Virüs ve bakteri gibi çeĢitli enfeksiyon etkenlerinin naklinde oldukça etkili bir role sahip olan keneler ve onların meydana getirdiği kene kökenli hastalıkların önemi son yıllarda giderek artmaktadır. Bu artıĢ, insanoğlunun tabiatla olan iliĢkisinde ona karĢı takındığı bencil tavrın olası sonuçlarından yalnızca biri olan küresel iklim değiĢikliği ile yakından iliĢkilidir (Bezirtzoglou ve ark., 2011). Ġnsanlarda görülen tüm rickettsial hastalıklar zoonotik karakterlidir (Bitam ve Raoult, 2009) ve bu hastalıkların insana naklinde son derece önemli olan vektörlerini tanımak, en az hastalık etkenini tanımak kadar önemlidir.
Bu bağlamda çalıĢmamızda 2006, 2007 ve 2008 yıllarına ait Tokat bölgesinde insanlar üzerinde parazitlenen yaklaĢık 600 kene örneği tür teĢhisi yapılarak Rickettsia varlığı bakımından araĢtırılmıĢtır. Bu araĢtırma neticesinde, moleküler teknikler kullanılarak, kene tutunması Ģikayetiyle hastaneye baĢvuran insanlar üzerinden alınan kene örneklerinden 38‟inde Rickettsia varlığı saptanmıĢtır (Bkz. Çizelge 4.2).
Bulgular baĢlığı altında bahsedildiği üzere Rickettsia bakımından pozitif 38 kene örneğinde; Rickettsia aeschlimannii, Rikettsia sibirica, Rickettsia slovaca, Rickettsia
japonica, Rickettsia hoogstraalii, Rickettsia raoulti ve Rickettsia marmionii olmak
üzere 7 farklı Rickettsia türünün bulunduğu tespit edilmiĢtir. Hyalomma
marginatum‟da R.aeschlimannii ve D.marginatus‟ta R.raoultii dıĢındaki tüm örnekler
ülkemiz için ilk kayıt özelliğindedir.
Rickettsia taĢıdığı saptanan 38 örneğin vektör olarak kullandıkları keneler, bölgemizde
özellikle yaz aylarında yoğun olarak görülen Hyalomma marginatum (%57),
Rhipicephalus bursa (%12) ve Dermacentor marginatus (% 11) türleridir. YaklaĢık
600 kene örneği için Rickettsia prevalansı %7,40 olarak saptanmıĢtır ki bu oldukça yüksek bir orandır.
Kene ısırığı olan kiĢilerde herhangi bâriz bir klinik sempttom görülmese de riketsiyoz testinin yapılmasında fayda bulunmaktadır. Kene kökenli Rickettsia türleri tarafından enfekte olan bireylerde sonradan kalp ve damar bozukluklarını geliĢebileceği gerçeği göz önünde bulundurularak, tanı konusunda daha dikkatli davranılması gerektiği göz ardı edilmemelidir.
Bu çalıĢmada bazı sert kenelerde Rickettsia varlığı ilk kez rapor edilmiĢ olup aslında riketsiyoz vakalarının diğer ülkeler gibi ülkemizde de bulunduğunu ve fakat büyük bir ihtimalle özel testler yapılmadığı için Rickettsia vakâlarının çoğuna tanı koyulmaksızın kaçırıldığı düĢünülmektedir. Bu anlamda Rickettsia türleri ve onların vektörlerine iliĢkin yapılacak ileriki çalıĢmalar, ülkemizin kene kökenli hastalıklar alanındaki eksikliğinin kapatılması açısından önemli derecede faydalı olacaktır.
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