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儿科急诊科收治的动物咬伤患儿破伤风疫苗接种状况核查

Verification of tetanus vaccination status of children admitted for animal bites in a pediatric emergency department.

作者信息

Nibbio Mathilde, de Jorna Claire, Lagrée Marion, Diallo Diariatou, Leruste Constance, Liber Melany, Dubos François

机构信息

CHU de Lille, Urgences pédiatriques & maladies infectieuses, Lille, France.

Univ. Lille, ULR2694: METRICS, Évaluation des technologies de santé et des pratiques médicales, Lille, France.

出版信息

Hum Vaccin Immunother. 2025 Dec;21(1):2559509. doi: 10.1080/21645515.2025.2559509. Epub 2025 Sep 15.

Abstract

Animal bites are high-risk wounds for tetanus. Our objective was to verify that children admitted to the pediatric emergency department (PED) for bites had reliable management of the risk of tetanus. This retrospective descriptive study was conducted at Lille University Hospital between 2015 and 2020. Patients under the age of 16 years admitted to the PED for bite wounds were included. The rate of appropriate management was calculated using a strict or pragmatic definition, based on the presentation or not of the health booklet. Among 336 patients included (median age 5 years, 47% boys, 69% wounds on the face; 90% of bites by dogs), 86% had their vaccination status mentioned in the medical observation, more often during daytime hours ( = .02) and by the medical team (as compared to the surgical team;  < 10). 90% of these were declared up-to-date for their tetanus vaccination. Management was deemed appropriate in 16% according to the strict definition and in 80% using the pragmatic definition. 28 patients were not up to date (10%). Eight of these 28 (29%) had an appropriate management. The management of a bite wound must be systematized with verification of tetanus vaccination status to avoid preventable disasters.

摘要

动物咬伤是感染破伤风的高风险伤口。我们的目的是核实因咬伤而入住儿科急诊科(PED)的儿童对破伤风风险是否得到了可靠的管理。这项回顾性描述性研究于2015年至2020年在里尔大学医院进行。纳入因咬伤伤口入住PED的16岁以下患者。根据健康手册是否出示,使用严格或实用的定义计算适当管理的比例。在纳入的336例患者中(中位年龄5岁,47%为男孩,69%的伤口在面部;90%为狗咬伤),86%的患者在医疗观察中提到了疫苗接种状况,在白天(P = 0.02)以及由医疗团队提及的情况更常见(与外科团队相比;P < 0.001)。其中90%的患者被宣布破伤风疫苗接种最新。根据严格定义,16%的管理被认为是适当的,使用实用定义时这一比例为80%。28例患者疫苗接种未达最新标准(10%)。这28例中的8例(29%)得到了适当的管理。咬伤伤口的处理必须系统化,并核实破伤风疫苗接种状况,以避免可预防的灾难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eaa/12439565/a4982bb2dee1/KHVI_A_2559509_F0001_B.jpg

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