Çocukluk çağında toplum kökenli pnömoni tanısı ile hastaneye yatırılan hastalarda bakteriyel ve viral etkenlerin insidansı ve klinik özellikleri
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Dosyalar
Tarih
2010
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışma ile Selçuk Üniversitesi Meram Tıp Fakültesi Çocuk Enfeksiyon Bölümü'nde toplum kökenli pnömoni tanısı (TKP) ile hastaneye yatırılan hastalarda bakteriyel ve viral etkenlerin insidansı ve klinik özellikleri araştırılması amaçlanmıştır. Gereç ve yöntemler: Bu çalışmada 1 Ekim 2008-28 Şubat 2010 tarihleri arasında Selçuk Üniversitesi Meram Tıp Fakültesi Çocuk Poliklinikleri ve Çocuk Acil Servisine başvuran ve yatış gereken, başvurudan 48 saat öncesine kadar antibiyotik kullanmayan, klinik olarak TKP tanısı alan toplam 91 hasta araştırıldı. Çalışmaya alınan hastaların demografik ve klinik özellikleri kaydedildi. Başvuru anında tüm hastalardan tam kan sayımı, eritrosit sedimantasyon hızı, C-reaktif protein, prokalsitonin, kan kültürü, viral etiyolojiyi saptamak amacıyla nazofaringeal aspirat örnekleri alındı. Çalışmaya alınan tüm hastalara hastaneye başvuru anında PA akciğer grafisi çekildi. Bulgular: Hastalarımızın %24.2'sinde (22/91) pnömoni etkeni saptanırken, %75.8 'inde (69/91) herhangi bir pnömoni etkeni saptanamadı. 91 hastanın 11'inde (%12.1) viral enfeksiyon, dokuzunda (%9.9) sadece bakteriyel enfeksiyon, üçünde (%3.3) viral koenfeksiyon, ikisinde (%2.2) hem virus hem de bakteri vardı. Virus tespit edilen 11 hastanın yedisinde (% 7.7) Parainfluenza (PIV) 2, ikisinde (% 2.2) PIV 3, birinde (% 1.1) adenovirus, ikisinde (%2.2) hem PIV3 hem adenovirus, birinde (%1.1) hem PIV2 hem de PIV3 tespit edildi. Hastaların hiçbirinde RSV, PIV1, hMPV saptanmadı. Bakteri tespit edilen 11 hastanın beşinde (%5.4) Stafilokokkus epidermidis, ikisinde (%2.2) Stafilokokkus saprophyticus, birinde (%1.1) Stafilokokkus hominis, birinde (%1.1) Stafilokokkus capitis, birinde (%1.1) Streptokokkus sobrinus ve birinde (%1.1) Streptokokkus mitis tespit edildi. Hastalarımızın ikisinde (%2.2) de karma viral-bakteriyel etken olduğu tespit edildi. Klinik olarak pnömoni tanısı alan hastalarımızın 28'inde (%30.7) radyolojik olarak pnömoni bulgusu saptanamazken, 59 hastada (%64.7) radyolojik olarak pnömoni varlığı saptandı. Radyolojik olarak pnömoni saptanan 59 hastanın 24'ünde (%26.3) alveolar pnömoni, 35'inde (%38.4) interstisyel pnömoni bulguları saptandı. Sonuç: Çalışmamız Konya'da TKP'li çocuklarda viral insidansın literatürde bildirilen veriler ile uyumlu olduğunu göstermektedir. TKP'li çocuklarda viral insidans yüksek olduğu için ileri tanı yöntemlerinin günlük kullanıma geçmesi ile gereksiz antibiyotik kullanımından kaçınılabilir. Ancak bu çalışmanın daha geniş hasta gruplarında, kontrollü olarak yapılmasına gereksinim vardır.
Objective: We aimed to investigate clinical characteristics and incidence of bacterial and viral pathogens in patients who were hospitalized with the clinical diagnosis of community acquired pneumonia (CAP) in Selcuk Univesity, Meram Faculty of Medicine, Department of Pediatric Infectious Diseases. Material and Methods: From October 2008 to February 2010, we investigated 91 patients between one month and sixteen years of age those required hospitalization and those who were admitted to pediatrics clinics and pediatric emergency services of Selcuk University, Meram Faculty of Medicine, and who did not use antibiotics 48 hours before hospital admission and had the clinical diagnosis of CAP. Demographic and clinic characteristics of the patients were recorded. Blood samples for complete blood count, erytrocyte sedimentation rate, C-reactive protein, procalcitonin, blood culture and nasopharngeal aspirate samples for detection of the viral etiologies were taken at the time of hospital admission. Initial posteroanterior chest X-rays of all patients were checked. Results: The agents of pneumonia were detected in 24.2 % (22/91) but not in 75.8 % (69/91) of our patients. Of 91 patients, 11 (12.1%) were positive for viral infections, 9 (9.9%) were positive for only bacterial infections, 3 (3.3%) had viral coenfection, 2 (2.2%) were positive for both viral and bacterial infections. Out of 11 viral positive patients, 7 (7.7%), 2 (2.2% ), 1 (4.9%), 2 (2.2%), and 1 (1.2%) patients were detected to have parainfluenza virus (PIV) 2, PIV 3, adenovirus, both PIV 3 and adenovirus, both PIV 2 and PIV 3, respectively. RSV, PIV 1 and hMPV virus were not detected in any of cases. Out of 11 bacteria positive patients, 5 (5.4%), 2(2.2%), 1 (1.1%), 1 (1.1%), 1 (1.1%), and 1 (1.1%) patients were detected to have Staphylococcus epidermidis, Staphylococcus saprophyticus, Staphylococcus hominis, Staphylococcus capitis, Streptococcus sobrinus and Streptococcus mitis. Also mixed viral-bacterial agent presence were detected in 2 (2.2%) of our patients. Out of ninety one pneumonia patients those having their diagnosis clinically, 28 (30.7%) had no radiological sign of pneumonia but 59 (64.7%) had. Out of 59 pneumonia patients those having radiological signs, 24 (26.3%) and 35 (38.4%) have detected to have alveolar pneumonia and interstitial pneumonia respectively. Conclusion: Our study shows that in children with CAP in Konya, viral incidence is in concordance with previous studies in literature. In children with CAP, as viral incidence is high, these diagnostic methods can be used in daily practice to prevent use of unnecessary antibiotics. Further larger and randomized controlled studies are needed to confirm our results.
Objective: We aimed to investigate clinical characteristics and incidence of bacterial and viral pathogens in patients who were hospitalized with the clinical diagnosis of community acquired pneumonia (CAP) in Selcuk Univesity, Meram Faculty of Medicine, Department of Pediatric Infectious Diseases. Material and Methods: From October 2008 to February 2010, we investigated 91 patients between one month and sixteen years of age those required hospitalization and those who were admitted to pediatrics clinics and pediatric emergency services of Selcuk University, Meram Faculty of Medicine, and who did not use antibiotics 48 hours before hospital admission and had the clinical diagnosis of CAP. Demographic and clinic characteristics of the patients were recorded. Blood samples for complete blood count, erytrocyte sedimentation rate, C-reactive protein, procalcitonin, blood culture and nasopharngeal aspirate samples for detection of the viral etiologies were taken at the time of hospital admission. Initial posteroanterior chest X-rays of all patients were checked. Results: The agents of pneumonia were detected in 24.2 % (22/91) but not in 75.8 % (69/91) of our patients. Of 91 patients, 11 (12.1%) were positive for viral infections, 9 (9.9%) were positive for only bacterial infections, 3 (3.3%) had viral coenfection, 2 (2.2%) were positive for both viral and bacterial infections. Out of 11 viral positive patients, 7 (7.7%), 2 (2.2% ), 1 (4.9%), 2 (2.2%), and 1 (1.2%) patients were detected to have parainfluenza virus (PIV) 2, PIV 3, adenovirus, both PIV 3 and adenovirus, both PIV 2 and PIV 3, respectively. RSV, PIV 1 and hMPV virus were not detected in any of cases. Out of 11 bacteria positive patients, 5 (5.4%), 2(2.2%), 1 (1.1%), 1 (1.1%), 1 (1.1%), and 1 (1.1%) patients were detected to have Staphylococcus epidermidis, Staphylococcus saprophyticus, Staphylococcus hominis, Staphylococcus capitis, Streptococcus sobrinus and Streptococcus mitis. Also mixed viral-bacterial agent presence were detected in 2 (2.2%) of our patients. Out of ninety one pneumonia patients those having their diagnosis clinically, 28 (30.7%) had no radiological sign of pneumonia but 59 (64.7%) had. Out of 59 pneumonia patients those having radiological signs, 24 (26.3%) and 35 (38.4%) have detected to have alveolar pneumonia and interstitial pneumonia respectively. Conclusion: Our study shows that in children with CAP in Konya, viral incidence is in concordance with previous studies in literature. In children with CAP, as viral incidence is high, these diagnostic methods can be used in daily practice to prevent use of unnecessary antibiotics. Further larger and randomized controlled studies are needed to confirm our results.
Açıklama
Anahtar Kelimeler
Etyoloji, Etiology, Hastaneye yatırma, Hospitalization, Pnömoni, Pneumonia, Çocuklar, Children, İnsidans, Incidence
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Sert, S. (2010). Çocukluk çağında toplum kökenli pnömoni tanısı ile hastaneye yatırılan hastalarda bakteriyel ve viral etkenlerin insidansı ve klinik özellikleri. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
