Centre of Research and Disruption of Infectious Disease, Department of Infectious Diseases, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark.
Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital-North Zealand, Denmark.
Clin Infect Dis. 2022 Aug 24;75(1):125-130. doi: 10.1093/cid/ciab856.
Risk of invasive meningococcal disease (IMD) is increased in patients with complement deficiency and human immunodeficiency virus (HIV) infection. Risk associated with comorbidity is not well described.
This was a nationwide adult case-control study. Cases for the period 1977-2018 were identified by the national meningococcus reference laboratory. Matched controls were identified by registry linkage. Comorbidities diagnosed prior to IMD were based on the International Classification of Diseases, Eighth or Tenth Revision. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by logistic regression after adjustment for sex, age, and other comorbidities.
We identified 1221 cases (45% male), with a median age of 45 years (interquartile range, 22-64 years). The dominant meningococcal serogroups were B (n = 738) and C (n = 337). Increased risk of IMD was associated with solid organ transplantation (SOT) (OR 40.47 [95% CI: 4.84-337.23]), hemolytic anemia (OR 7.56 [95% CI: 2.63-21.79]), renal disease (OR 2.95 [95% CI: 1.77-4.92]), liver disease (OR 2.54 [95% CI: 1.58-4.08]), cancer (OR 2.31 [95% CI: 1.85-2.89]), diabetes (OR 1.74 [95% CI: 1.27-2.39]), neurological disease (OR 1.72 [95% CI: 1.20-2.46]), and autoimmune disease (OR 1.70 [95% CI: 1.63-2.11]). Having 1, 2, and ≥3 comorbidities was associated with increased risk of IMD (ORs 1.6-3.5). Increased risk was not associated with specific serogroups.
This study of adults with IMD over 4 decades showed increased risk of IMD associated with renal disease, immunological disorders, liver disease, cancer, and SOT ranging from a 2- to 40-fold increased risk. Vaccination may be warranted in these populations.
补体缺陷和人类免疫缺陷病毒（HIV）感染患者侵袭性脑膜炎球菌病（IMD）的风险增加。合并症相关的风险尚未得到充分描述。
这是一项全国性的成人病例对照研究。1977 年至 2018 年期间，通过国家脑膜炎球菌参考实验室确定病例。通过登记联系确定匹配对照。在 IMD 之前诊断出的合并症基于国际疾病分类、第八或第十版。通过 logistic 回归调整性别、年龄和其他合并症后，估计比值比（OR）及其 95%置信区间（CI）。
我们确定了 1221 例病例（45%为男性），中位年龄为 45 岁（四分位间距，22-64 岁）。主要脑膜炎球菌血清群为 B（n=738）和 C（n=337）。IMD 风险增加与实体器官移植（SOT）（OR 40.47 [95%CI：4.84-337.23]）、溶血性贫血（OR 7.56 [95%CI：2.63-21.79]）、肾脏疾病（OR 2.95 [95%CI：1.77-4.92]）、肝脏疾病（OR 2.54 [95%CI：1.58-4.08]）、癌症（OR 2.31 [95%CI：1.85-2.89]）、糖尿病（OR 1.74 [95%CI：1.27-2.39]）、神经系统疾病（OR 1.72 [95%CI：1.20-2.46]）和自身免疫性疾病（OR 1.70 [95%CI：1.63-2.11]）相关。存在 1、2 和≥3 种合并症与 IMD 风险增加相关（OR 1.6-3.5）。风险增加与特定血清群无关。
这项对 40 多年来 IMD 成人的研究表明，与肾脏疾病、免疫性疾病、肝脏疾病、癌症和 SOT 相关的 IMD 风险增加，风险增加 2 至 40 倍。这些人群可能需要接种疫苗。
