Turhan Ayse Bozkurt, Us Tercan, Dinleyici Ener Cagri, Yildirim Gonca Kilic, Kasifoglu Nilgun, Ozdemir Zeynep Canan, Bor Ozcan
Division of Pediatric Hematology-Oncology, Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
Department of Microbiology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
North Clin Istanb. 2021 Jan 5;8(3):249-254. doi: 10.14744/nci.2020.99896. eCollection 2021.
This study aims to compare the frequency of respiratory viruses using real-time and multiplex polymerase chain reaction technology and nasopharyngeal swabs taken during exacerbation of patients aged 0-18 years followed for febrile neutropenia (FN) with non-FN children.
This prospective study included a total of 40 patients with FN and malignancies followed at Eskisehir Osmangazi University, Department of Pediatric Hematology and Oncology. The control group (n=76) consisted of age-matched patients with upper respiratory tract infections (URTIs) or lower respiratory tract infections (LRTIs) who were admitted to the emergency service due to fever.
Viral agents were detected in 16 of 53 FN attacks (30.1%). The most commonly isolated viruses were coronavirus (23.7%, n=9), influenza B (18.4%, n=7), and adenovirus (18.4%, n=7). Of 76 children diagnosed with URTI with fever (52.6%) had viral agents, and only 28 of them had a single agent. The most commonly isolated virus was adenovirus (28.6%, n=14). Viral factors were found in 32 of 42 patients (76.1%) patients diagnosed with LRTI, while respiratory syncytial virus was the most common virus in 27 patients (21.7%, n=5).
Our study results show that viral agents play an important role in the etiology of FN. This is the first study to show that viral agents play an important role in the etiology of this disease and viral factors in non-neutropenic febrile children at the same time period by detecting respiratory viruses in 30% of FN cases. More similar studies provide antiviral therapy in selected patients, as well as these studies lead to reduce the use of antimicrobial agents or allow more selective use of antibiotics and/or the earlier discontinuation of these antibiotics in febrile neutropenic children who have been shown to have viral cause of respiratory tract infection based on clinical and microbiological/molecular diagnostic criteria.
本研究旨在比较采用实时和多重聚合酶链反应技术以及从0至18岁因发热性中性粒细胞减少症（FN）接受随访的患者病情加重期间采集的鼻咽拭子，与非FN儿童中呼吸道病毒的检出频率。
这项前瞻性研究共纳入了40例在埃斯基谢希尔奥斯曼加齐大学儿科血液学和肿瘤学系接受随访的FN及恶性肿瘤患者。对照组（n = 76）由年龄匹配的因发热入住急诊的上呼吸道感染（URTI）或下呼吸道感染（LRTI）患者组成。
在53次FN发作中有16次检测到病毒病原体（30.1%）。最常分离出的病毒是冠状病毒（23.7%，n = 9）、乙型流感病毒（18.4%，n = 7）和腺病毒（18.4%，n = 7）。在76例诊断为发热性URTI的儿童中，52.6%检测到病毒病原体，其中只有28例为单一病原体。最常分离出的病毒是腺病毒（28.6%，n = 14）。在42例诊断为LRTI的患者中有32例（76.1%）发现病毒因素，而呼吸道合胞病毒是27例患者中最常见的病毒（21.7%，n = 5）。
我们的研究结果表明，病毒病原体在FN的病因中起重要作用。这是第一项通过在30%的FN病例中检测呼吸道病毒，同时表明病毒病原体在该疾病病因以及非中性粒细胞减少性发热儿童的病毒因素中起重要作用的研究。更多类似研究可为特定患者提供抗病毒治疗，并且这些研究有助于减少抗菌药物的使用，或允许在根据临床和微生物学/分子诊断标准已证明有呼吸道感染病毒病因的发热性中性粒细胞减少儿童中更有选择性地使用抗生素和/或更早停用这些抗生素。
