ASSESSMENT OF CASES ADMITTED TO THE NEONATAL INTENSIVE CARE UNIT WITH LOWER RESPIRATORY TRACT INFECTION

Year 2022, , 75 - 81, 17.01.2022

Özgül Bulut , Kaan Kahraman Çağla Uçar Fahri Ovalı

https://doi.org/10.18229/kocatepetip.775543

Abstract

OBJECTIVE: The purpose of this study is to assess the clinical features, laboratory findings, diagnosis and treatments of neonates in the neonatal intensive care unit with a diagnosis of lower respiratory tract infection (LRTI).
MATERIAL AND METHODS: The data of neonates hospitalized in the neonatal intensive care unit of our hospital between 2017 and 2019 with a diagnosis of LRTI was retrospectively obtained from the file records. Demographical features, diagnosis and treatments were analyzed.
RESULTS: A total of 57 patients diagnosed with LRTI were included in the study. The mean gestational age of the patients was 36.8 ± 3 weeks and their mean birth weight was 2864 ± 787 g. The 67% (n = 38) of them were term infants and the 33% (n = 19) of them were preterm infants. When the symptoms, examination findings and chest radiographs of the cases were examined at the time of admission, tachypnea, prolonged expiration, and nutritional difficulty in 67% of cases (n = 38), cough in 26% (n = 15) of the cases, fever in 20% (n = 12) of the cases, vomiting in 12% (n = 7) of the cases, apnea in 7% (n = 4)of the cases, and increased aeration in lung imaging in 21% (n = 12) of the cases were detected. Respiratory panel using Polymenase Chain Reaction (PCR) method was investigated in nasopharyngeal swab samples of 61% (n = 35) of the patients, respiratory syncytial virus (RSV) in 57% (n = 20), rhinovirus in 14% (n = 5), and metapneumovirus in 3% (n = 1) of the cases were observed. The 47% of the patients (n = 27) received high-flow oxygen, 26% (n= 15) nasal CPAP, 58% (n=33) antibiotics, 63% (n= 36) inhaler bronchodilator and hypertonic saline treatment.
CONCLUSIONS: In accordance with the literature, a high rate of RSV infection was detected in neonates with LRTI in the neonatal intensive care unit of our hospital. Early diagnosis is important to prevent unnecessary use of antibiotics and to prevent nosocomial infections.

Keywords

Newborn, Polymerase chain reaction, Respiratory syncytial virus, Respiratory tract infections

ALT SOLUNUM YOLU ENFEKSİYONU TANISI İLE YENİDOĞAN YOĞUN BAKIM ÜNİTESİNE YATIRILAN OLGULARIN DEĞERLENDİRİLMESİ

Abstract

AMAÇ: Bu çalışmanın amacı, alt solunum yolu enfeksiyonu (ASYE) tanısıyla yenidoğan yoğun bakım ünitesine yatırılan bebeklerin klinik özelliklerinin ve laboratuvar bulgularının, tanı ve tedavilerinin değerlendirilmesidir.
GEREÇ VE YÖNTEM: Hastanemizde 2017 - 2019 tarihleri arasında yenidoğan yoğun bakım ünitesine ASYE tanısı konularak yatırılan bebeklerin verileri retrospektif olarak dosya kayıtlarından elde edildi. Demografik özellikleri, tanı ve tedavileri analiz edildi.
BULGULAR: Çalışmaya ASYE tanısı alan toplam 57 hasta dahil edildi. Hastaların ortalama gestasyon yaşı 36.8±3 hafta, ortalama doğum ağırlığı 2864±787 g idi. % 67 (n=38)’si term, % 33 (n=19)’ü preterm bebekti. Olguların başvuru anındaki semptom, muayene bulguları ve akciğer grafileri incelendiğinde; %67 (n=38)’inde takipne, ekspiryumda uzama ve beslenme güçlüğü, %26 (n=15)’sında öksürük, %20 (n=12)’sinde ateş, %12 (n=7)’sinde kusma, %7 (n=4)’sinde apne, %21 (n=12)’inde akciğer grafisinde havalanma artışı saptandı. Hastaların %61 (n=35)’inde nazofarengeal sürüntü örneklerinde PCR yöntemi ile solunum paneli bakıldı, bunlarında %57 (n=20)’sinde Respiratuvar sinsityal virüs (RSV) enfeksiyonu, %14 (n=5)’ünde Rhinovirüs, %3 (1)’ünde Metapnömovirüs pozitif saptandı. Hastaların %47 (n=27)’si yüksek akımlı oksijen, %26 (n= 15)’sı nazal CPAP, %58 (n=33)’i antibiyotik, % 63 (n= 36)’ü inhaler bronkodilatör ve hipertonik salin tedavisi aldı.
SONUÇ: Hastanemizde ASYE tanısı ile yatırılan olgularda literatürle uyumlu olarak yüksek oranda RSV enfeksiyonu saptandı. Tanının erken konulması, gereksiz antibiyotik kullanımı ve nozokomiyal enfeksiyonları önlemek açısından önem taşımaktadır.

Keywords

Yenidoğan, Polimeraz zincir reaksiyonu, Respiratuvar sinsityal virüs, Solunum yolu enfeksiyonları

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