Akan Hülya, İzbırak Güldal, Gürol Yesim, Sarıkaya Sezgin, Gündüz Tehlile S, Yılmaz Gülden, Hayran Osman, Vitrinel Ayca
Department of Family Medicine, Yeditepe University Faculty of Medicine, İnönü Mahallesi, Kayışdağı Cad, 26 Ağustos Yerleşimi, 34755 Kadıköy, İstanbul, Turkey.
Department of Microbiology and Clinical Microbiology, Yeditepe University Faculty of Medicine, İnönü Mahallesi, Kayışdağı Cad, 26 Ağustos Yerleşimi, 34755 Kadıköy, İstanbul, Turkey.
Asia Pac Fam Med. 2009 Nov 29;8(1):8. doi: 10.1186/1447-056X-8-8.
Diarrhea is the third leading cause of death related to infectious diseases all over the world. The diseases related to viral gastroenteritis are gradually increasing, particularly in the developed countries. The purpose of our study was to determine the frequency and to investigate the clinical manifestations of acute rotavirus and adenovirus gatroenteritis and to assess the diagnostic value of the related clinical findings.
In 2007-2008 patients with diarrhea and/or vomiting attended to Yeditepe University Hospital and related clinics, Istanbul, were studied. The rotavirus and/or adenovirus antigen in stool of these patients were investigated. Data regarding clinical findings were collected from the electronic records, retrospectively. Age, gender, symptoms, fever, antibiotic use, vomiting, number of vomiting and diarrhaeae, dehydration, abdominal pain, the other pathological physical examination findings were analyzed by the physicians in the study group. To investigate the rotavirus and adenovirus antigen CerTest Rota-Adeno Blister Test (CerTest, Biotec, Spain), a qualitative immunochromotographic assay was used. Statistical analysis wasperformed with SPSS v. 11,5 statistical software. X2 test was used for bivariate and logistic regression analysis was used for multivariate analysis.
Rotavirus positivity was 18,7% (n = 126). Concomitantly, in 596 cases adenovirus antigen test were also performed. Adenovirus positivity was 8,9% (n = 53) and rota-adenovirus co-infection was 4,4% (n = 26). Most of rotavirus positive cases were seen in December, January, February and March (p < 0.001). In clinical parameters, there was a significant difference between rotavirus positive cases and negative cases regarding to vomiting, dehydration and vomiting and diarrhea coexistence (respectively p = 0.010, p < 0.00, p = 0.007).
Rotavirus can be seen in all age groups, but more frequently in childhood. Although there is no clinical gold standard to distinguish the rotavirus cases from the other gastroenteritis agents, the findings of dehydration and vomiting-diarrhea coexistence, considering months of referral may lead clinician to perform rapid antigen tests and affect approach to the treatment. Prospective studies with representative samples are needed to determine the rotavirus and adenovirus incidence and to develop safe and reliable protective policies in our country.
腹泻是全球与传染病相关的第三大死因。与病毒性肠胃炎相关的疾病正在逐渐增加,尤其是在发达国家。我们研究的目的是确定急性轮状病毒和腺病毒性肠胃炎的发病率,调查其临床表现,并评估相关临床发现的诊断价值。
对2007 - 2008年在伊斯坦布尔耶迪特佩大学医院及相关诊所就诊的腹泻和/或呕吐患者进行研究。对这些患者粪便中的轮状病毒和/或腺病毒抗原进行检测。回顾性地从电子记录中收集有关临床表现的数据。研究组的医生分析了年龄、性别、症状、发热、抗生素使用情况、呕吐、呕吐次数和腹泻次数、脱水、腹痛以及其他病理体格检查结果。为检测轮状病毒和腺病毒抗原,采用了CerTest Rota - Adeno Blister Test(CerTest,Biotec,西班牙),这是一种定性免疫层析检测法。使用SPSS v. 11.5统计软件进行统计分析。采用卡方检验进行双变量分析,采用逻辑回归分析进行多变量分析。
轮状病毒阳性率为18.7%(n = 126)。同时,对596例患者也进行了腺病毒抗原检测。腺病毒阳性率为8.9%(n = 53),轮状病毒与腺病毒合并感染率为4.4%(n = 26)。大多数轮状病毒阳性病例出现在12月、1月、2月和3月(p < 0.001)。在临床参数方面,轮状病毒阳性病例与阴性病例在呕吐、脱水以及呕吐和腹泻同时出现方面存在显著差异(分别为p = 0.010,p < 0.00,p = 0.007)。
轮状病毒可见于所有年龄组,但在儿童中更为常见。尽管目前尚无区分轮状病毒病例与其他肠胃炎病原体的临床金标准,但考虑到就诊月份,脱水以及呕吐和腹泻同时出现的表现可能会促使临床医生进行快速抗原检测并影响治疗方法。需要进行具有代表性样本的前瞻性研究,以确定我国轮状病毒和腺病毒的发病率,并制定安全可靠的预防措施。