fa بررسی فراوانی ویروس انفلوانزا، SARS-CoV-2 و HRSV در گیرندگان بزرگسال پیوند کلیه بستری با عفونت حاد تنفسی: مطالعه مقطعی با روشMultiplex Real-Time RT-PCR medicine, paraclinic medicine, paraclinic پژوهشي Research <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:120%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">زمینه و هدف: گیرندگان پیوند &nbsp;کلیه به‌</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">دلیل دریافت داروهای سرکوب‌کننده ایمنی، در معرض خطر بالاتری برای عفونت‌های ویروسی تنفسی و پیامدهای شدیدتر قرار دارند. با توجه به همپوشانی بالینی </span></span></span>SARS-CoV-2<span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">، ویروس انفلوانزا و ویروس سنسیشیال تنفسی انسانی (HRSV)، تشخیص مولکولی همزمان می‌تواند در تصمیم‌گیری بالینی این بیماران اهمیت داشته باشد. هدف مطالعه حاضر، تعیین فراوانی این سه عامل ویروسی در گیرندگان بزرگسال پیوند کلیه بستری با عفونت حاد تنفسی بود.</span></span></span><span dir="LTR" style="line-height:120%"><span style="font-family:"Cambria",serif"></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:120%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">روش ها</span></span></span> <span b="" dir="LTR" nazanin="" style="font-family:">: </span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">این</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">مطالعه</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">مقطعی</span></span></span> <span b="" dir="LTR" nazanin="" style="font-family:">از آبان</span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">۱۴۰۲</span></span></span> <span b="" dir="LTR" nazanin="" style="font-family:">تا بهمن</span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">۱۴۰۳</span></span></span> <span b="" dir="LTR" nazanin="" style="font-family:">(نوامبر ۲۰۲۳ تا ژانویه/فوریه ۲۰۲۵) </span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">در</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">مرکز</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">پیوند</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">ببیمارستان</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">شهید</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">دکتر</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">لبافی</span></span></span><span b="" dir="LTR" nazanin="" style="font-family:">‌</span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">نژاد،</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">تهران،</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">ایران</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">انجام</span></span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">شد</span></span></span><span b="" dir="LTR" nazanin="" style="font-family:">. </span><span b="" dir="LTR" nazanin="" style="font-family:">نمونه‌گیری به‌ صورت در دسترس و مبتنی بر مراجعه بیماران بستری انجام گرفت و عمدتاً فصول پاییز، زمستان و بهار را پوشش داد. حضور</span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:"> ویروس ها </span></span></span><span b="" dir="LTR" nazanin="" style="font-family:">در نمونه‌های تنفسی با </span><span lang="FA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">&nbsp;روش </span></span></span><span cambria="" dir="LTR" style="font-family:">Multiplex real time RT-PCR</span><span lang="FA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:"> بررسی </span></span></span><span b="" dir="LTR" nazanin="" style="font-family:">و داده‌های</span> &nbsp;<span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">دموگرافیک</span></span></span><span b="" dir="LTR" nazanin="" style="font-family:">، بالینی و آزمایشگاهی</span> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">استخراج</span></span></span> <span b="" dir="LTR" nazanin="" style="font-family:">گردید.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:120%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">یافته‌ها: میانگین سنی بیمارا</span></span></span><b><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">ن میانگین سنی بیماران 33</span></span></span></b><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">.۱۴ </span></span></span></b><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:120%"><span calibri="" style="font-family:">&plusmn;</span></span></span></b><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:"> ۴۵.۱۶</span></span></span></b><b><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:"> سال بود (فاصله اطمینان </span></span></span></b><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">۹۵</span></span></span></b><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:120%"><span arial="" style="font-family:">٪</span></span></span></b><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">: ۴۳</span></span></span></b><b><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:"> تا </span></span></span></b><b><span lang="FA" style="font-size:10.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">۴۸</span></span></span></b><b><span lang="AR-SA" style="font-size:10.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:"> سال). </span></span></span></b><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">بیشترین فراوانی مربوط به گروه سنی ۳۵ تا </span></span></span><span lang="AR-SA" style="line-height:120%"><span b="" lotus="" style="font-family:">۴۹ سال بود. در </span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">میان ۱۴۱ نمونه واجد شرایط، </span></span></span>SARS-CoV-2<span style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:"> در ۱۸</span></span></span><span lang="AR-SA" style="line-height:120%"><span b="" lotus="" style="font-family:"> مورد </span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">(</span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span arial="" style="font-family:">٪</span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">۱۲/۸)، ویروس انفلوانزا در ۱۳ مورد (</span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span arial="" style="font-family:">٪</span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">۹/۲) و </span></span></span>HRSV<span style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:"> در یک مورد (</span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span arial="" style="font-family:">٪</span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">۰/۷) شناسایی شد. در داده‌های آزمایشگاهی ثبت‌شده، موردی از عفونت همزمان دو یا چند ویروس گزارش نشد.</span></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="line-height:120%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:">نتیجه‌گیری: در گیرندگان بزرگسال پیوند کلیه بستری با عفونت حاد تنفسی، </span></span></span>SARS-CoV-2<span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:"> و ویروس انفلوانزا عوامل غالب بودند و HRSV فراوانی پایینی داشت. با توجه به همپوشانی علائم بالینی، </span></span></span>Multiplex real time RT-PCR<span style="font-size:11.0pt"><span style="line-height:120%"><span b="" lotus="" style="font-family:"> می‌تواند به‌عنوان یک راهبرد تشخیصی ارزشمند در مراکز پیوند مورد توجه قرار گیرد؛ با این حال، برای تعمیم نتایج، مطالعات چندمرکزی با پوشش فصلی کامل و حجم نمونه بزرگ‌تر ضروری است. </span></span></span></span></span></span></span></span></span><br> &nbsp; <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span dir="LTR" style="line-height:115%">Background and Objectives:</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:120%"><span new="" roman="" style="font-family:" times=""><span style="line-height:120%">Kidney transplant recipients </span><span style="line-height:120%">are more vulnerable to respiratory viral infections because of </span><span style="line-height:120%">immunosuppressive therapy</span><span style="line-height:120%">. Given the clinical overlap between <b>SARS-CoV-2</b>, influenza virus, and </span><span style="line-height:120%">human respiratory syncytial virus (HRSV), </span><span style="line-height:120%">simultaneous molecular testing may support timely clinical decision-making. This study aimed to determine the prevalence of these viruses among hospitalized adult kidney transplant recipients with acute respiratory infection</span><span style="line-height:120%">.</span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:120%"><span new="" roman="" style="font-family:" times=""><span style="line-height:120%">Methods:</span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:120%"><span new="" roman="" style="font-family:" times=""><span style="line-height:120%">This cross-sectional study was conducted </span><span style="line-height:120%">from November 2023 to January/February 2025 (corresponding to Aban 1402 to Bahman 1403 in the Persian calendar) at </span><span style="line-height:120%">Shahid Dr. Labbafinejad Hospital, Tehran, Iran. </span><span style="line-height:120%">Convenience sampling was performed among hospitalized adult</span><span style="line-height:120%"> kidney </span><span style="line-height:120%">transplant recipients with acute respiratory infection, mainly during autumn, winter, and spring. Respiratory samples were tested for SARS-CoV-2, influenza virus, and HRSV</span><span style="line-height:120%"> using multiplex real-time RT-PCR</span><span style="line-height:120%">,</span><span style="line-height:120%"> and </span><span style="line-height:120%">demographic, </span><span style="line-height:120%">clinical</span><span style="line-height:120%">, and laboratory</span><span style="line-height:120%"> data were collected.</span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:120%"><span new="" roman="" style="font-family:" times=""><span style="line-height:120%">Results:</span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:120%"><span new="" roman="" style="font-family:" times=""><span style="line-height:120%">The mean age was 45.16 &plusmn; 14.33 years (95% CI: </span><span style="line-height:120%">43&ndash;48</span><span style="line-height:120%">years). SARS</span><span style="line-height:120%">_</span><span style="line-height:120%">CoV</span><span style="line-height:120%">_</span><span style="line-height:120%">2 </span><span style="line-height:120%">was </span><span style="line-height:120%">detected in 18 cases (</span><span style="line-height:120%">12.8%),</span><span style="line-height:120%"> influenza </span><span style="line-height:120%">virus</span><span style="line-height:120%"> in 13 cases (9.2%), and HRSV in one case (0.7%).</span><span style="line-height:120%"> No viral co-infection was recorded in the available laboratory dataset.</span><span style="line-height:120%"></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><span dir="LTR" style="line-height:115%">Conclusion:</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:120%"><span new="" roman="" style="font-family:" times=""><span style="line-height:120%">&nbsp;SARS-CoV-2 and influenza virus were</span><span style="line-height:120%"> the </span><span style="line-height:120%">dominant</span><span style="line-height:120%"> respiratory viruses </span><span style="line-height:120%">among hospitalized adult kidney transplant recipients with acute respiratory infection, whereas HRSV was uncommon. Multiplex real-time</span><span style="line-height:120%"> RT-PCR </span><span style="line-height:120%">may</span><span style="line-height:120%"> be </span><span style="line-height:120%">a valuable</span><span style="line-height:120%"> diagnostic strategy in transplant centers</span><span style="line-height:120%">, although larger multicenter studies with full seasonal coverage are needed</span><span style="line-height:120%">.</span></span></span></span><br> <br> &nbsp; انفلوانزا, SARS-CoV-2 , ویروس سنسیشیال تنفسی, پیوند کلیه, Multiplex Real-Time RT-PCR, عفونت حاد تنفسی Influenza, SARS-CoV-2, HRSV, Kidney transplantation, Multiplex real-time RT-PCR, Acute respiratory infection 0 0 http://feyz.kaums.ac.ir/browse.php?a_code=A-10-5112-1&slc_lang=fa&sid=1 Sara Heydari Sirat سارا حیدری سیرت sara_heydarisirat@modares.ac.ir 2900319475328460053727 0009-0004-1039-8494 No Tarbiat Modares University دانشگاه تربیت مدرس Somayeh Shatizadeh Malekshahi سمیه شاطی زاده ملک شاهی s.shatizadeh@modares.ac.ir 2900319475328460053728 2900319475328460053728 Yes Tarbiat Modares Univesity دانشگاه تربیت مدرس