Araştırma Makalesi
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Incidence of Rotavirus, Norovirus GI and GII genotypes and Adenovirus in Children with Acute Gastroenteritis

Yıl 2024, Cilt: 4 Sayı: 1, 8 - 12, 30.01.2024

Öz

Aim: Acute gastroenteritis is the second-leading cause of childhood morbidity and mortality worldwide. The majority of these develop due to viral agents, and 18% of children under the age of five with gastroenteritis result in death. In routine Clinical Microbiology laboratories rapid antigen tests for rotavirus and adenovirus are often performed, no test for norovirus is performed. In our study, it was aimed to detect rotavirus, norovirus and adenovirus viral antigens in pediatric patients presenting with gastroenteritis complaints and to compare the results of the immunochromatographic test method with Enzyme Linked Immunosorbent Assay (ELISA) test method for rotavirus antigen.
Methods: A total of 213 stool samples from children with gastroenteritis, submitted to Marmara University Pendik Training and Research Hospital Clinical Microbiology Laboratory for investigation of viral antigen in stool between 1 December 2017 and 1 March 2018, were included in our study. Stool samples were examined macroscopically and microscopically, and those containing blood, mucus, or leukocytes upon direct examination were excluded from the study. Samples were studied with a rapid immunochromatographic test for rotavirus- adenovirus antigen (CerTest combo card test, Certest Biotec S.L., Spain). The same samples were studied with an ELISA kit (DRG Instruments, Germany) for rotavirus antigen, and the results of both methods were evaluated. For norovirus antigen, an ELISA kit (RIDASCREEN, third generation, R-Biopharm, Darmstdt, Germany) was used to determine GI and GII genotypes.
Results: Of these stool specimens 55.9% were from males and 44.1% were from female patients. While rotavirus positivity was detected in 21% of the patients, norovirus and enteric adenovirus antigen were positive in 2.3% and 1.3% respectively. The sensitivity and specificity were found to be 100% for immunochromatographic test method when compared with ELISA in the detection of rotavirus antigen.
Conclusion: In our study, norovirus was found to be the most common causative agent after rotavirus in children with acute gastroenteritis. These results showed that norovirus antigen, which is not currently investigated in routine clinical microbiology laboratories, should be screened. Rapid detection of viral agents that cause acute gastroenteritis is of critical importance in preventing unnecessary antibiotic use and providing treatment appropriate to the agent.

Proje Numarası

SAG-C-YLP-120917-0512

Kaynakça

  • 1. Aksoy-Gökmen A, Çiçek C, Kalfaoğlu H, Saz EU. Gastroenterit semptomları olan olgularda adenovirüs sıklığının shell-vial hücrü kültürü yöntemi ile saptanması. Turk Hij Den Biyol Derg, 2019;76(2):177-182.
  • 2. Altay A, Bozdayı G, Meral M, Dallar Bilge Y, Dalgıç B, Ozkan S, Ahmet K. Investigation of norovirus infection incidence among 0-5 years old children with acute gastroenteritis admitted to two different hospitals in Ankara, Turkey. Mikrobiyol Bul. 2013;47(1): 98-108.
  • 3. Bagali S, Kakhandaki L, Karigoudar R, Wavare S, Shahapur PR, Patil MM. Comparative analysis of enzyme-linked immunosorbent assay and immunochromatography for rotavirus and adenovirus detection in children below five years with acute gastroenteritis. J Lab Physicians. 2023;15 (1):110-116.
  • 4. Banyai K,Estes MK,Martella V, Parashar U, Viral gastroenteritis, Lancet, 2018;392(10142):175-186.
  • 5. Bayraktar B, Toksoy B, Bulut E. Akut gastroenteritli çocuklarda rotavirus ve adenovirus saptanması. Klimik Dergisi. 2010;23(1):15-17.
  • 6. Dhiman S, Devi B, Singh K, Devi P. Comparison of enzyme-linked immunosorbent assay and immunochromatography for rotavirus detection in children below five years with acute gastroenteritis. J Clin Diagn Res. 2015;9(9):6-9.
  • 7. Elliott EJ. Acute gastroenteritis in children. BMJ. 2007;334(7583):35-40.
  • 8. Guarino A, Albano F, Ashkenazi S, Gendrel D, Hoekstra JH, Shamir R, Hania S. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition/European Society for Paediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe. J Pediatr Gastroenterol Nutr. 2008;46(2):81-122.
  • 9. Hallowell BD, Chavers T, Parasher U, Tate JE. Global estimates of rotavirus hospitalizations among children below 5 years in 2019 and current and projected ımpacts of rotavirus vaccination. J Pediatric Infect Dis Soc, 2022;11(4):149-158.
  • 10. Ibrahim SB, El-Bialy AA, Mohammed MS, El-Sheikh AO, Elhewala A, Bahgat S. Detection of rotavirus in children with acute gastroenteritis in Zagazig University Hospitals. Eygpt Electron Physician. 2015;7(5):1227-33.
  • 11. Kumthip K, Khamrin P, Saikruang W, Supadej K, Ushijima H, Maneekarn N. Comparative evaluation of norovirus infection in children with acute gastroenteritis by rapid immunochromatographic test, RT-PCR and Real-time RT-PCR. Journal of Tropical Pediatrics. 2017;63(6):468-475.
  • 12. Liao Y, Hong X, Wu A, Jiang Y, Liang Y, Gao J, Xue L, Kou, X. Global prevalence of norovirus in cases of acute gastroenteritis from 1997 to 2021: An updated systematic review and meta-analysis. Microb Pathog. 2021;161(Pt A):105259.
  • 13. Loharikar A, Dumolard L, Chu S, Hyde T, Goodman T, Mantel C. Status of new vaccine introduction-worldwide, September 2016. MMWR Morb Mortal Wkly Rep. 2016;65(41):1136-1140.
  • 14. Ozkul AA, Kocazeybek BS, Turan N, Reuter G, Bostan K, Yilmaz A, Altan E, Uyunmaz G, Karaköse AR, Muratoglu K, Elevli M, Helps CR, Yilmaz H. Frequency and phylogeny of norovirus in diarrheic children in Istanbul, Turkey. J Clin Virol. 2011;51(3):160-164.
  • 15. Parashar U, Quiroz ES, Mounts AW, Monroe SS, Fankhauser RL, Ando T, Noel JS, Bulens SN , Beard SR , Li JF , Bresee JS , Glass RI. "Norwalk-like viruses". Public health consequences and outbreak management. MMWR Recomm Rep. 2001;50(RR-9):1-17.
  • 16. Patel MM, López-Collada VR, Bulhões MM, De Oliveira LH, Bautista Márquez A, Flannery B, et al. Intussusception risk and health benefits of rotavirus vaccination in Mexico and Brazil. N Engl J Med. 2011;364(24):2283-2292.
  • 17. Payne DC, Vinjé J, Szilagyi PG, Edwards KM, Staat MA, Weinberg GA, et al. Norovirus and medically attended gastroenteritis in U.S. children. N Engl J Med. 2013;368(12):1121-1130.
  • 18. Schmidt MA, Groom HC, Rawlings AM, Mattison CP, Salas SB, Burke RM, Hallowell BD, Calderwood LE, Donald J, Balachandran N, Hall A. Incidence, etiology, and healthcare utilization for acute gastroenteritis in the community, United States. J.Emerg Infect Dis. 2022 Nov;28(11):2234-2242.
  • 19. Shieh WJ. Human adenovirus infections in pediatric population - An update on clinico-pathologic correlation. Biomed J. 2022;45(1):38-49.
  • 20. Tapisiz A, Bedir Demirdag T, Cura Yayla BC, Gunes C, Ugraş Dikmen A, Tezer H, et al. Rotavirus infections in children in Turkey: A systematic review. Rev Med Virol. 2019;29(1): e2020.
  • 21. Thornton AC, Jennings-Conklin KS, McCormick MI. Noroviruses: agents in outbreaks of acute gastroenteritis. Disaster Manag Response. 2004;2(1):4-9.
  • 22. Timurkan M, Aydin H, Aktaş O. Frequency and molecular characterization of human norovirus in Erzurum, Turkey. Turk J Med Sci. 2017;47(3):960-966.
  • 23. Uyar Y, Carhan A, Ozkaya E, Ertek M. Evaluation of laboratory diagnosis of the first norovirus outbreak in Turkey in 2008. Mikrobiyol Bul. 2008;42(4):607-615.
  • 24. Vinjé J, Green J, Lewis DC, Gallimore CI, Brown DW, Koopmans MP. Genetic polymorphism across regions of the three open reading frames of "Norwalk-like viruses". Arch Virol. 2000;145(2):223-241.
  • 25. World Health Organization;. Diarrhoeal disease https://www.who.int/health-topics/diarrhoea/diarrhoeal-disease; 2017. Erişim tarihi: 10 Ekim 2023.
  • 26. World Health Organization; Rotavirus vaccines: WHO position paper https://www.who.int/ /publications/i/item/ July 2021. Erişim tarihi: 10 Ekim 2023.
  • 27. Yoon SH, Kim HR, Ahn JG. Diagnostic accuracy of immunochromatographic tests for the detection of norovirus in stool specimens: a systematic review and meta-analysis. Microbiol Spectr. 2021;9(1): e0046721.

Akut Gastroenteritli Çocuklarda Rotavirüs, Norovirüs GI ve GII genotip ve Adenovirüs Sıklığının Araştırılması

Yıl 2024, Cilt: 4 Sayı: 1, 8 - 12, 30.01.2024

Öz

ÖZET
Amaç: Akut gastroenteritler, dünya çapında çocukluk çağı morbidite ve mortalitesine neden olan ikinci en sık enfektif hastalıklardır. Bunların büyük çoğunluğu viral etkenlere bağlı gelişmekte, ve beş yaş altındaki çocukların %18’i ölümle sonuçlanmaktadır. Rutin klinik mikrobiyoloji laboratuvarlarında sıklıkla rotavirüs ve adenovirüs antijen testleri hızlı yöntemlerle çalışılmasına karşın, norovirüse yönelik bir test yapılmamaktadır. Çalışmamızda gastroenterite bağlı şikayetlerle başvuran çocuk hastalarda rotavirüs, norovirus ve adenovirüs viral antijenlerinin saptanması ve rotavirus antijeni için Enzyme Linked Immunosorbent Assay (ELISA) test yöntemi ile immünokromatografik test yöntem sonuçlarının karşılaştırılması amaçlanmıştır.
Gereç ve Yöntem: Marmara Üniversitesi Pendik Eğitim ve Araştırma Hastanesi Klinik Mikrobiyoloji Laboratuvarı’na dışkıda viral antijen araştırılması için 1 Aralık 2017-1 Mart 2018 tarihleri arasında gönderilen, gastroenterit tanılı çocuklara ait 213 dışkı örneği çalışmamıza dahil edilmiştir. Dışkı örnekleri makroskobik ve mikroskobik olarak incelenmiş, kanlı, mukuslu ve direkt incelemesinde lökosit olanlar çalışma dışı bırakılmıştır. Örnekler adenovirüs-rotavirüs antijeni için hızlı immünokromatografik test (CerTest combo kart testi, Certest Biotec S.L.,İspanya) ile çalışılmıştır. Aynı örnekler rotavirus antijeni için ELISA kiti (DRG Instruments, Almanya) ile çalışılmış, her iki yöntemin sonuçları değerlendirilmiştir. Norovirüs antijeni için ise GI ve GII genotiplerini tayin eden ELISA kiti (RIDASCREEN, üçüncü jenerasyon, R-Biopharm, Darmstdt, Almanya) kullanılmıştır.
Bulgular: Örneklerin %55,9’u erkek hastalara ait olup %44,1’i ise kadın hastalara aittir. Hastaların %21’inde rotavirüs pozitifliği saptanırken, %2,3’ünde norovirüs, %1,3’ünde adenovirüs antijeni pozitif olarak saptanmıştır. Rotavirüs antijen tespitinde ELISA testi referans alındığında immunokromatografik yöntemin duyarlılık ve özgüllüğü %100 bulunmuştur.
Sonuç: Çalışmamızda akut gastroenteritli çocuklarda rotavirüsten sonra en sık görülen etkenin norovirüs olduğu belirlendi. Bu sonuçlar halen rutin klinik mikrobiyoloji laboratuvarlarında araştırılmayan norovirüs antijeninin taranması gerektiğini göstermiştir. Akut gastroenterite neden olan viral etkenlerin hızlı tespiti, gereksiz antibiyotik kullanımının önlenmesi ve etkene uygun tedavinin sağlanması açısından kritik öneme sahiptir.

Etik Beyan

Bu çalışma, Marmara Üniversitesi Sağlık Bilimleri Enstitüsü Etik Kurulu tarafından (09.01.2017 tarih ve 32 kayıt numarası) onaylanmıştır.

Destekleyen Kurum

Marmara Üniversitesi Bilimsel Araştırma Projeleri Koordinatörlüğü tarafından proje olarak desteklenmiştir

Proje Numarası

SAG-C-YLP-120917-0512

Kaynakça

  • 1. Aksoy-Gökmen A, Çiçek C, Kalfaoğlu H, Saz EU. Gastroenterit semptomları olan olgularda adenovirüs sıklığının shell-vial hücrü kültürü yöntemi ile saptanması. Turk Hij Den Biyol Derg, 2019;76(2):177-182.
  • 2. Altay A, Bozdayı G, Meral M, Dallar Bilge Y, Dalgıç B, Ozkan S, Ahmet K. Investigation of norovirus infection incidence among 0-5 years old children with acute gastroenteritis admitted to two different hospitals in Ankara, Turkey. Mikrobiyol Bul. 2013;47(1): 98-108.
  • 3. Bagali S, Kakhandaki L, Karigoudar R, Wavare S, Shahapur PR, Patil MM. Comparative analysis of enzyme-linked immunosorbent assay and immunochromatography for rotavirus and adenovirus detection in children below five years with acute gastroenteritis. J Lab Physicians. 2023;15 (1):110-116.
  • 4. Banyai K,Estes MK,Martella V, Parashar U, Viral gastroenteritis, Lancet, 2018;392(10142):175-186.
  • 5. Bayraktar B, Toksoy B, Bulut E. Akut gastroenteritli çocuklarda rotavirus ve adenovirus saptanması. Klimik Dergisi. 2010;23(1):15-17.
  • 6. Dhiman S, Devi B, Singh K, Devi P. Comparison of enzyme-linked immunosorbent assay and immunochromatography for rotavirus detection in children below five years with acute gastroenteritis. J Clin Diagn Res. 2015;9(9):6-9.
  • 7. Elliott EJ. Acute gastroenteritis in children. BMJ. 2007;334(7583):35-40.
  • 8. Guarino A, Albano F, Ashkenazi S, Gendrel D, Hoekstra JH, Shamir R, Hania S. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition/European Society for Paediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe. J Pediatr Gastroenterol Nutr. 2008;46(2):81-122.
  • 9. Hallowell BD, Chavers T, Parasher U, Tate JE. Global estimates of rotavirus hospitalizations among children below 5 years in 2019 and current and projected ımpacts of rotavirus vaccination. J Pediatric Infect Dis Soc, 2022;11(4):149-158.
  • 10. Ibrahim SB, El-Bialy AA, Mohammed MS, El-Sheikh AO, Elhewala A, Bahgat S. Detection of rotavirus in children with acute gastroenteritis in Zagazig University Hospitals. Eygpt Electron Physician. 2015;7(5):1227-33.
  • 11. Kumthip K, Khamrin P, Saikruang W, Supadej K, Ushijima H, Maneekarn N. Comparative evaluation of norovirus infection in children with acute gastroenteritis by rapid immunochromatographic test, RT-PCR and Real-time RT-PCR. Journal of Tropical Pediatrics. 2017;63(6):468-475.
  • 12. Liao Y, Hong X, Wu A, Jiang Y, Liang Y, Gao J, Xue L, Kou, X. Global prevalence of norovirus in cases of acute gastroenteritis from 1997 to 2021: An updated systematic review and meta-analysis. Microb Pathog. 2021;161(Pt A):105259.
  • 13. Loharikar A, Dumolard L, Chu S, Hyde T, Goodman T, Mantel C. Status of new vaccine introduction-worldwide, September 2016. MMWR Morb Mortal Wkly Rep. 2016;65(41):1136-1140.
  • 14. Ozkul AA, Kocazeybek BS, Turan N, Reuter G, Bostan K, Yilmaz A, Altan E, Uyunmaz G, Karaköse AR, Muratoglu K, Elevli M, Helps CR, Yilmaz H. Frequency and phylogeny of norovirus in diarrheic children in Istanbul, Turkey. J Clin Virol. 2011;51(3):160-164.
  • 15. Parashar U, Quiroz ES, Mounts AW, Monroe SS, Fankhauser RL, Ando T, Noel JS, Bulens SN , Beard SR , Li JF , Bresee JS , Glass RI. "Norwalk-like viruses". Public health consequences and outbreak management. MMWR Recomm Rep. 2001;50(RR-9):1-17.
  • 16. Patel MM, López-Collada VR, Bulhões MM, De Oliveira LH, Bautista Márquez A, Flannery B, et al. Intussusception risk and health benefits of rotavirus vaccination in Mexico and Brazil. N Engl J Med. 2011;364(24):2283-2292.
  • 17. Payne DC, Vinjé J, Szilagyi PG, Edwards KM, Staat MA, Weinberg GA, et al. Norovirus and medically attended gastroenteritis in U.S. children. N Engl J Med. 2013;368(12):1121-1130.
  • 18. Schmidt MA, Groom HC, Rawlings AM, Mattison CP, Salas SB, Burke RM, Hallowell BD, Calderwood LE, Donald J, Balachandran N, Hall A. Incidence, etiology, and healthcare utilization for acute gastroenteritis in the community, United States. J.Emerg Infect Dis. 2022 Nov;28(11):2234-2242.
  • 19. Shieh WJ. Human adenovirus infections in pediatric population - An update on clinico-pathologic correlation. Biomed J. 2022;45(1):38-49.
  • 20. Tapisiz A, Bedir Demirdag T, Cura Yayla BC, Gunes C, Ugraş Dikmen A, Tezer H, et al. Rotavirus infections in children in Turkey: A systematic review. Rev Med Virol. 2019;29(1): e2020.
  • 21. Thornton AC, Jennings-Conklin KS, McCormick MI. Noroviruses: agents in outbreaks of acute gastroenteritis. Disaster Manag Response. 2004;2(1):4-9.
  • 22. Timurkan M, Aydin H, Aktaş O. Frequency and molecular characterization of human norovirus in Erzurum, Turkey. Turk J Med Sci. 2017;47(3):960-966.
  • 23. Uyar Y, Carhan A, Ozkaya E, Ertek M. Evaluation of laboratory diagnosis of the first norovirus outbreak in Turkey in 2008. Mikrobiyol Bul. 2008;42(4):607-615.
  • 24. Vinjé J, Green J, Lewis DC, Gallimore CI, Brown DW, Koopmans MP. Genetic polymorphism across regions of the three open reading frames of "Norwalk-like viruses". Arch Virol. 2000;145(2):223-241.
  • 25. World Health Organization;. Diarrhoeal disease https://www.who.int/health-topics/diarrhoea/diarrhoeal-disease; 2017. Erişim tarihi: 10 Ekim 2023.
  • 26. World Health Organization; Rotavirus vaccines: WHO position paper https://www.who.int/ /publications/i/item/ July 2021. Erişim tarihi: 10 Ekim 2023.
  • 27. Yoon SH, Kim HR, Ahn JG. Diagnostic accuracy of immunochromatographic tests for the detection of norovirus in stool specimens: a systematic review and meta-analysis. Microbiol Spectr. 2021;9(1): e0046721.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Halk Sağlığı (Diğer)
Bölüm Araştırma Makaleleri
Yazarlar

Yaşar Mercan 0000-0001-6748-1185

Esra Baran 0000-0002-3517-6036

Arzu Akşit İlki 0000-0003-3887-7003

Proje Numarası SAG-C-YLP-120917-0512
Yayımlanma Tarihi 30 Ocak 2024
Gönderilme Tarihi 13 Kasım 2023
Kabul Tarihi 29 Ocak 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 4 Sayı: 1

Kaynak Göster

APA Mercan, Y., Baran, E., & Akşit İlki, A. (2024). Akut Gastroenteritli Çocuklarda Rotavirüs, Norovirüs GI ve GII genotip ve Adenovirüs Sıklığının Araştırılması. Journal of Health Sciences and Management, 4(1), 8-12.