狂犬病暴露后预防：比利时队列中启动时间和抗体反应的回顾性分析。
Rabies post-exposure prophylaxis: A retrospective analysis of timing of initiation and antibody responses in a Belgian cohort.
机构信息
Department of Clinical Sciences, Institute of Tropical Medicine, Kronenburgstraat 43, 2000, Antwerp, Belgium.
Department of Clinical Sciences, Institute of Tropical Medicine, Kronenburgstraat 43, 2000, Antwerp, Belgium.
出版信息
Travel Med Infect Dis. 2024 Nov-Dec;62:102761. doi: 10.1016/j.tmaid.2024.102761. Epub 2024 Sep 19.
BACKGROUND
We aimed to determine the timeliness of rabies post-exposure prophylaxis (PEP) and the proportion of individuals with an adequate antibody response post-PEP among those attending the Belgian national reference center.
METHODS
Retrospective analysis of patient records who attended our center from 2018 to 2023. Delay was defined as rabies immunoglobulin (RIG) and vaccine initiation beyond 2 calendar days after exposure. Antibodies were measured by rapid fluorescent focus inhibition test (RFFIT) after PEP in high-risk exposures. A titer ≥0.5 IU/ml was considered adequate.
RESULTS
We reviewed 317 patient records. Among individuals with inland exposure (n = 103), 85 % timely received PEP. Among travelers exposed abroad (n = 214), administration of RIG and vaccine initiation were timely in 30 % and 50 % of cases, respectively. An adequate antibody response was detected in 99.5 % (195/196) individuals.
CONCLUSION
Substantial PEP delays among travelers were observed. The robust antibody responses suggest that routine serological follow-up is not necessary for all patients.
背景
本研究旨在确定在比利时国家参考中心就诊的狂犬病暴露后预防（PEP）的及时性以及 PEP 后具有足够抗体应答的个体比例。
方法
对 2018 年至 2023 年期间来我中心就诊的患者记录进行回顾性分析。延迟定义为暴露后 2 个日历日以上开始使用狂犬病免疫球蛋白（RIG）和疫苗。高危暴露后通过快速荧光灶抑制试验（RFFIT）检测抗体。抗体滴度≥0.5 IU/ml 被认为是足够的。
结果
我们回顾了 317 例患者记录。在有内陆暴露的患者（n=103）中，85%的患者及时接受了 PEP。在国外旅行暴露的患者（n=214）中，RIG 的给药和疫苗接种的及时性分别为 30%和 50%。195/196（99.5%）名个体检测到了足够的抗体应答。
结论
观察到旅行者中存在大量的 PEP 延迟。强大的抗体应答表明并非所有患者都需要常规进行血清学随访。
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