Türkiye'de Menenjite Neden Olan Bakteriyel Ajanlar ve Meningokokal Serogrupların Seroprevalansı

Successful vaccination policies for protection from bacterial meningitis are dependent on determination of the etiology of bacterial meningitis. During 2009-2011, cerebrospinal fluid (CSF) samples were obtained prospectively from children (1 month – ≤ 18 years of age) with suspected meningitis, in order to determine the etiology of bacterial meningitis in Turkey. DNA evidence of Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae), and Haemophilus influenzae type b (Hib) was detected using multiplex polymerase chain reaction (PCR). In total 500 CSF samples were collected and bacterial etiology was determined in 109 cases; N. meningitidis was detected in 65.1 %, S. pneumoniae in 30.3 %, and Hib in 4.6 %of the PCR positive samples. Of the N. meningitidis positive samples, 58 %, 22 %, and 6 %belonged to serogroups W135, A, and B, respectively, while 14 %were non-groupable. These results highlight the need for broad based protection against meningococcal disease in Turkey.Bakteriyel menenjitlerden korunmak için başarılı aşılama politikalarının geliştirilebilmesi bakteriyel menenjit nedenlerinin tespit edilebilmesine dayanmaktadır. Türkiye’deki bakteriyel menenjit nedenlerini tespit edebilmek için menenjit şüphesi olan çocuklardan (1 ay- 18 yaş), 2009-2011 yılları esnasında prospektif olarak beyin omurilik sıvısı (BOS) örnekleri toplanmıştır. Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae) ve Haemophilus influenzae type b (Hib) DNA’ları çoklu polimeraz zincir reaksiyonu (PZR) kullanılarak tespit edilmiştir. Total olarak toplanan 500 BOS örneğinin 109’unda bakteriyel etiyoloji tespit edilmiş olup; PZR pozitif örneklerin %65.1’inde N. meningitidis, %30.3’ünde S. pneumoniae ve %4.6’sında Hib tespit edilmiştir. N. meningitidis pozitif örneklerin %14’ünü gruplandırılamayan örnekler oluştururken serogrup W135, A ve B sırasıyla, %58, %22 ve %6’sını oluşturmaktadır. Bu sonuçlar Türkiye’de meningokokal hastalığa karşı geniş tabanlı koruma ihtiyacını vurgulamaktadır

Viral etiology of influenza-like illnesses during the influenza season between December 2011 and April 2012

The aim of this study was to determine the frequency of respiratory viruses responsible for respiratory tract infections in Turkish children during the 2011-2012 influenza season. Nasal swabs were obtained from patients with symptoms suggestive of an influenza-like illness between December 2011 and April 2012. Samples were analyzed with multiplex real-time polymerase chain reaction (RT-PCR) to help identify the causative viral pathogen. A total of 200 patients were enrolled in the study. A respiratory virus was detected successfully in 102 (51%) children; influenza A (H3N2) in 39.2%, influenza B in 23.5%, RSV in 15.6%, rhinovirus in 13.7%, bocavirus in 2.9%, coronavirus in 2.9%, and metapneumovirus in 0.9% of patients. Only one patient was co-infected with bocavirus and influenza A virus. A statistically significant difference in the mean age of presentation was observed between the various viral pathogens (P < 0.001). Patients with RSV were significantly younger whereas children infected with the influenza viruses were significantly older. Comparison of symptoms revealed that fever and headache occurred more frequently with the influenza viruses than the other viruses combined (P < 0.001, <0.05). Durations of symptoms such as fever, cough, nasal congestion, and rhinorrhea were also significantly longer in the influenza group (P < 0.001, <0.005, <0.001, <0.005, respectively). Demographic analyses revealed that the school/daycare attendance was the only parameter associated with a significantly increased risk for influenza infection. With an overall viral pathogen detection rate of 51%, findings of the present study suggest other respiratory pathogens, whether viral or bacterial, may also lead to hospital visits due to influenza-like illnesses in children. J. Med. Virol. 86:865-871, 2014. (c) 2013 Wiley Periodicals, Inc