The investigation of community-acquired and nosocomial respiratory syncytial virus and other viral respiratory tract infections in children.

Although respiratory viruses are known as the major causes of community-acquired respiratory tract infections all over the world, they can also cause serious nosocomial respiratory infections and hospital outbreaks. The aim of this study is to investigate the incidence of community-acquired and nosocomial RSV and other viral respiratory tract infections in children hospitalized at the Pediatric Intensive Care Unit of Cukurova University Faculty of Medicine. Nasopharyngeal swab samples were taken from 100 children aged 0-16 years with suspected community-acquired (60) and nosocomial (40) respiratory tract infections from September 2018 to June 2021. The Multiplex real-time PCR test was used for the diagnosis of respiratory viruses. Of children with community-acquired respiratory tract infections, 65% (39/60) were positive for at least one virus and the rate of coinfection in this group was 35.9% (14/39). In children with nosocomial respiratory tract infection, positivity was detected to be 62.5% (25/40) and the coinfection rate was 40% (10/25). The most predominant virus in community-acquired respiratory tract infections was influenza A virus (25%), followed by ADV (18.3%), hBoV (15%), RSV (11.7%), and RhV (10%). In nosocomial viral respiratory tract infections, the most common virus was RSV (20%), followed by influenza A virus (12.5%), RhV (12.5%), ADV (12.5%), hMpV (10%), and hBoV (10%). Early diagnosis of respiratory viral infections with real-time PCR test is important in terms of reducing morbidity and mortality, applying control methods to prevent the spread of nosocomial viruses, shortening the hospitalization period, preventing the use of unnecessary antibiotics, and giving appropriate antiviral treatment.

BK Virus Infections and Hemorrhagic Cystitis in Allogeneic Hematopoietic Stem Cell Transplant Recipients.

BK virus (BKV) associated with hemorrhagic cystitis (HC) is the most important complication that develops after hematopoietic stem cell transplantation (HSCT) in patients with hematological malignancies. This study aims to investigate BKV infections and HC in pediatric patients after allogeneic hematopoietic stem cell transplantation. Between November 2018 and November 2019, a total of 51 patients between the ages of 11 months and 17 years were included in the study. BKV Bosphore ® v1 quantification kit (Geneworks Anatolia, Turkey) was used for the detection of BKV DNA in urine and blood samples. Among the total of 51 patients, the incidence of BKV infection was found to be 86.3%. Allogeneic HSCT was performed in 40 patients and autologous HSCT in 11 patients. BK viruria and/or viremia were detected in 85% (44) of patients who underwent allogeneic HSCT and in 90% in the autologous group. High-level BK viruria (>107 copies/mL) was found in 41% (9) of 22 patients who were BKV positive before transplantation, while in 27.5% (8) of 29 patients who were BKV negative before transplantation; thus, BKV positivity before transplantation was considered a risk factor for high-level BK viruria. Acute GVHD developed in 6 of 40 patients in the allogeneic group. HC was prevented in 12 (67%) of 18 patients who received preemptive treatment, while HC developed in 6 (33%). HC occurred at a median of 35 days (17-49 days) post-transplant. Despite preemptive treatment, 6 (15%) patients who developed HC associated with BKV were in the allogeneic group but not in the autologous group. Of these patients with HC, 5 received a myeloablative treatment regimen, and 1 patient was given a reduced-intensity treatment regimen. The viral load in urine was found to be 107-9 copies/mL within 2 weeks before the development of HC and has been identified as a prognostic indicator. In conclusion, early diagnosis of viral infections by monitoring BKV viral load in HSCT patients will be effective in preventing the progression of complications such as BKV-associated HC by providing timely initiation of preemptive treatment.