Abstract
Giriş: Üst solunum yolu
enfeksiyonları (ÜSYE) çocuklarda en sık karşılaşılan enfeksiyonlardır.
Çalışmamızın amacı ÜSYE için klinik bir skorlama geliştirerek viral-bakteriyel
ayrımını yapabilmektir.
Yöntem: Bu çalışma ÜSYE
tanısı konulan 5-15 yaşları arasındaki 220 hastada yapıldı. Çalışmamızda incelenececek belirti ve bulguların tespit
edilmesi için klinik skorlama ile bakteriyel ve bakteriyel olmayan ÜSYE
ayırımını yapmayı hedefleyen önceki çalışmalar gözden geçirildi. Bu belirti,
bulgu ve boğaz kültürü sonuçları kayıt altına alındı.
Bulgular: Boğaz
kültürlerinde 93 hastada (%42) üreme oldu. Bu klinik skorlamaya göre ateş,
ağrılı anterior servikal lenfadenopati, öksürük olmaması, tonsiller hipertrofi
enfeksiyonun bakteriyel olduğunu düşündürmesi açısından istatistiksel olarak
anlamlı bulunmuştur. Yutma güçlüğü, karın ağrısı, baş ağrısı, konjoktivit
olmaması, ses kısıklığının olmaması, diyare olmaması, istatistiksel olarak
anlamsız bulundu.
Sonuç: Toplam skor
kültür ilişkisine göre, toplam skor 7 ve üzerinde ise sonuç anlamlı kabul
edilebilir. Çalışmamızda parametrelerin çokluğu, sensitivite ve spesifitenin
düşük olması nedeniyle etkin bir skorlama geliştirilemedi.
References
- 1.Tenover FC, Hughes JM. The challenge of emerging infectious diseases. Development and spread of multiply-resistant bacterial pathogens. JAMA 1996;275:300-4.
- 2. Brook I. Microbiology of common infections in the upper respiratory tract. Prim Care 1998;25(3):633-48.
- 3.Çocuk Enfeksiyon Hastalıkları Derneği: Çocuklarda Üst Solunum Yolu Enfeksiyonları. İstanbul, Çocuk Enfeksiyon Hastalıkları Derneği Yayınları: 1-19.3-7,2002
- 4.Garry R. Upper respiratory tract infections in family practice. Pediatric Infect Dis 1998;17:73-8.
- 5.Bisno AL, Gerber MA, Gwaltney JM, et al. Diagnosis and management of group A streptococcal pharyngitis: a practice guideline. Infectious Diseases Society of America. Clin Infect Dis 1997;25(3):574.
- 6. Del Mar C, Glasziou P, Lowe JB, et al. Addressing antibiotic resistance—focusing on acute respiratory infections in primary care. Aust Fam Physician. 2012;41(11):839– 40.
- 7.McIsaac WJ, White D, Tannenbaum D, et al. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ 1998; 158: 75-83.
- 8.Joachim L, Campos D Jr, Smeesters PR. Pragmatic scoring system for pharyngitis in low-resource settings. Pediatrics 2010;126:608-14.
- 9.Dagnelie CF, Bartelink ML, Van der Graaf Y, et al. Towards a better diagnosis of throat infections (with group A beta-haemolytic streptococcus) in general practice. Br J Gen Pract 1998;48:959-62.
- 10. Hayden GF, Turner RB. Acute pharyngitis. Kleigman R.Jenson H, Behrman R, Stanton B, (eds). Nelson Texbook of Pediatrics Philadelphia, Saunders; p:1752-4.2007.
- 11.Perry M, Whyte A. Immunology of the tonsils. Immunol Today 1998;19:414-21.
- 12.K Roos, R Claesson, U Persson, et al. The economic cost of a streptococcal tonsillitis episode. Scand J Prim Health Care 1995;13(4):257-60.
- 13.Martin JM, Green M, Bardabora MT, et al. Group A Streptococci Among School Aged Children: Clinical Characteristics and Carrier State. Pediatrics 2004;114:1212-9.
- 14.Brook I, Gober AE. Increased recovery of Moraxella catarrhalis and Haemophilus influenzae in association with group A (beta)-haemolytic streptococci in healthy children and those with pharyngo-tonsillitis. J Med Microbiol 2006;55:989-92.
- 16.Stingu CS, Turku T, Dimitriu S, et al. The impact of a sore throat score on clinical management of streptococcal angina. Rev Med Chir Soc Med 2005;109:136-9.
- 14.Breese BB. A simple scorecard for the tentative diagnosis of streptococcal pharyngitis. Am J Dis Child 1977;131:514-17.
- 17.Ulukol B, Günlemez A, Aysev D, et al. Alternative diagnostic method for streptococcal pharyngitis: Breese scoring system. Turk J Pediatr 2000;42:96-100.
- 18.Le Marechal F, Martinot A, Duhamel A, et al. Streptococcal pharyngitis in children: a meta-analysis of clinical decision rules and their clinical variables. BMJ Open 2013;3:e001482. doi: 10.1136/bmjopen-001482.
- 19.Dobbs F. A scoring system for predicting group A streptococcal throat infection. Br J Gen Pract 1996;46:461-4.
Clinical scoring for distinction of bacterial and viral upper respiratory tract infections of children
Abstract
Introduction: Upper
respiratory tract infections (URTI) are
the most common infections of childhood.
The purpose of our study is to develop a clinical scoring method to
distinguish viral and bacterial infections in the patients who were diagnosed
with URTI.
Methods: This study was conducted in pediatric 220 patients
with URTI whose ages were between 5 and 15. The previous studies about clinical scoring of
bacterial and nonbacterial URTI were reviewed to determine signs and symptoms
to evaluate in our study. These signs,
symptoms and throat swab culture results of the patients were
recorded.
Results: Throat swab culture were positive at 93 patients
(42%). According to this clinic scoring system; fever, painful anterior
servical lymphadenopathy, lack of cough, tonsillar hypertrophy were found to be
statistically significant in terms of predicting bacterial infections.
Dysphagia, abdominal pain, headache, lack of conjunctivitis, the absence of
hoarseness and the absence of diarrhea were found to be statistically
insignificant.
Conclusion: Acording to total score – culture relationship,
total score 7 and higher could be considered significant. As a result of our
study, we could not develop an effective scoring due to the high number of
parameters, low sensitivity and specifity.
References
- 1.Tenover FC, Hughes JM. The challenge of emerging infectious diseases. Development and spread of multiply-resistant bacterial pathogens. JAMA 1996;275:300-4.
- 2. Brook I. Microbiology of common infections in the upper respiratory tract. Prim Care 1998;25(3):633-48.
- 3.Çocuk Enfeksiyon Hastalıkları Derneği: Çocuklarda Üst Solunum Yolu Enfeksiyonları. İstanbul, Çocuk Enfeksiyon Hastalıkları Derneği Yayınları: 1-19.3-7,2002
- 4.Garry R. Upper respiratory tract infections in family practice. Pediatric Infect Dis 1998;17:73-8.
- 5.Bisno AL, Gerber MA, Gwaltney JM, et al. Diagnosis and management of group A streptococcal pharyngitis: a practice guideline. Infectious Diseases Society of America. Clin Infect Dis 1997;25(3):574.
- 6. Del Mar C, Glasziou P, Lowe JB, et al. Addressing antibiotic resistance—focusing on acute respiratory infections in primary care. Aust Fam Physician. 2012;41(11):839– 40.
- 7.McIsaac WJ, White D, Tannenbaum D, et al. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ 1998; 158: 75-83.
- 8.Joachim L, Campos D Jr, Smeesters PR. Pragmatic scoring system for pharyngitis in low-resource settings. Pediatrics 2010;126:608-14.
- 9.Dagnelie CF, Bartelink ML, Van der Graaf Y, et al. Towards a better diagnosis of throat infections (with group A beta-haemolytic streptococcus) in general practice. Br J Gen Pract 1998;48:959-62.
- 10. Hayden GF, Turner RB. Acute pharyngitis. Kleigman R.Jenson H, Behrman R, Stanton B, (eds). Nelson Texbook of Pediatrics Philadelphia, Saunders; p:1752-4.2007.
- 11.Perry M, Whyte A. Immunology of the tonsils. Immunol Today 1998;19:414-21.
- 12.K Roos, R Claesson, U Persson, et al. The economic cost of a streptococcal tonsillitis episode. Scand J Prim Health Care 1995;13(4):257-60.
- 13.Martin JM, Green M, Bardabora MT, et al. Group A Streptococci Among School Aged Children: Clinical Characteristics and Carrier State. Pediatrics 2004;114:1212-9.
- 14.Brook I, Gober AE. Increased recovery of Moraxella catarrhalis and Haemophilus influenzae in association with group A (beta)-haemolytic streptococci in healthy children and those with pharyngo-tonsillitis. J Med Microbiol 2006;55:989-92.
- 16.Stingu CS, Turku T, Dimitriu S, et al. The impact of a sore throat score on clinical management of streptococcal angina. Rev Med Chir Soc Med 2005;109:136-9.
- 14.Breese BB. A simple scorecard for the tentative diagnosis of streptococcal pharyngitis. Am J Dis Child 1977;131:514-17.
- 17.Ulukol B, Günlemez A, Aysev D, et al. Alternative diagnostic method for streptococcal pharyngitis: Breese scoring system. Turk J Pediatr 2000;42:96-100.
- 18.Le Marechal F, Martinot A, Duhamel A, et al. Streptococcal pharyngitis in children: a meta-analysis of clinical decision rules and their clinical variables. BMJ Open 2013;3:e001482. doi: 10.1136/bmjopen-001482.
- 19.Dobbs F. A scoring system for predicting group A streptococcal throat infection. Br J Gen Pract 1996;46:461-4.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Publication Date | December 28, 2017 |
| Submission Date | September 13, 2017 |
| Acceptance Date | December 4, 2017 |
| Published in Issue | Year 2017Volume: 2 Issue: 3 |
