Abstract
Objective:Infectious gastroenteritis is a global infectious disease that can be accompanied by outbreaks.Causes include a wide range of bacteria,viruses and parasites.In our study,we aimed to determine the distribution of bacterial agents that cause gastroenteritis cases in our region,their epidemiological characteristics,such as age and season.It is aimed to light the way on the true frequency of Campylobacter species,which are difficult to detect by conventional methods,by multiplex real-time polymerase chain reaction method.
Material and method:Between January 2016 and August 2019,7659 stool samples sent to microbiology laboratory for detection of bacterial agents from various clinics of our hospital were retrospectively reviewed.
Results:21.7% of the evaluated cases were positive and 78.3% were negative.In 92% of positive samples,any of the four agents were positive,while in 7.9% 2 agents and 0.1% 3 agents were positive together.Campylobacter(35.8%) was the most positive single agent at all ages.The others were Shiga toxin(23.6%),Shigella/Enteroinvaziv E. coli(22.3%) and Salmonella(18.3%),respectively. Campylobacter(43.6%) was most common in children and Shigella(30.6%) was positive in adults. Positivity was most common in summer(37.6%),while at least(17.8%) was detected in winter.Campylobacter(38.7%), the most frequently positive agent in summer,was found to be Shigella/ Enteroinvaziv E. coli(39.7%) in winter.
Conclusion:There are difficulties in identifying Campylobacter species by conventional methods.Our study will contribute to the literature in terms of determining the true frequency of gastroenteritis caused by Campylobacter species and showing how the distribution of other agents in our region is influenced by epidemiological factors.On the other hand,although molecular-based methods are not accepted as the gold standard in terms of diagnosis,they may direct empirical treatment by contributing to early diagnosis.
References
- 1. Riddle MS, Dupont HL, Connor BA. ACG clinical guideline: Diagnosis, treatment, and prevention of acute diarrheal infections in adults. Am J Gastroenterol. 2016;111(5):602–22.
- 2. Chen J, Wan CM, Gong ST, et al. Chinese clinical practice guidelines for acute infectious diarrhea in children. World J Pediatr. 2018;14(5):429–36.
- 3. da Cruz Gouveia MA, Lins MTC, da Silva GAP. Acute diarrhea with blood: diagnosis and drug treatment J Pediatr (Rio J). 2020;96(1):20-28.
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- 6. Yılmaz E. Salmonella Enfeksiyonlarının Epidemiyolojisi. Turkiye Klinikleri J Inf Dis-Special Topics 2013;6(2):7-132013;6(2):7–13.
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- 11. Harrington SM, Buchan BW, Doern C, et al. Multicenter evaluation of the BD max enteric bacterial panel PCR assay for rapid detection of salmonella spp., Shigella spp., campylobacter spp. (C. jejuni and C. coli), and shiga toxin 1 and 2 genes. J Clin Microbiol. 2015 May 1;53(5):1639–47.
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- 15. Martín A, Pérez-Ayala A, Chaves F, Lora D, Orellana MÁ. Evaluation of the multiplex PCR Allplex-GI assay in the detection of bacterial pathogens in diarrheic stool samples. J Microbiol Methods. 2018;144(October 2017):33–6.
- 16. Göktaş Ş, Gökmen AA, Şamlıoğlu P. Detection of Acute Gastroenteritis Agents By Molecular Methods. J Clin Exp Investig. 2018;9(1):21–5.
- 17. Keske Ş, Zabun B, Aksoy K, Palaog E. Rapid Molecular Detection of Gastrointestinal Pathogens and Its Role in Antimicrobial Stewardship. J Clin Microbiol. 2018;56(5):1–5.
- 18. Wohlwend N, Tiermann S, Risch L, Risch M, Bodmer T. Evaluation of a multiplex real-time PCR assay for detecting major bacterial enteric pathogens in fecal specimens: Intestinal inflammation and bacterial load are correlated in campylobacter infections. J Clin Microbiol. 2016;54(9):2262–6.
- 19. Beal SG, Tremblay EE, Toffel S, Velez L, Rand KH. A Gastrointestinal PCR Panel Improves Clinical Management and Lowers Health Care Costs. J Clin Microbiol. 2018;56(1).
Bir Üniversite Hastanesinde Dışkı Örneklerinde Çalışılan Multipleks Pcr Bakteri Paneli Değerlendirilmesi
Abstract
Amaç:Enfeksiyöz gastroenterit salgınlarla seyredebilen küresel bulaşıcı hastalıktır. Akut gastroenteritlerin nedenleri arasında çok çeşitli bakteri, virüs ve parazitler bulunur. Çalışmamızda bölgemizdeki gastroenterit vakalarına neden olan bakteriyel etkenlerin dağılımının yanı sıra yaş ve mevsim gibi epidemiyolojik özelliklerini belirlemek, konvansiyonel metotlarla tespit edilmesi zor olan Campylobacter türlerinin multipleks gerçek zamanlı polimeraz zincir reaksiyonu yöntemiyle gerçek sıklığına ışık tutmak amaçlandı.
Gereç ve Yöntem:Ocak 2016 ve Ağustos 2019 tarihleri arasında hastanemizin çeşitli kliniklerinden bakteriyel etkenlerin saptanması amacıyla mikrobiyoloji laboratuvarına gönderilen 7659 dışkı örneğinin bakteri paneli sonuçları geriye dönük olarak incelendi.
Bulgular:Değerlendirilen olguların %21,7’si pozitif, %78,3’ü negatif saptandı. Pozitif örneklerin %92’sinde dört etkenden herhangi biri pozitif iken %7,9’unda 2 etken, %0,1’inde ise 3 etken birlikte pozitif saptandı. Tüm yaşlarda en çok tekli pozitif bulunan etken toplamda Campylobacter (%35,8) idi. Diğerleri sırayla Shiga toksin (%23,6 ), Shigella/ Enteroinvaziv E. coli (%22,3) ve Salmonella (%18,3) idi. Çocuklarda en sık Campylobacter (%43,6), erişkinlerde ise Shigella (%30,6 ) pozitif idi. Pozitiflik en sık yaz aylarında (%37,6) iken en az (%17,8) kış aylarında saptandı. Yaz aylarındaki en sık pozitif olan etken Campylobacter (%38,7), kış aylarında ise Shigella/ Enteroinvaziv E. coli (%39,7) olarak bulundu.
Sonuç:Konvansiyonel yöntemlerle yapılan dışkı kültürlerinde özellikle Campylobacter türlerinin tanımlanmasında zorluklar yaşanmaktadır. Çalışmamız Campylobacter türlerinin neden olduğu gastroenteritlerin gerçek sıklığını belirlemek ve diğer etkenlerin bölgemizdeki dağılımının epidemiyolojik faktörlerden nasıl etkilendiğini göstermek açısından literatüre katkı sağlayacaktır. Diğer taraftan moleküler temelli yöntemler tanı açısından her ne kadar altın standart olarak kabul edilmese de, erken tanıya katkıda bulunarak ampirik tedaviye yön verebilir.
References
- 1. Riddle MS, Dupont HL, Connor BA. ACG clinical guideline: Diagnosis, treatment, and prevention of acute diarrheal infections in adults. Am J Gastroenterol. 2016;111(5):602–22.
- 2. Chen J, Wan CM, Gong ST, et al. Chinese clinical practice guidelines for acute infectious diarrhea in children. World J Pediatr. 2018;14(5):429–36.
- 3. da Cruz Gouveia MA, Lins MTC, da Silva GAP. Acute diarrhea with blood: diagnosis and drug treatment J Pediatr (Rio J). 2020;96(1):20-28.
- 4. Samie A, Guerrant RL, Barrett L, Besong PO, Igumbor EO, Obi CL. Prevalence of intestinal parasitic and bacterial pathogens in diarrhoeal and non-diarroeal human stools from Vhembe district, South Africa. J Health Popul Nutr. 2009;27(6):739–45.
- 5. Coker AO, Isokpehi RD, Thomas BN, Amisu KO , Obi CL. Human campylobacteriosis in developing countries. Emerg Infect Dis. 2002;8(3):237–43.
- 6. Yılmaz E. Salmonella Enfeksiyonlarının Epidemiyolojisi. Turkiye Klinikleri J Inf Dis-Special Topics 2013;6(2):7-132013;6(2):7–13.
- 7. Lee MS, Tesh VL. Roles of shiga toxins in immunopathology. Toxins (Basel). 2019;11(4):1–26.
- 8. Klinik Bakteriyoloji Tanı Standartları Çalışma Grubu. Akut İshal. In: Ulusal Mikrobiyoloji Standartları, Bulaşıcı Hastalıklar Laboratuvar Tanı Rehberi. 2015. p. SY-01.
- 9. Binnicker MJ. Multiplex molecular panels for diagnosis of gastrointestinal infection: Performance, result interpretation, and cost-effectiveness. J Clin Microbiol. 2015;53(12):3723–8.
- 10. Akan H, İzbırak G, Gürol Y, et al. Rotavirus and adenovirus frequency among patients with acute gastroenteritis and their relationship to clinical parameters: a retrospective study in Turkey. Asia Pac Fam Med. 2009;8(1):8.
- 11. Harrington SM, Buchan BW, Doern C, et al. Multicenter evaluation of the BD max enteric bacterial panel PCR assay for rapid detection of salmonella spp., Shigella spp., campylobacter spp. (C. jejuni and C. coli), and shiga toxin 1 and 2 genes. J Clin Microbiol. 2015 May 1;53(5):1639–47.
- 12. Kurugöl Z, Devrim I. Gastrointestinal Enfeksiyonlar. Cocuk Enfeksiyon Derg. 2014;8(2):71–81.
- 13. Maurelli AT. Shigella and enteroinvasive Escherichia coli : Paradigms for pathogen evolution and host – parasite interactions [Internet]. Second Edi. Escherichia coli: Pathotypes and Principles of Pathogenesis. Elsevier; 2013. 215–245 .
- 14. Guarino A, Giannattasio A. New molecular approaches in the diagnosis of acute diarrhea: Advantages for clinicians and researchers. Curr Opin Gastroenterol. 2011;27(1):24–9.
- 15. Martín A, Pérez-Ayala A, Chaves F, Lora D, Orellana MÁ. Evaluation of the multiplex PCR Allplex-GI assay in the detection of bacterial pathogens in diarrheic stool samples. J Microbiol Methods. 2018;144(October 2017):33–6.
- 16. Göktaş Ş, Gökmen AA, Şamlıoğlu P. Detection of Acute Gastroenteritis Agents By Molecular Methods. J Clin Exp Investig. 2018;9(1):21–5.
- 17. Keske Ş, Zabun B, Aksoy K, Palaog E. Rapid Molecular Detection of Gastrointestinal Pathogens and Its Role in Antimicrobial Stewardship. J Clin Microbiol. 2018;56(5):1–5.
- 18. Wohlwend N, Tiermann S, Risch L, Risch M, Bodmer T. Evaluation of a multiplex real-time PCR assay for detecting major bacterial enteric pathogens in fecal specimens: Intestinal inflammation and bacterial load are correlated in campylobacter infections. J Clin Microbiol. 2016;54(9):2262–6.
- 19. Beal SG, Tremblay EE, Toffel S, Velez L, Rand KH. A Gastrointestinal PCR Panel Improves Clinical Management and Lowers Health Care Costs. J Clin Microbiol. 2018;56(1).
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | February 20, 2023 |
| Submission Date | July 26, 2022 |
| Acceptance Date | November 1, 2022 |
| Published in Issue | Year 2023 Volume: 5 Issue: 1 |
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