Bakteriyel Etkenler

Server Yağcı; Yasemin Ay Altıntop; Esma Saatçi

doi:10.37609/akya.3281

Yazarlar

Server Yağcı

https://orcid.org/0000-0003-1956-6074

Yasemin Ay Altıntop

https://orcid.org/0000-0002-6586-5561

Esma Saatçi

https://orcid.org/0000-0002-6521-2077

DOI: https://doi.org/10.37609/akya.3281.c11622

Özet

Afet sonrası toplu yaşam; yetersiz hijyen ve beslenmeyle bağışıklığın azalması üst ve alt solunum yolu enfeksiyonlarını artırabilmektedir. Bu enfeksiyonlarda bakteriyel etkenler virüslerden sonra ikinci sırada görülür. Tsunami sinüziti en çok görülen üst solunum yolu enfeksiyonudur. Deniz kumunun sinüslerde birikmesiyle oluşur ve çoklu gram negatif bakteriler en sık görülen etkendir. Alt solunum yolu salgınlarında ise en sık sırasıyla Streptococcus pneumoniae, Haemophilus influenzae, Bordetella pertussis, Legionella spp. ve Mycobacterium tuberculosis etken olmaktadır. Tüberküloz hastalığının doğası gereği afet dönemlerinde yaşam koşullarının fiziksel değişkenliğinden dolayı daha hızlı yayılabilir. Afetzedelerin kişisel risk faktörlerinin artması ile latent tüberküloz vakalarının aktif hale geçmesinde artış gözlenir. Afet sonrasında tüberküloz dışı mikobakteri enfeksiyonlarında da bozulmuş ekosisteme bağlı olarak artış görülmektedir. Solunum yolu örneklerinin özelliklerine bağlı olarak ayırıcı tanıda zorluklar yaşanabilmektedir. Solunum yolu enfeksiyonlarının tanısında kültür halen altın standart yöntem olarak yerini korumaktadır. Ancak afet dönemlerinde tanı için hızlı boyama yöntemleri, hasta başı hızlı moleküler yöntemler ile tanı konulması ve direnç patentlerinin belirlenmesi ile vakaların tedavisi zamanında yapılmalıdır. Akut solunum yolu enfeksiyonu tanısında kullanılan sendromik panel testlerinin pratik ve maliyet etkin bir yöntem olarak kullanımı için ise biraz daha zamana ihtiyaç vardır.

Communal living after the disaster; decreased immunity due to inadequate hygiene and malnutrition can increase upper and lower respiratory tract infections. Bacterial pathogens are seen second only to viruses. Tsunami sinusitis is the most common upper respiratory tract infection. It occurs when sea sand accumulates in the sinuses and gram-negative bacteria are the most common agents. The most common pathogens in bacterial lower respiratory tract epidemics due to disasters are Streptococcus pneumoniae, Haemophilus influenzae, Bordetella pertussis, Legionella spp. and Mycobacterium tuberculosis. Due to the nature of tuberculosis disease, it can spread more rapidly during disaster periods because of the physical variability of living conditions. There is an increase in the activation of latent tuberculosis cases due to increased personal risk factors of disaster victims. There is also an increase in non-tuberculous mycobacterial infections after a disaster based on the disrupted ecosystem. Difficulties may be experienced in differential diagnosis depending on the characteristics of respiratory tract samples. Culture remains the gold standard method in the diagnosis of respiratory tract infections. However, rapid staining methods for the diagnosis in disaster periods, diagnosis with rapid molecular methods at the bedside, determination of resistance patents, and treatment of cases should be done in a timely manner. Time is needed for research of syndromic panel tests used in the diagnosis of acute respiratory tract infection to be used as a practical and cost-effective method.

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