ÖZ

Amaç

Böbrek nakli, son dönem böbrek yetmezliği olan hastalarda en başarılı sağkalım sağlayan renal replasman tedavi seçeneğidir. Ancak böbrek nakli sonrasında uygulanan immün baskılayıcı ajanlar fırsatçı enfeksiyon riskini artırmaktadır. Microsporidialar, immün sistemi baskılanmış hastalarda ölümcül olabilen zorunlu hücre içi patojenlerdir. Bu çalışmada böbrek nakil hastalarında microsporidia prevalansının belirlenmesi ve tespit edilen türlerin moleküler karakterizasyonunun yapılması amaçlandı.

Yöntemler

Böbrek nakli hastalarında renal microsporidiosis prevalansını değerlendirmek için toplam 325 hastadan alınan idrar örnekleri Encephalitozoon spp. ve Enterocytozoon bieneusi açısından gerçek zamanlı ve nested polimeraz zincir reaksiyonu ile analiz edildi.

Bulgular

Erişkin hastalardan sadece biri (%0,4) Encephalitozoon türleri yönünden pozitif belirlendi, çocuk hastalarda ise pozitiflik saptanmadı. ITS rRNA gen bölgesi sekans analizi sonucunda tespit edilen türün Encephalitozoon intestinalis olduğu görüldü. Bu çalışma ile Türkiye’de ilk kez insanlardan izole edilen bir microsporidia türü karakterize edilerek GenBank’a kaydedildi.

Sonuç

Elde edilen epidemiyolojik sonuçlar, renal transplant hastalarında renal microsiporidiosis prevalansının çok düşük olduğunu göstermektedir. Ayrıca tespit edilen izolatın filogenetik analizi sonucunda Kayseri’de köpeklerden bildirilen izolatlarla %100 benzer olduğu görüldü. Bu çalışma microsporidiaların zoonotik bulaşma dinamikleri açısından önemli bir veri sağlamaktadır.

Anahtar Kelimeler: Renal microsporidiosis, Encephalitozoon intestinalis, zoonotik bulaş, böbrek nakli, Türkiye

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Renal Transplant Alıcılarında Renal Microsporidiosis Prevalansı ve Encephalitazoon intestinalis Moleküler Karakterizasyonu

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References