Sinan Mahir KAYIRAN, Erhan PALOĞLU, Berkan Gürakan

Bronşiyolit tanısıyla izlenen küçük çocuklarda RSV sıklığı klinik ve laboratuvar özellikleri Özgün Araştırma

Özet Amaç: Bu çalışmanın amacı 2008 2009 yıllarında bronşiyolit tanısı alan küçük çocuklarda respiratuvar sinsisyal virüs RSV sıklığını klinik ve laboratuvar özelliklerini incelemek Gereç ve Yöntem: Ekim 2008 Mayıs 2009 tarihleri arasında alt solunum yolu enfeksiyonu tanısı alan ve nazofarengeal sürüntü örneğinde RSV antijeni bakılan iki yaşından küçük 79 hastanın dosyaları geriye dönük olarak taranarak klinik ve laboratuvar özellikleri değerlendirildi Bulgular: Nazofarengeal salgıda RSV antijeni bakılan 79 hastanın 16 rsquo;sında 20 RSV pozitif saptandı Bu hastalarda yaş cinsiyet ortalama gebelik haftası anne sütü ile beslenme süresi vücut ısısı lökosit sayısı C reaktif protein CRP düzeyi ve yatırılarak tedavi oranı RSV negatif hastalardan istatistiksel olarak farklı bulunmadı Hastalarda RSV enfeksiyonu en sık Aralık ayında saptandı Respiratuvar sinsisyal virüs enfeksiyonu geçiren bebeklerin yoğun bakım biriminde yatırılarak tedavi oranı RSV negatif hasta grubundan istatistiksel olarak anlamlı derecede yüksek bulundu Çıkarımlar: Bronşiyolit tanısıyla izlenen iki yaş altı çocuklarda RSV sıklığı literatür ile uyumlu olarak 20 bulundu Respiratuvar sinsisyal virüs enfeksiyonu hastaneye yatış oranlarını etkilememekle birlikte RSV pozitif hastalarda solunum desteği ihtiyacı nedeniyle yoğun bakım biriminde tedavi oranının RSV negatif hastalardan yüksek olduğu gözlendi Bu nedenle bebeklerde ve riskli hasta grubunda RSV enfeksiyonunun ağır seyretmesi erken tanı ve koruyucu tedavinin önemini artırmaktadır Türk Ped Arş 2010; 45: 252 6 Anahtar sözcükler: Alt solunum yolu enfeksiyonu çocuklar respiratuvar sinsisyal virüs

Anahtar Kelimeler:

Alt solunum yolu enfeksiyonu, çocuklar, respiratuvar sinsisyal virüs

The frequency clinical and laboratory features of RSV in small children with bronchiolitis Original Article

Summary Aim: The aim of this study was to determine the frequency and of RSV clinical and laboratory features of respiratory syncytial virus RSV in small children with bronchiolitis in 2008 2009 Material and Method: A total of 79 children younger than two years of age with bronchiolitis at whom RSV antigen was analyzed in the nasopharengeal secretion between October 2008 May 2009 were evaluated from clinical charts retrospectively Results: Respiratory syncytial virus antigen in nasopharengeal secretions was positive in 16 20 of 79 patients The age sex mean gestational week duration of breast feeding fever mean leukocyte count C reactive protein CRP level and hospitalization rate were not significantly different between the RSV positive and negative patients Respiratory syncytial virus infection was frequently detected in December Intensive care unit admission for advanced respiratory support was found significantly higher in the RSV positive patients Conclusions: Respiratory syncytial virus incidence in children younger than two years old with the diagnosis of bronchiolitis was 20 concordant with the literature Although hospitalization rate of RSV positive and negatif patients is similar intensive care unit admission for advanced respiratory support was significantly higher in RSV positive patients Therefore as RSV infection in infants and high risk patients has a severe clinical course this situation increases the importance of early diagnosis and prophylaxis Turk Arch Ped 2010; 45: 252 6 Key words: Children lower respiratory tract infection respiratory syncytial virus

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Black CP. Systematic review of the biology and medical management of respiratory syncytial virus infection. Respir Care 2003; 48: 209-31. (Abstract) / (PDF)
Mcintosh K. Respiratory syncytial virus. In: Behrman RE, Kliegman RM (eds). Nelson Textbook of Pediatrics. 18. edition. Philadelphia: WB Saunders, 2007: 1388-90.
Yilmaz G, Uzel N, Isik N, Baysal SU, Aslan S, Badur S. Viral lower respiratory tract infections in children in Istanbul, Turkey. Pediatr Infect Dis J 1999; 18: 173. (Abstract)
Kanra G, Tezcan S, Yilmaz G. Turkish National Respiratory Syncytial Virus (RSV) Team. Respiratory syncytial virus epidemiology in Turkey. Turk J Pediatr 2005; 47: 303-8. (Abstract) / (Full Text) / (PDF)
Hatipoğlu S, Arıca S, Çelik Y, Öztora S, ŞevketoğluE, Erkum T. Alt solunum yolu enfeksiyonu tanısıyla hastanemize yatırılan olgularda RSV enfeksiyonu sıklığı ve klinik özellikleri. Düzce Tıp Dergisi 2009; 11: 38-44. (PDF)
Hacımustafaoğlu M, Çelebi S, Aynacı E, Köksal N, Sınırtaş M, Göral G. Evaluation of RSV frequency in acute bronchiolitis by different methods. Çocuk Enf Derg 2008; 4: 156-61. (Abstract) / (Full Text) / (PDF)
American Academy of Pediatrics Committee on Infectious Diseases. In: Peter G (ed). 1997 Red Book : Report of the Committee on Infectious Diseases. 24th edition. Elk Grove Village, Illinois: American Academy of Pediatrics, 1976; 89: 11-15.
Hacımustafaoğlu M. RSV İnfeksiyonları. ANKEM Derg 2006; 20: 240-7. (PDF)
Law BJ, Carbonell-Estrany X, Simoes EA. An update on respiratory syncytial virus epidemiology: a developed country per- spective. Respir Med 2002; 96 Suppl B: S1-7. (Abstract) / (PDF)
Figueras-Aloy J, Carbonell-Estrany X, Quero J; IRIS Study Group. Case-control study of the risk factors linked to respiratory syncytial virus infection requiring hospitalization in premature infants born at a gestational age of 33-35 weeks in Spain. Pediatr Infect Dis J 2004; 23: 815-20. (Abstract)
American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics 2006; 118: 1774-93. (Abstract) / (Full Text) / (PDF)
Comittee on infectıous diseases. Policy statement-modified recommendations for use of palivizumab for prevention of respiratory syncytial virus ınfections. Pediatrics 2009; 124; 2345-55.
Morris SK, Dzolganovski B, Beyene J, Sung L. A meta-analysis of the effect of antibody therapy for the prevention of severe respiratory syncytial virus infection. BMC Infect Dis 2009; 9:106-25. (Abstract) / (Full Text) / (PDF)
Jonathan N. Diagnostic utility of BINAX NOW RSV-an evaluation of the diagnostic performance of BINAX NOW RSV in comparison with cell culture and direct immunofluorescence. Ann Clin Microbiol Antimicrob 2006; 5:13-8. (Abstract) / (Full Text) / (PDF)
Selvarangan R, Abel D, Hamilton M. Comparison of BD Directigen EZ RSV and Binax NOW RSV tests for rapid detection of respiratory syncytial virus from nasopharyngeal aspirates in a pediatric population. Diagn Microbiol Infect Dis 2008; 62: 157-61. (Abstract) / (Full Text) / (PDF)
Simoes EA. RSV disease in the pediatric population: epidemiology, seasonal variability, and long-term outcomes. Manag Care 2008; 17: 3-6. (Abstract)
Doering G, Gusenleitner W, Belohradsky BH, Burdach S, Resch B, Liese JG. The risk of respiratory syncytial virus-relat- ed hospitalizations in preterm infants of 29 to 35 weeks' gestational age. Pediatr Infect Dis J 2006; 25: 1188-90. (Abstract)
Damore D, Mansbach JM, Clark S, Ramundo M, Camargo CA Jr. Prospective multicenter bronchiolitis study: predicting intensive care unit admissions. Acad Emerg Med 2008; 15: 887-94. (Abstract) / (Full Text) / (PDF)
Oddy WH, Sly PD, de Klerk NH, et al. Breast feeding and respiratory morbidity in infancy: a birth cohort study. Arch Dis Child 2003; 88: 224-8. (Abstract) / (PDF)
Simões EA, Carbonell-Estrany X, Fullarton JR, et al. A predictive model for respiratory syncytial virus (RSV) hospitalisation of premature infants born at 33-35 weeks of gestational age, based on data from the Spanish FLIP Study. Respir Res 2008; 9: 78-88. (Abstract) / (Full Text) / (PDF)
Paes B, Steele S, Janes M, Pinelli J. Risk-Scoring Tool for respiratory syncytial virus prophylaxis in premature infants born at 33-35 completed weeks' gestational age in Canada. Curr Med Res Opin 2009; 25: 1585-91. (Abstract) / (Full Text) / (PDF)
Erten M, Karayağar N, Ergüven M, ve ark. Bronşiyolitli olgularımızda respiratuvar sinsisyal virüs (RSV) infeksiyonu sıklığının değerlendirilmesi. Göztepe Tıp Dergisi 2006; 21:113-5. (Abstract)
Sigurs N, Gustafsson PM, Bjarnason R, et al. Severe respiratory syncytial virus bronchiolitis in infancy and asthma and allergy at age 13. Am J Respir Crit Care Med 2005; 171: 137-41. (Abstract) / (Full Text) / (PDF)
Henderson J, Hilliard TN, Sherriff A, Stalker D, Al Shammari N, Thomas HM. Hospitalization for RSV bronchiolitis before 12 months of age and subsequent asthma, atopy and wheeze: a longitudinal birth cohort study. Pediatr Allergy Immunol 2005; 16: 386-92. (Abstract) / (Full Text) / (PDF)
Kneyber MCJ, Steyerberg EW, de Groot R, Moll HA. Long-term effects of respiratory syncytial virus (RSV) bronchiolitis in infants and young children: a quantitative review. Acta Paediatr 2000; 89: 654-60. (Abstract) / (PDF)
Valkonen H, Waris M, Ruohola A, Ruuskanen O, Heikkinen T. Recurrent wheezing after respiratory syncytial virus or non-respiratory syncytial virus bronchiolitis in infancy: a 3-year follow-up. Allergy 2009; 64: 1359-65. (Abstract) / (Full Text) / (PDF)
Simoes EA, Groothuis JR, Tristram DA, et al. Respiratory syncytial virus-enriched globulin for the prevention of acute otitis media in high risk children. J Pediatr 1996; 129: 214-9. (Abstract) / (Full Text) / (PDF)
Thorburn K. Pre-existing disease is associated with a significantly higher risk of death in severe respiratory syncytial virus infection. Arch Dis Child 2009; 94: 99-103. (Abstract) / (Full Text) / (PDF)