Molekularno dokazovanje virusnih in bakterijskih povzročiteljev težko potekajočih pljučnic

Erzar, Kaja (author), Petrovec, Miroslav (mentor), Uršič, Tina (comentor)

Pljučnica je najpogostejši vzrok za obravnavo bolnika v bolnišnici in tudi najpogostejši vzrok smrti. Povzročajo jo tako bakterije kot virusi in glive. V preteklosti je bilo več pozornosti usmerjenih v klasično mikrobiološko diagnostiko bakterijskih in glivnih povzročiteljev. Z razvojem sodobnih molekularnih metod se je močno izboljšala možnost diagnostike tudi za virusne povzročitelje. V okviru magistrskega dela smo želeli opredeliti virusno in bakterijsko etiologijo težko potekajočih pljučnic pri odraslih osebah. V raziskavo smo vključili 117 vzorcev spodnjih dihal, ki so bili zbrani v okviru prospektivne študije pri bolnikih, ki so bili zaradi pljučnice zdravljeni na Oddelku intenzivne terapije, Klinike za infekcijske bolezni in vročinska stanja, UKC Ljubljana. Za podrobnejšo etiološko opredelitev, smo rezultatom komercialnega molekularnega sistema, ki smo ga uporabili v naši raziskavi, dodali rezultate pridobljenih z bakterijsko kultivacijo in molekularno diagnostiko atipičnih povzročiteljev pljučnice, ki so bili pridobljeni v času prospektivne študije. Etiološko smo povzročitelja uspeli dokazati pri 78,6 % bolnikov. Kot edini povzročitelji pljučnice, se najpogosteje pojavljajo virusi. Najpogosteje se je pojavljal virus influence A (18,8 %). Najpogosteje dokazana bakterija je bila S. pneumoniae (15 %). Več kot enega povzročitelja smo dokazali pri 27,4 % bolnikov, pri čemer so prevladovale virusno bakterijske okužbe (18 %). Z raziskavo smo potrdili, da uporaba modernih molekularnih metod predstavlja pomembno orodje pri mikrobiološki diagnostiki pljučnic, saj nam omogočajo visoko specifičen in hitrejši način vpogleda v etiologijo pljučnic.

• Language: Slovenian
• Keywords: okužbe dihal, pljučnica, virusna pljučnica, bakterijska pljučnica, atipična pljučnica, virusi, bakterije, molekularna diagnostika, verižna reakcija s polimerazo, RT-PCR v realnem času
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: BF - Biotechnical Faculty
• Place of publishing: Ljubljana
• Publisher: [K. Erzar]
• Year: 2021
• PID: 20.500.12556/RUL-129566
• UDC: 579.61:616.24-078:577.2.088
• COBISS.SI-ID: 74978307
• Publication date in RUL: 05.09.2021

ERZAR, Kaja, 2021, Molekularno dokazovanje virusnih in bakterijskih povzročiteljev težko potekajočih pljučnic [online]. Master’s thesis. Ljubljana : K. Erzar. [Accessed 1 April 2025]. Retrieved from: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=eng&id=129566

Secondary language

• Language: English
• Title: Molecular detection of viral and bacterial pathogens in patients with severe pneumonia

Abstract

Pneumonia has been defined as an infection of lung parenchyma, and is the leading cause of hospitalization and death in developed countries. It is usually caused by infectious pathogens, bacterial, viral and fungal. In previous years classical microbiology methods were used in pneumonia patients where the therapeutic intervention was relatively effective. With the development of molecular microbiology methods the diagnostics of viral agents has been greatly improved. The aim of our study was to identify viral and bacterial etiology in patients with severe pneumonia. We tested 117 samples of the lower respiratory track. Samples were collected under the main prospective study from patients who have been due to severe pneumonia treated in Department of Intensive therapies (OIT), Department of Infectious Diseases University Medical Centre Ljubljana. The samples in our study were tested with commercial molecular system. For a detailed identify of pneumonia etiology, we added the results obtained by bacterial cultivation and molecular diagnostics of atypical pneumonia agents obtained during the prospective study. Causative agent was detected in 78,6 % of patients. Viruses were the most common cause of pneumonia. Influenza A was the most common detected virus (18,8 %). The most commonly detected bacteria was S. pneumoniae (15 %). Coinfection occurred in 27,4 % of patients, most common were viral-bacterial infections in 18 % of patients. Our study confirmed that the use of modern molecular methods is an important tool in the microbiological diagnosis of pneumonia. Molecular testing significantly improves pathogen detection with a highly specific and faster way of insight into the etiology of pneumonia.

• Keywords: respiratory infection, pneumonia, viral pneumonia, bacterial pneumonia, atypical pneumonia, viruses, bacteria, molecular diagnostic, polymerase chain reaction, real time RT-PCR