CAMPILOBACTERIOZA LA COPII - TABLOU CLINIC ŞI CONFIRMARE ETIOLOGICĂ PRIN PCR MULTIPLEX

Abstract

Introducere. Campilobacterioza reprezintă o cauză majoră de boală diareică acută la copil, în special la vârste mici, fiind asociată cu forme severe şi risc de complicaţii. Conform ghidurilor pediatrice ESPGHAN 2020-2025, diagnosticul rapid şi precis este esenţial pentru iniţierea precoce a terapiei. Scop. Evaluarea caracteristicilor clinico-epidemiolog-ice şi de laborator ale campilobacteriozei confirmate prin PCR multiplex la copiii spitalizaţi, în vederea îmbunătăţirii conduitei terapeutice. Material şi metode. A fost realizat un studiu descriptiv-prospectiv pe un lot de 46 de copii internaţi cu diagnosticul de campilobacterioză în perioada rece a anului. Diagnosticul etiologic s-a bazat pe detecţia prin PCR multiplex din materii fecale. S-au analizat date clinice, epidemiologice şi paraclinice, aplicând teste statistice descriptive (medie, frecvenţă). Rezultate. Majoritatea pacienţilor (84,7%) au fost sugari şi preşcolari. Infecţia a fost monomicrobiană la 56,5% şi mixtă (cu rotavirus, nor-ovirus, Escherichia coli) la 43,5%. Clinic, au predominat febra, vărsăturile, hemocolita şi deshidratarea. Din rezultatele examinărilor de laborator s-au constatat leucocitoză, VSH accelerat, PCR crescut, acetonurie şi hipertransami-nazemie uşoară. Durata medie de spitalizare a fost de 5 zile, copii au fost externaţi la domiciliu în stare satisfăcătoare S-a administrat rehidratare, antimicrobiene (nifuroxazid, cotrimoxazol), antibiotice (ceftriaxonă, cefotaxim), probiotice şi tratament simptomatic. Concluzii. Studiul a demonstrat că campilobacterioza are evoluţie severă, în special la vârste mici, frecvent cu hemocolita şi sindrom toxic pronunţat. Diagnosticul prin PCR multiplex permite confirmarea rapidă a etiologiei şi ghidarea tratamentului conform recomandărilor pediatrice recente.

Introduction. Campylobacteriosis is a major cause of acute diarrheal illness in children, particularly under the age of five, and is associated with more severe forms and risk of complications. According to ESPGHAN guidelines (20202025), early and accurate etiological diagnosis is essential for optimal management. Objective. To assess the clinical, epidemiological and laboratory features of Campylobacteriosis confirmed by multiplex PCR in hospitalized children, in order to improve therapeutic conduct. Material and methods. A prospective descriptive study was conducted on a group of 46 children hospitalized with confirmed Campylobacteriosis between January and September 2024. Etiologic diagnosis was established using real-time multiplex PCR from stool samples. Clinical, epidemiological and laboratory data were analyzed using descriptive statistics (mean, frequency). Results. Most patients (84.7%) were infants and preschoolers. The infection was monomicrobial in 56.5% and mixed (with rotavirus, norovirus, Escherichia coli) in 43.5%. Clinically, fever, vomiting, hemocolitis and dehydration predominated. Laboratory examination results revealed leukocytosis, accelerated ESR, increased CRP, aceton-uria and mild hypertransaminasemia. The average length of hospitalization was 5 days, children were discharged home in satisfactory condition. Rehydration, antimicrobials (ni-furoxazide, cotrimoxazole), antibiotics (ceftriaxone, cefotaxime), probiotics and symptomatic treatment were administered, diet. Conclusion. The study demonstrated that campylobacteriosis has a severe course, especially at young ages, frequently with hemocolitis and pronounced toxic syndrome. Diagnosis by multiplex PCR allows rapid confirmation of the etiology and guidance of treatment according to recent pediatric recommendations.