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儿童炎症性肠病的肺炎球菌多糖疫苗接种

Pneumococcal Polysaccharide Vaccination in Pediatric Inflammatory Bowel Disease.

作者信息

Temtem Tsega, Whitworth John, Bagga Bindiya

机构信息

University of Tennessee Health Science Center, Memphis, TN, USA.

出版信息

Glob Pediatr Health. 2019 May 18;6:2333794X19849754. doi: 10.1177/2333794X19849754. eCollection 2019.

Abstract

According to current recommendations, in addition to 13-valent pneumococcal conjugate vaccine (PCV13) series, all children with inflammatory bowel disease (IBD) aged ≥2 years, with planned or current immunosuppression, should receive pneumococcal polysaccharide vaccine (PPSV23). The primary aim was to determine the PPSV23 immunization rates in our pediatric IBD patients. The secondary aim was to determine the incidence of invasive pneumococcal disease in these patients. The IBD database at Le Bonheur Children's Hospital was retrospectively reviewed to identify all cases diagnosed from 2003 to 2015. Out of 190 IBD patients, 106 on immunosuppressive drugs, whose immunization records could be obtained from the state database, were included in the study. Medical records were reviewed to determine infections seen in these patients from the time of diagnosis to date. IBD patients in our study ranged from age 2 to 18 years. Only 4 of 106 (3.7%) patients had received PPSV23 vaccine. Only 1 patient (0.9%) had probable pneumococcal disease and none with invasive pneumococcal disease. (11 patients) and colitis (4 patients) were more commonly encountered. All our patients received the recommended PCV13 vaccine. The majority of our pediatric IBD patients did not receive PPSV23 vaccine. Fortunately, we did not see a high rate of invasive pneumococcal disease in our patients suggesting that they may be protected by the primary PCV13 vaccine series. Non-pneumococcal infections were more common in this population.

摘要

根据目前的建议,除了接种13价肺炎球菌结合疫苗(PCV13)系列外,所有年龄≥2岁、计划进行或正在进行免疫抑制治疗的炎症性肠病(IBD)儿童都应接种肺炎球菌多糖疫苗(PPSV23)。主要目的是确定我们儿科IBD患者中PPSV23的免疫接种率。次要目的是确定这些患者侵袭性肺炎球菌疾病的发病率。对勒博纳尔儿童医院的IBD数据库进行了回顾性研究,以确定2003年至2015年诊断的所有病例。在190例IBD患者中,有106例正在接受免疫抑制药物治疗,其免疫接种记录可从州数据库中获取,纳入本研究。审查病历以确定这些患者从诊断到目前为止所发生的感染情况。我们研究中的IBD患者年龄在2岁至18岁之间。106例患者中只有4例(3.7%)接种了PPSV23疫苗。只有1例患者(0.9%)可能患有肺炎球菌疾病,没有侵袭性肺炎球菌疾病患者。(11例患者)和结肠炎(4例患者)更为常见。我们所有的患者都接种了推荐的PCV13疫苗。我们大多数儿科IBD患者没有接种PPSV23疫苗。幸运的是,我们在患者中没有看到高侵袭性肺炎球菌疾病发生率,这表明他们可能受到了最初的PCV13疫苗系列的保护。非肺炎球菌感染在该人群中更为常见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffdb/6537249/016d906554af/10.1177_2333794X19849754-fig1.jpg

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