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2008-2020年挪威完整脊髓切除术患者的疫苗接种指南的遵守,挪威,2008-2020年

Saima Orangzeb¹, Sara Viksmoen Watle¹, Dominique A Caugant¹

¹Department of Community Medicine and Global Health, Faculty of Medicine, University of Oslo, Oslo, Norway; Division for Infection Control, Norwegian Institute of Public Health, Oslo, Norway.

|June 19, 2023

概括

在挪威,脊髓切除术患者的疫苗接种覆盖率很低,这增加了他们感染侵入性细菌感染的风险. 提高肺炎球菌和脑膜炎球菌等疫苗的免疫率对于预防这些感染在阿斯普莱尼克患者中至关重要.

科学领域:

免疫学免疫学免疫学
公共卫生公共卫生
流行病学流行病学

背景情况:

脏在过血液和对病原体的免疫反应中发挥着至关重要的作用.
手术切除脏 (脊髓切除术) 增加了严重感染的终身风险,特别是来自封装细菌的风险.
对于没有脏的人来说,建议接种疫苗,以预防由肺炎菌,脑膜炎菌和b型流感菌 (Hib) 引起的感染.

研究的目的:

评估在挪威接受了手术脊髓切除术的患者中对关键细菌病原体的疫苗接种覆盖率 (VC).
确定免疫状况的差距,并评估疫苗接种对预防风险人群中侵袭性细菌感染的潜在影响.

主要方法:

来自挪威患者登记,国家免疫登记和挪威传染病监测系统的患者数据的回顾性分析.
通过使用Nomesco手术程序分类代码识别了3155名经过完全脊髓切除术的患者.
对肺炎球菌结合疫苗 (PCV),肺炎球菌多糖体疫苗,脑膜炎球菌疫苗 (ACWY和血清组B) 和Hib疫苗的疫苗接种状态的评估.

主要成果:

观察到疫苗接种覆盖率较低:29.0%接种PCV至少一剂,42.0%接种肺炎球菌多糖体疫苗,18.7%接种两种疫苗.
脑膜炎球菌疫苗覆盖率特别低 (在2014年后的患者中,ACWY为4.2%,血清组B为8.0%).
Hib疫苗覆盖率为18.7%,尽管在10岁以下的儿童中很高. 所有疫苗的覆盖率都随着年龄的增长而下降. 脊髓切除术后发生了29例侵入性细菌感染,其中8例可能通过疫苗接种预防.

结论:

在挪威的脊髓切除患者中,接种疫苗的覆盖率低于最佳水平,特别是对于脑膜炎球菌疫苗.
年龄是一个重要因素,老年人群的覆盖率较低.
显然需要有针对性的干预措施来提高免疫率,并减少阿斯普莱尼病患者的侵入性细菌感染负担.

关键词:

阿斯普莱尼亚症 (Asplenia) 是一个侵袭性细菌性疾病是一种侵袭性细菌性疾病.脊髓切除术后感染的压倒性影响是巨大的.脊椎切除术 (Splenectomy) 是一个切除脊椎的方法.接种疫苗的覆盖范围

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