Kronik obstrüktif akciğer hastalığı alevlenmelerinde balgamda streptococcus pneumoniae, haemophilus influenzae ve moraxella catarrhalis’in gerçek zamanlı polimeraz zincir reaksiyonu tekniği ile kantitatif olarak saptanması
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Tarih
2011
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info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada, kronik obstrüktif akciğer hastalığı (KOAH) alevlenmesinin en sık rastlanılan üç bakteriyel etkeni olan S. pneumoniae, H. influenzae ve M. catarrhalis’in gerçek zamanlı polimeraz zincir reaksiyonu (PCR) tekniği ile saptanması ve sonuçların kültür ile karşılaştırılması amaçlanmıştır. Yöntem: Çalışmaya KOAH alevlenmesi olan 62 hasta alındı. Hastalar Anthonisen kriterlerine göre sınıflandırıldı. Hastaların başvuru sırasında indüklenmiş balgam örnekleri alınarak üç solunum mikroorganizması için gerçek zamanlı PCR uygulandı. Bulgular: Gerçek zamanlı PCR 47 hastada (%75.8) çalışılan üç mikroorganizmadan biri için pozitif, bakteri kültürleri ise sadece 11 hastada (%17.7) pozitifti. Gerçek zamanlı PCR ile multipl patojenler de saptanabilirken kültür buna olanak sağlamadı. Çalışılan üç mikroorganizmanın gerçek zamanlı PCR ile saptanma oranları sırasıyla S. pneumoniae %53.2, H. influenzae %17.7 ve M. catarrhalis %35.5 şeklindeydi. Gerçek zamanlı PCR sonuçları ile hasta karakteristikleri arasında anlamlı bir ilişki görülmedi. Sonuç: Çalışmamızda, KOAH alevlenmesiyle başvuran hastalarda gerçek zamanlı PCR tekniği ile bakteri saptanma oranları kültüre göre belirgin derecede yüksekti. İnfekte alevlenme oranının yüksek olması nedeniyle, orta ve ağır şiddette alevlenmeli hastalara ampirik antibiyotik tedavisi başlanmalı ve verilecek antibiyotikler üç ana solunum patojenini etkileyebilecek spektruma sahip olmalıdır.
Aim: The aim of this study was the detection of the most common three bacterial causes (S. Pneumoniae, H. influenzae and M. catarrhalis) of chronic obstructive pulmonary disease (COPD) exacerbations, using real-time polymerase chain reaction (PCR) technique and to compare it with the culture results. Methods: Sixty two patients with COPD exacerbation were enrolled to the study. Patients were classified according to Anthonisen’s criteria for COPD exacerbations. Real-time PCR for 3 respiratory microorganisms was performed on induced sputums collected at admission. Results: Real-time PCR was positive in 47 patients (75.8%) for at least one of the three microorganisms, hovewer bacterial cultures were positive in only 11 patients (17.7%). Multiple pathogens were also found with real-time PCR but were not detected by culture. Detection rates of the three studied microorganisms by real-time PCR were as follows: S. pneumoniae 53.2%, H. influenzae 17.7% and M. catarrhalis 35.5%. There was no significant relationship between real-time PCR results and patient characteristics. Conculation: Our study showed that the prevalence of bacteria detected by real-time PCR was substantially higher in comparison to the culture. Because of the high rate of infected exacerbations, an ampiric antibiotic therapy should be started and the spectrum of this therapy should cover these three major respiratory pathogens.
Aim: The aim of this study was the detection of the most common three bacterial causes (S. Pneumoniae, H. influenzae and M. catarrhalis) of chronic obstructive pulmonary disease (COPD) exacerbations, using real-time polymerase chain reaction (PCR) technique and to compare it with the culture results. Methods: Sixty two patients with COPD exacerbation were enrolled to the study. Patients were classified according to Anthonisen’s criteria for COPD exacerbations. Real-time PCR for 3 respiratory microorganisms was performed on induced sputums collected at admission. Results: Real-time PCR was positive in 47 patients (75.8%) for at least one of the three microorganisms, hovewer bacterial cultures were positive in only 11 patients (17.7%). Multiple pathogens were also found with real-time PCR but were not detected by culture. Detection rates of the three studied microorganisms by real-time PCR were as follows: S. pneumoniae 53.2%, H. influenzae 17.7% and M. catarrhalis 35.5%. There was no significant relationship between real-time PCR results and patient characteristics. Conculation: Our study showed that the prevalence of bacteria detected by real-time PCR was substantially higher in comparison to the culture. Because of the high rate of infected exacerbations, an ampiric antibiotic therapy should be started and the spectrum of this therapy should cover these three major respiratory pathogens.
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13
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