yolu enfeksiyonu tanısı ile hastanede yatan çocuklarda viral etkenlerin epidemiyolojik ve klinik özellikleri

Amaç: Solunum yolu enfeksiyonları tüm dünyada en yaygın görülen enfeksiyon hastalıkları arasındadır. Virüsler çocuklardaki solunum yolu enfeksiyonlarının en sık nedenidir. Bu yazıda, alt solunum yolu enfeksiyonu nedeniyle hastanede yatan çocuklarda viral etkenlerin epidemiyolojik ve klinik özelliklerinin incelemesi amaçlandı. Gereç ve Yöntemler: Fakültemiz çocuk enfeksiyon servisinde Aralık 2012– Aralık 2016 tarihlerinde akut solunum yolu enfeksiyonları tanısı ile yatırılan 422 hastadan nasofarengeal sürüntü örneklemesi alındı. Virüslerin saptaması için multpileks polimeraz zincir reaksiyonu yöntemi kullanıldı. Bulgular: Viral solunum yolu virüsleri 311 hastada saptandı (%73,7). Solunum yolu virüslerinin tiplendirilmesi yapıldığında; 103 hastada (%33,1) respiratuvar sinsitiyal virüs, 102 hastada (%32,7) insan rinovirüs, 49 hastada (%15,7) çoklu virüs, 15 hastada (%4,8) parainfluenza virus, 13 hastada (%4,1) adenovirus, dokuz hastada (%2,8) metapnömovirüs, 8 hastada (%2,5) koronavirüs, altı hastada (%1,9) bokavirüs, beş hastada (%1,6) influenza virüsü ve bir hastada enterovirus saptandı. Çoklu virus saptanan hastaların yaşı daha küçüktü (p

The epidemiologic and clinical features of viral agents among hospitalized children with lower respiratory tract infections

infectious diseases worldwide. Respiratory viruses are the leading causeof respiratory infections in children. Herein, we aimed to determine theepidemiologic and clinical feautures of viral agents among hospitalizedchildren with lower respiratory tract infections.Material and Methods: Nasopharyngeal swab specimens were obtainedfrom the 422 patients hospitalized with a diagnosis of lower respiratorytract infections between December 2012 and December 2016. Multiplexreverse-transcription polymerase chain reaction was performed for thedetection of viruses.Results: Viral respiratory pathogens were detected in 311 patients(73.7%). In regard to respiratory virus subtypes, 103 patients (33.1%) hadrespiratory syncytial virus, 102 (32.7%) had human rhinovirus, 49 (15.7%)had multiple viruses, 15 (4.8%) had parainfluenzavirus, 13 (4.1%) hadadenovirus, nine (2.8%) had human metapneumovirus, eight (2.5%) hadhuman coronaviruses, six (1.9%) had bocavirus, five (1.6%) had influenzavirus, and one patient (0.3%) had enterovirus. The median age was lowerin patients with multiple viruses (p

PDF

___

1. Global Burden of Disease Child and Adolescent Health Collaboration, Kassebaum N, Kyu HH, et al. Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study. JAMA Pediatr 2017; 171: 573–92. [CrossRef ]
2. Johansson N, Kalin M, Hedlund J. Clinical impact of combined viral and bacterial infection in patients with community-acquired pneumonia. Scand J Infect Dis 2011; 43: 609–15. [CrossRef ]
3. Fendrick AM, Monto AS, Nightengale B, Sarnes M. The economic burden of non-influenza-related viral respiratory tract infection in the United States. Arch Intern Med 2003; 163: 487–94. [CrossRef ]
4. Iwane MK, Edwards KM, Szilagyi PG, et al. Populationbased surveillance for hospitalizations associated with respiratory syncytial virus, influenza virus, and parainfluenza viruses among young children. Pediatrics 2004; 113: 1758–64. [CrossRef ]
5. Liolios L, Jenney A, Spelman D, Kotsimbos T, Catton M, Wesselingh S. Comparison of a multiplex reverse transcription-PCR-enzyme hybridization assay with conventional viral culture and immunofluorescence techniques for the detection of seven viral respiratory pathogens. J Clin Microbiol 2001; 39: 2779–83. [CrossRef ]
6. Salez N, Vabret A, Leruez-Ville M, et al. Evaluation of Four Commercial Multiplex Molecular Tests for the Diagnosis of Acute Respiratory Infections. PLoS One 2015; 10: e0130378. [CrossRef ]
7. Brittain-Long R, Nord S, Olofsson S, Westin J, Anderson LM, Lindh M. Multiplex real-time PCR for detection of respiratory tract infections. J Clin Virol 2008; 41: 53–6.
8. Bicer S, Giray T, Çöl D, et al. Virological and clinical characterizations of respiratory infections in hospitalized children. Ital J Pediatr 2013; 39: 22. [CrossRef ]
9. Karadag-Oncel E, Ciblak MA, Ozsurekci Y, Badur S, Ceyhan M. Viral etiology of influenza-like illnesses during the influenza season between December 2011 and April 2012. J Med Virol 2014; 86: 865–71. [CrossRef ]
10. Mengelle C, Mansuy JM, Pierre A, et al. The use of a multiplex real-time PCR assay for diagnosing acute respiratory viral infections in children attending an emergency unit. J Clin Virol 2014; 61: 411–7. [CrossRef ]
11. Bezerra PG, Britto MC, Correia JB, et al. Viral and atypical bacterial detection in acute respiratory infection in children under five years. PLoS One 2011; 6: e18928. [CrossRef ]
12. Fretzayas A, Moustaki M. Etiology and clinical features of viral bronchiolitis in infancy. World J Pediatr 2017; 13: 293–9. [CrossRef ]
13. WHO. Consultation on respiratory syncytial virus (RSV) vaccine development. Available from: www.who.int/immunization/research/meetings_workshops/rsv_vaccine_ development/en/. Accessed June 5, 2017.
14. Miller EK, Gebretsadik T, Carroll KN, et al. Viral etiologies of infant bronchiolitis, croup and upper respiratory illness during 4 consecutive years. Pediatr Infect Dis J 2013; 32: 950–5. [CrossRef ]
15. Midulla F, Scagnolari C, Bonci E, et al. Respiratory syncytial virus, human bocavirus and rhinovirus bronchiolitis in infants. Arch Dis Child 2010; 95: 35–41. [CrossRef ]
16. Gökçe Ş, Kurugöl Z, Koturoğlu G, Çiçek C, Aslan A. Etiology, Seasonality, and Clinical Features of Viral Respiratory Tract Infections in Children Hospitalized With Acute Bronchiolitis: A Single-Center Study. Glob Pediatr Health 2017; 4: 2333794X17714378. [CrossRef ]
17. Hacımustafaoğlu M, Celebi S, Bozdemir SE, et al. RSV frequency in children below 2 years hospitalized for lower respiratory tract infections. Turk J Pediatr 2013; 55: 130–9.
18. Papadopoulos NG, Moustaki M, Tsolia M, et al. Association of rhinovirus infection with increased disease severity in acute bronchiolitis. Am J Respir Crit Care Med 2002; 165: 1285–9. [CrossRef ]
19. Jacques J, Bouscambert-Duchamp M, Moret H, et al. Association of respiratory picornaviruses with acute bronchiolitis in French infants. J Clin Virol 2006; 35: 463–6.
20. Goka EA, Vallely PJ, Mutton KJ, Klapper PE. Single and multiple respiratory virus infections and severity of respiratory disease: a systematic review. Paediatr Respir Rev 2014; 15: 363–70. [CrossRef ]
21. Bonzel L, Tenenbaum T, Schroten H, Schildgen O, Schweitzer-Krantz S, Adams O. Frequent detection of viral coinfection in children hospitalized with acute respiratory tract infection using a real-time polymerase chain reaction. Pediatr Infect Dis J 2008; 27: 589–94. [CrossRef ]
22. Martin ET, Kuypers J, Wald A, Englund JA. Multiple versus single virus respiratory infections: viral load and clinical disease severity in hospitalized children. Influenza Other Respir Viruses 2012; 6: 71–7. [CrossRef ]
23. Cilla G, Oñate E, Perez-Yarza EG, Montes M, Vicente D, Perez-Trallero E. Viruses in community-acquired pneumonia in children aged less than 3 years old: High rate of viral coinfection. J Med Virol 2008; 80: 1843–9. [CrossRef ]
24. du Prel JB, Puppe W, Gröndahl B, et al. Are meteorological parameters associated with acute respiratory tract infections?. Clin Infect Dis 2009; 49: 861–8. [CrossRef ]
25. Stensballe LG, Devasundaram JK, Simoes EA. Respiratory syncytial virus epidemics: the ups and downs of a seasonal virus. Pediatr Infect Dis J 2003; 22: S21–32. [CrossRef ]
26. Mizuta K, Abiko C, Aoki Y, et al. Seasonal patterns of respiratory syncytial virus, influenza A virus, human metapneumovirus, and parainfluenza virus type 3 infections on the basis of virus isolation data between 2004 and 2011 in Yamagata, Japan. Jpn J Infect Dis 2013; 66: 140–5. [CrossRef ]
27. Yazgan H, Yokuş O, Çaşkurlu H, et al. Prevalence of Cytopenia and Evaluation of Its Clinical Significance in Children with influenza A (H1N1). Eur J Gen Med 2010; 7: 414−8. [CrossRef ]