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新生儿百日咳感染的管理和预防。

Management and prevention of pertussis infection in neonates.

机构信息

Department of Health Sciences, Anna Meyer Children's University Hospital, University of Florence, Viale Pieraccini 24, I-50139, Florence, Italy.

出版信息

Expert Rev Anti Infect Ther. 2014 Dec;12(12):1515-31. doi: 10.1586/14787210.2014.979156. Epub 2014 Nov 5.

Abstract

Despite the fact that universal immunization against pertussis led to a dramatic decrease in the incidence and mortality in high-income countries, it has left a window of vulnerability for newborns. Although specific guidelines concerning management of neonatal whooping cough have not yet been developed, the present review summarizes the main available recommendations on diagnostic work-up and treatment of neonatal pertussis. Additionally, new prevention strategies are explored, including the use of an additional booster dose of vaccine to adolescents and adults, vaccination of healthcare workers, immunization of household contacts and caregivers (cocooning strategy), vaccination of pregnant women and, finally, neonatal immunization with novel vaccines. These strategies are analyzed and discussed in terms of efficacy, safety and cost-effectiveness.

摘要

尽管针对百日咳的普遍免疫接种导致高收入国家的发病率和死亡率显著下降,但它为新生儿留下了一个脆弱的窗口期。尽管尚未制定关于新生儿百日咳管理的具体指南,但本综述总结了关于新生儿百日咳诊断和治疗的主要现有建议。此外,还探讨了新的预防策略,包括为青少年和成年人接种额外的加强剂量疫苗、为医护人员接种疫苗、为家庭接触者和照顾者(茧居策略)接种疫苗、为孕妇接种疫苗,以及最终为新生儿接种新型疫苗。这些策略从疗效、安全性和成本效益方面进行了分析和讨论。

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