欧洲儿科透析患者的流感和肺炎球菌疫苗接种率：建议与现实的差距一项欧洲儿科透析工作组和欧洲儿科学肾脏病学会透析工作组的研究。

Influenza and pneumococcus vaccination rates in pediatric dialysis patients in Europe: recommendations vs reality A European Pediatric Dialysis Working Group and European Society for Pediatric Nephrology Dialysis Working Group study.

机构信息

Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey

Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

出版信息

Turk J Med Sci. 2021 Dec 13;51(6):2881-2886. doi: 10.3906/sag-2012-26.

DOI:10.3906/sag-2012-26

PMID:33535736

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10734874/

Abstract

BACKGROUND/AIM: Children on dialysis are under increased risk of influenza and invasive pneumococcal disease. Although vaccination against these microorganisms are recommended in dialysis patients and despite the fact that these vaccines can reduce disease burden and rates of hospitalization due to infection, vaccination rates are below expected and desired. We aimed to evaluate influenza and pneumococcal vaccination and infection rates in European pediatric dialysis centers.

MATERIALS AND METHODS

In 16 centers from 11 countries, 357 pediatric dialysis patients were evaluated retrospectively during 1 year of observation period between 01.01.2014 and 01.01.2015.

RESULTS

In all centers, vaccination policy included immunization of dialysis patients with inactive influenza vaccine and pneumococcal conjugate vaccine (PCV). Fifty percent of the centers recommended pneumococcal polysaccharide vaccine following routine PCV series. A significantly higher pneumococcal vaccination rate (43.9%) was seen in peritoneal dialysis (PD) patients compared to those on hemodialysis (HD) (32.9%) (p = 0.035), while the rates for influenza were similar (42.4% and 46.1% respectively, p = 0.496). Among all dialysis patients, 2.2% (n = 8) developed pneumonia and 6.4% (n = 23) was infected by Influenza. Pneumococcic pneumonia rate was 5% for 140 patients who received antipneumococcal vaccine, while only one pneumonia episode was recorded out of 217 unvaccinated patients (p = 0.007). The influenza virus infection rates were similar for patients vaccinated and nonvaccinated (7 % and 6 %, respectively).

CONCLUSIONS

Although influenza and pneumococcal vaccines are highly recommended in pediatric dialysis patients, vaccination rates were lower than expected. Pneumococcal vaccination rates were higher in PD compared to the patients on HD. The rate of children with influenza infection was higher than pneumonia. The efficacy of influenza and pneumococcal vaccines was highlighted by the low infection rates. Higher pneumonia rates in patients vaccinated against pneumococcus compared to unvaccinated ones might be due to coexisting risk factors.

摘要

背景/目的：接受透析治疗的儿童感染流感和侵袭性肺炎球菌病的风险增加。尽管透析患者推荐接种这些微生物疫苗，并且这些疫苗可以降低因感染导致的疾病负担和住院率，但疫苗接种率仍低于预期和理想水平。我们旨在评估欧洲儿科透析中心的流感和肺炎球菌疫苗接种和感染率。

材料和方法

在 11 个国家的 16 个中心，对 357 名儿科透析患者进行了回顾性评估，观察期为 2014 年 1 月 1 日至 2015 年 1 月 1 日的 1 年。

结果

所有中心的疫苗接种政策均包括为透析患者接种无活性流感疫苗和肺炎球菌结合疫苗（PCV）。50%的中心建议在常规 PCV 系列后接种肺炎球菌多糖疫苗。与血液透析（HD）患者（32.9%）相比，腹膜透析（PD）患者的肺炎球菌疫苗接种率（43.9%）显著更高（p=0.035），而流感疫苗接种率相似（分别为 42.4%和 46.1%，p=0.496）。在所有透析患者中，有 2.2%（n=8）发生肺炎，6.4%（n=23）感染流感。在接受抗肺炎球菌疫苗接种的 140 名患者中，肺炎球菌肺炎发生率为 5%，而在 217 名未接种疫苗的患者中，仅有 1 例肺炎发作（p=0.007）。接种疫苗和未接种疫苗的患者流感病毒感染率相似（分别为 7%和 6%）。