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2019, Cilt 49, Sayı 3, Sayfa(lar) 125-131
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Investigation of Viral Agents in the Respiratory Tract Samples of Neutropenic Patients
Harun Ağca1, Halis Akalın2, Rıdvan Ali3, Ezgi Demirdöğen Çetin4, Burcu Dalyan Cilo1, Esra Kazak2, Fahir Özkalemkaş3, Beyza Ener1
1Bursa Uludağ Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Bursa
2Bursa Uludağ Üniversitesi Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Bursa
3Bursa Uludağ Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Hematoloji Bilim Dalı, Bursa
4Bursa Uludağ Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları ve Tüberküloz Anabilim Dalı, Bursa
Keywords: Virus, respiratory infection, PCR

Objective: Viral respiratory infections are frequently seen and lead to substantial amount of morbidity and mortality. Unfortunately the distribution of these agents are not well known in immunosupressed inpatients. We aimed to detect viral agents in the nasopharyngeal (NS) and bronchoalveolar (BAL) samples which were concurrently obtained from patients with neutropenic hematologic malignancy.

Methods: A total of 50 patients diagnosed of hematologic malignancies with neutrophil counts lower than 500/mL and fever (>38°C) who were hospitalized between 12.01.2013 and 12.31.2015 in the hematology department that were investigated with bronchoscopy were enrolled in the study. NS and BAL samples were obtained on the same day. Viruses in these samples were searched by a commercial multiplex Real- Time PCR assay kit that enables identification of 21 respiratory viral agents.

Results: At least one virus was detected in BAL and/or NS samples concurrently obtained from 31 (62%) of 50 patients Viruses were detected in 38% of BAL and 40% of nasopharyngeal swab samples. More frequently coronaviruses (types NL63, 229E, 0C43, and HKU1), and parainfluenza viruses (types 1, 2, 3, and 4) were detected in both samples; while influenza viruses (types A, B,and A/H1N1) were found in BAL samples as predominant agents. Six of the 25 agents detected in BAL samples were also detected in NS samples.

Conclusion: It was found that viruses detected in BAL samples were not in much accordance with viruses detected in NS samples, and it was considered that NS results should be evaluated carefully. It was considered that viral analyses in BAL samples should be performed by highly sensitive, new diagnostic methods and taking the clinical findings and other pathogens into consideration would lead to better interpretation of the results.

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