Öz
Amaç
Bu çalışmada ishal şikayeti ile başvuran immünosüpresif hastalarda Cryptosporidium spp. sıklığını mikroskobik, serolojik ve moleküler yöntemlerle araştırmayı ve sonuçları direkt floresan antikor (DFA) yöntemi ile karşılaştırarak değerlendirmeyi amaçladık.
Yöntemler
İmmünosüpresif ishalli hastalardan alınan 90 dışkı örneği çalışmaya alınmıştır. Cryptosporidium spp. tespiti amacıyla tüm dışkı örneklerine modifiye asit fast boyama, polimeraz zincir reaksiyonu (PZR) ve enzyme-linked immunosorbent assay (ELISA) testi uygulanmıştır. DFA yöntemi ile incelenen örnekler, diğer tanı testlerinde pozitif bulunan örneklere ek olarak diğer örneklerden rastgele seçilmiştir. Bu tanı yöntemlerinden herhangi biriyle pozitif saptanan dışkı örnekleri immünokromatografik kart test ile değerlendirilmiştir.
Bulgular
Çalışmaya alınan 90 örneğin 44’ü (%48,8) erkek, 46’sı (%51,2) kadın hastalara aittir. Hastaların yaş ortalaması 37,8±27,5 olarak bulunmuştur. Çalışmada çocuk hastalara ait 31 (%34,4) örnek bulunmaktadır ve bu hastaların yaş ortalamaları 5,3±4,34 olarak tespit edilmiştir. Kullanılan yöntemlerin hiçbirinde hastaların pozitiflik durumu ile yaşı ve cinsiyeti arasında istatistiksel olarak anlamlı bir farklılık bulunmamıştır (p>0,05). Çalışılan dışkı örneklerinde modifiye asit fast yöntemiyle 5 (%5,6), PZR ile 2 (%2,2), ELISA yöntemiyle 1 (%1,1) örnekte Cryptosporidium spp. pozitif tespit edilmiştir. DFA yöntemi uygulanan 51 örneğin 6’sı pozitif saptanmıştır. Bu yöntemlerden herhangi biri ile pozitif bulunan 7 dışkı örneğinin 4’ünde immünokromatografik kart test ile Cryptosporidium spp. pozitif tespit edilmiştir.
Sonuç
Cryptosporidium spp. tanısında DFA yöntemi altın standart yöntem kabul edildiğinde modifiye asit fast yöntemi yüksek duyarlılık ve özgüllükle rutin tanıda kullanılabilir. Ayrıca yoğun iş akışı olan laboratuvarlarda immünokromatografik tanı testlerinin pratik kullanımı ve hızlı sonuç sağlaması nedeniyle faydalı olacağı düşünülmektedir.
Anahtar Kelimeler: Cryptosporidium, ishal, direkt floresan antikor, immünosüpresif
Kaynakça
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