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Dışkı örneklerinde gastroenterit etkenlerinin araştırılması

Authors: Yazıcı, Vesile;

Dışkı örneklerinde gastroenterit etkenlerinin araştırılması

Abstract

Amaç ve Hipotez: Gastroenterit; tüm dünyada oldukça sık görülen, önemli bir halk sağlığı sorunudur. Gastroenteritlerde etkenin belirlenmesi ve tedavinin antibiyotik duyarlılık testi sonucuna göre belirlenmesi, mortalite ve morbiditeyi azaltmasının yanı sıra antibiyotik kullanım politikasını belirleyeceğinden önem taşımaktadır. Bu çalışmada hastanemize başvuran olgularda akut gastroenterit nedeni olan başlıca bakteriyel ve viral etkenlerin sıklığının, yaş ve aylara göre dağılımının, antibiyotiklere direnç durumunun saptanması, bölgemizdeki gastroenteritli hastalara yaklaşımda yol gösterecek verilerin elde edilmesi amaçlanmıştır.Yöntem: Bu çalışma 1 Ocak 2007-15 Şubat 2008 tarihleri arasında Adnan Menderes Üniversitesi Tıp Fakültesi Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dalı Laboratuvarında yapılmıştır. Gastroenterit semptomları bulunan 200 olgu ve kontrol grubunu oluşturmak üzere semptomsuz hastalardan alınan 80 dışkı örneği incelenmiştir. Alınan örneklerde kültür ile Campylobacter türleri, Aeromonas türleri, Yersinia enterocolitica, EHEC, V. cholerae, Shigella türleri, Salmonella türleri, immünokromatografik yöntem ile rotavirüs ve adenovirüs antijenleri (VIKIA Rota-Adeno, BioMérieux) araştırılmıştır. Campylobacter kökenleri klasik yöntemler, API Campy (BioMérieux) ticari kiti ve polimeraz zincir reaksiyonu ile tanımlanmıştır.Bulgular: Gastroenterit ön tanılı olgulardan alınan dışkı örneklerinin kültüründe dokuz (% 4,5) Campylobacter jejuni, beş (% 2,5) Salmonella spp. saptanmış, Aeromonas spp., Yersinia enterocolitica, enterohemorajik Escherichia coli, Vibrio cholerae üretilmemiştir. Bu grupta 22 (% 11) örnekte rotavirüs, üç (% 1,5) örnekte adenovirüs antijeni saptanmıştır. Kontrol grubunu oluşturan 80 olguda aranılan patojenlerin hiçbirine rastlanmamıştır. Campylobacter jejuni kökenlerinde E-test yöntemi ile ofloksasine direnç % 56 oranında tespit edilirken, test edilen diğer antibiyotiklere (trimetoprim-sülfametoksazol, tetrasiklin, eritromisin) dirençli köken saptanmamıştır.Sonuç: Çalışmamızda araştırılan gastroenterit etkenleri arasında ilk sırayı alan rotavirüsler, çocukların yanı sıra erişkinlerde de en sık görülen etken olmuştur. Campylobacter jejuni'nin en sık saptanan bakteriyel etken olması nedeni ile bölgemizde rutin dışkı kültüründe bu bakterinin de araştırılması gerektiği düşünülmektedir.Anahtar Kelimeler: Campylobacter türleri, Gastroenterit, Salmonella türleri, rotavirüs, PZR.

Aim and hypotesis: Gastroenteritis is a major common worldwide public health problem. The fact that the complicating factors of gastroenteritis are determined and the treatment is determined depending on the results of antibiotic sensitivity testing is of great importance in improving mortality and morbidity, as well as in establishing the antimicrobical therapeutic regimen. The present study is aimed at determining the prevalence of major acute gastroenteritis, distribution by age and months, and resistance to antibiotics in those admitted to our hospital, and obtaining the data concerned as a basis for approaching the patient with gastroenteritis.Method: In the study was accomplished Laboratory of Department of Microbiology and Clinical Microbiology, Adnan Menderes University Faculty of Medicine, between 1th January 2007- 15th February 2008. We examined samples of stool from 200 subjects with the symptoms of gastroenteritis and 80 samples from those without gastroenteritis as controls, In the samples obtained, the species of Campylobacter, Aeromonas, Yersinia enterocolitica, EHEC, V. cholerae, Shigella, Salmonella were investigated using culture, and rotavirus and adenovirus antigens by immunochromatographic method. The strains of Campylobacter were identified using traditional methods (VIKIA Rota-Adeno, BioMérieux), API Campy commercial kit (BioMérieux), and polymerase chain reaction.Result: Campylobacter jejuni was found in nine (4,5%) and Salmonella spp. in five (2,5%) of the culture specimens from those with gastroenteritis, but no Aeromonas spp., Yersinia enterocolitica, Enterohemorrhagic Escherichia coli, Vibrio cholarae were detected. In this group we found antigens of rotavirus in 22 and adenovirus in three specimens. No fastidious organisms were found in any of the controls. Ofloxacin susceptibility of C. jejuni strains by E-test method was 56 percent, whereas no resistance to any other antibiotics tested was found.Conclusion: Rotaviruses, the most investigated among the gastroenteritis factors in our study, are the most common in children, as well as in adults. As C. jejuni is the most commonly detected bacterial agent, we believe that Campylobacter species must also be investigated in routine stool culture.Keywords: Campylobacter spp., Gastroenteritis, Salmonella spp., rotavirus, PCR.

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Turkey
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Keywords

Gastroenterit, Mikrobiyoloji, Campylobacter Spp., Salmonella Spp., 610, 600, Rotavirüs, Campylobacter Spp, Microbiology, Gastroenteritis, Salmonella Türleri, PCR, Ampylobacter Türleri, PZR, Salmonella Spp

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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