Taha Muhamed-Kheir, Weil-Olivier Catherine, Bouée Stéphane, Emery Corinne, Nachbaur Gaëlle, Pribil Céline, Loncle-Provot Véronique
Invasive Bacterial Infections Unit, Institut Pasteur, Paris, France.
Service de Pédiatrie, Université de Paris VII Diderot, Paris, France.
Hum Vaccin Immunother. 2021 Jun 3;17(6):1858-1866. doi: 10.1080/21645515.2020.1849518. Epub 2021 Jan 15.
Vaccination of at-risk populations against is an important strategy to prevent invasive meningococcal disease (IMD). The objective of this study was to characterize preexisting risk factors in patients with IMD and to compare their relative importance. This case-control analysis was performed in the French national public health insurance database (). Cases consisted of all people hospitalized for IMD in France over a six-year period (2012-2017). Controls were matched by age, gender, and district of residence. Medical risk factors were identified from ICD-10 codes in the . Socioeconomic risk factors studied were low household income and social deprivation of the municipality of residence. Associations of these risk factors with hospitalization for IMD were quantified as odds ratios (ORs) between cases and controls with their 95% confidence intervals (95%CI). The medical risk factors showing the most robust associations were congenital immunodeficiency (OR: 39.1 [95%CI: 5.1-299], acquired immunodeficiency (10.3 [4.5-24.0]) and asplenia/hyposplenia (6.7 [3.7-14.7]). In addition, certain chronic medical conditions, such as autoimmune disorders (5.4 [2.5-11.8]), hemophilia (4.7 [1.8-12.2]) and severe chronic respiratory disorders (4.3 [3.1-6.2]) were also strongly associated, as was low household income (1.68 [1.49-1.80]). In conclusion, this study has documented potential risk factors associated with hospitalization for IMD in a large and comprehensive sample of individuals with IMD in France. Several of the risk factors identified may help identify groups who could benefit from targeted prevention measures (such as vaccination) in order to reduce the burden of IMD.
对高危人群进行针对[疾病名称未给出]的疫苗接种是预防侵袭性脑膜炎球菌病（IMD）的一项重要策略。本研究的目的是描述IMD患者预先存在的风险因素，并比较它们的相对重要性。这项病例对照分析是在法国国家公共医疗保险数据库（[数据库名称未给出]）中进行的。病例包括在六年期间（2012 - 2017年）在法国因IMD住院的所有人。对照按年龄、性别和居住地区进行匹配。从[数据库名称未给出]中的国际疾病分类第十版（ICD - 10）编码中识别医疗风险因素。所研究的社会经济风险因素是家庭收入低和居住市镇的社会剥夺情况。这些风险因素与因IMD住院之间的关联以病例与对照之间的比值比（OR）及其95%置信区间（95%CI）进行量化。显示出最强烈关联的医疗风险因素是先天性免疫缺陷（OR：39.1 [95%CI：5.1 - 299]）、获得性免疫缺陷（10.3 [4.5 - 24.0]）和无脾/脾功能减退（6.7 [3.7 - 14.7]）。此外，某些慢性疾病状况，如自身免疫性疾病（5.4 [2.5 - 11.8]）、血友病（4.7 [1.8 - 12.2]）和严重慢性呼吸系统疾病（4.3 [3.1 - 6.2]）也有很强的关联，家庭收入低（1.68 [1.49 - 1.80]）也是如此。总之，本研究在法国一个大型且全面的IMD患者样本中记录了与因IMD住院相关的潜在风险因素。所确定的一些风险因素可能有助于识别那些可能从针对性预防措施（如疫苗接种）中受益的群体，以减轻IMD的负担。
