ALT SOLUNUM YOLU ENFEKSİYONU TANISI İLE TAKİP EDİLEN HASTALARIN EPİDEMİYOLOJİK, KLİNİK VERİLERİNİN VE PCR SONUÇLARININ DEĞERLENDİRİLMESİ

Tez Türü: Tıpta Uzmanlık

Tezin Yürütüldüğü Kurum: Diğer (Kurumlar,hastaneler Vb.), SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ÇOCUK SAĞLIĞI HASTALIKLARI, Türkiye

Tez Danışmanı: Prof. Dr. Şükrü Arslan

Tezin Onay Tarihi: 2013

Tezin Dili: Türkçe

Desteklendiği Program: Diğer

Özet:

THE EVULATİON OF EPİDEMİOLOJİCAL, CLİNİCAL AND PCR RESULTS OF THE CHİLDREN WİTH LOWER RESPIRATORY TRACT İNFECTİONS

OBJECTİVE

In this study, we aimed to evaluate epidemiological properties, age distribution, clinical manifestations and frequency of viral agents isolated by the PCR from nasopharyngeal swab specimen in patients, diagnosed and hospitalized for lower respiratory tract infection.

METHODS

Two hundred ninety eight patients, aged between 1 month and 14 years old, admitted to pediatric clinics with the diagnosis of lower respiratory tract infections (LRTI) between May 2011 and May 2012 were included in the study. Nasopharyngeal swab samples were taken from all patients. Data regarding demographic features, symptoms, physical and laboratory findings, chest radiography were obtained retrospectively from medical records of patients, clinical diagnosis, medication and duration of hospitalization were noted. PCR was employed for 15 respiratory viruses.

RESULTS

Of all the 298 patients 186 (62.4%) were male and 113 (37.9%) were less than 6 month. The majority of the admissions season was winter and the main clinical condition was bronchiolitis. At least one virus was isolated in 205 (69%) cases by PCR, while no viral agent was detected in 92 (31%). RSV was the most frequently isolated (60 patients 20.2 % )viruses. Other viruses were respectively Rhinovirus(34 patients 11.4 % ) , hMPV (15 patients 5.1% ) , ADV(9 patients 3.0%) influenza A (7 patients 2.4 %). Viral co-infections found in 61 (20.4%) cases ; 57 (19.1%) of them were infected by two and 4 of them (1.34 %) by three viruses. There were no significantly difference was not found between virus negative and positive group in respect to demographic, clinical, radiologic or laboratory parameters except children with dispne. Children infected with trial viruses had longer hospital stay than group with one virus infected.

CONCLUSİON

This study showed that the viruses were commonly detected as the causative agents of LRTI among the hospitalized children. Isolation of a viral agent by PCR in the diagnosis of LRTI may definitely contribute to avoid unnecessary use of antibiotics and allow for preventive isolation of infected patients. Virus scan by PCR will be beneficial for both patients and the national economy. In addition we suggested that our study will be helpful for clinicians for choosing the most appropriate treatment protocol.