Yao Zhijian, Kido Takahiro, Hosaka Sho, Imagawa Kazuo, Fukushima Hiroko, Morio Tomohiro, Nonoyama Shigeaki, Takada Hidetoshi
Doctoral Program in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan.
Pediatr Int. 2025 Jan-Dec;67(1):e70093. doi: 10.1111/ped.70093.
Differences in infection prevention methods and their corresponding effects on patients with inborn errors of immunity (IEI) between departments that treat patients with IEI and other departments, such as local hospitals, are not known.
We compared the differences in infection prevention methods between low-volume departments (treating fewer than 20 patients with IEI) and high-volume departments (treating 20 or more patients with IEI) using recent nationwide survey data from Japan.
There was an uneven distribution of IEI categories between low- and high-volume departments. High-volume departments have set higher target trough levels for immunoglobulin replacement therapy in patients with BTK deficiency and those who have undergone transplantation. Furthermore, sulfamethoxazole-trimethoprim and itraconazole were used more frequently in high-volume departments for patients with hyper-IgE syndrome. Additionally, more patients with common variable immunodeficiency in high-volume departments received inactivated vaccines, whereas low-volume departments used macrolides more frequently than prophylactic antibiotics. Overall, infection prevention management appeared to be relatively similar in low- and high-volume departments. However, there were some notable differences in the specific practices.
The latest and most optimal infection control methods must be shared with every department where patients with IEI are treated.
治疗先天性免疫缺陷(IEI)患者的科室与其他科室(如当地医院)在感染预防方法及其对IEI患者的相应影响方面的差异尚不清楚。
我们使用来自日本近期的全国性调查数据,比较了低容量科室(治疗少于20例IEI患者)和高容量科室(治疗20例或更多IEI患者)在感染预防方法上的差异。
低容量科室和高容量科室之间IEI类别分布不均衡。高容量科室为BTK缺乏症患者和接受移植的患者设定了更高的免疫球蛋白替代治疗目标谷浓度。此外,对于高IgE综合征患者,高容量科室更频繁地使用磺胺甲恶唑-甲氧苄啶和伊曲康唑。此外,高容量科室中更多的常见可变免疫缺陷患者接受了灭活疫苗,而低容量科室比预防性抗生素更频繁地使用大环内酯类药物。总体而言,低容量科室和高容量科室的感染预防管理似乎相对相似。然而,在具体做法上存在一些显著差异。
必须与治疗IEI患者的每个科室分享最新和最优化的感染控制方法。