改善肺炎球菌疫苗接种率在免疫抑制的儿科患者与类风湿性疾病
Julia G Harris1,2, Jordan T Jones1,2, Leslie Favier1,2
1From the Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Mo.
Pediatric quality & safety
|May 16, 2024
概括
患有风湿性疾病的免疫抑制患者患有肺炎球菌疾病的风险很高. 一个质量改进项目成功提高了肺炎球菌疫苗接种率,大大降低了这种风险.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 预防传染病 预防传染病
背景情况:
- 患有风湿性疾病的患者经常经历免疫抑制,增加了侵入性肺炎球菌疾病的风险.
- 系统性红斑狼,混合结合组织疾病,青少年皮肤肌炎和系统性血管炎是与这种高风险相关的关键条件.
研究的目的:
- 实施质量改进项目,以提高高风险,免疫抑制患者肺炎球菌疫苗接种率.
- 目标1:在一年内,在全身性红斑狼和混合结缔组织疾病患者中,增加肺炎球菌疫苗接种率,从9.6%增加到80%.
- 目标2:在一年内,在患有全身性红斑狼,混合性结缔组织疾病,青少年性皮肤肌炎和全身性血管炎的免疫抑制患者中,增加疫苗接种率,从62.6%增加到80%.
主要方法:
- 利用质量改进框架进行干预,包括免疫算法,患者报告,教育,提醒和预访规划.
- 针对13性肺炎球菌结合疫苗 (PCV13) 和23性肺炎球菌多糖体疫苗 (PPSV23) 的监测疫苗接种情况.
- 定义主要结果是PCV13和PPSV23疫苗接种完全最新.
主要成果:
- 第一个阶段,肺炎球菌联合疫苗接种率从9.6%大幅增加到91.1%,持续高率.
- 第二阶段表现出明显的改善:PCV13的发病率从68.8%上升到93.4%,PPSV23的发病率从65.2%上升到88.5%,综合发病率从62.6%上升到86.5%.
结论:
- 质量改进举措有效地增加并维持了高风险,免疫抑制患者群体的肺炎球菌疫苗接种覆盖率.
- 这些努力对于减轻侵袭性肺炎球菌病在脆弱个体中的发病率至关重要.
- 持续优先考虑疫苗接种计划对于患者安全和疾病预防至关重要.
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