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Vaccinations and Immunization Status in Pediatric Inflammatory Bowel Disease: A Multicenter Study From the Pediatric IBD Porto Group of the ESPGHAN
M. Martinelli, FP. Giugliano, C. Strisciuglio, V. Urbonas, DE. Serban, A. Banaszkiewicz, A. Assa, I. Hojsak, T. Lerchova, VM. Navas-López, C. Romano, M. Sladek, G. Veres, M. Aloi, R. Kucinskiene, E. Miele
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články, multicentrická studie
PubMed
31689349
DOI
10.1093/ibd/izz264
Knihovny.cz E-zdroje
- MeSH
- Crohnova nemoc farmakoterapie imunologie MeSH
- dítě MeSH
- dodržování směrnic MeSH
- idiopatické střevní záněty farmakoterapie imunologie MeSH
- imunosupresiva škodlivé účinky MeSH
- infekce virem Epsteina-Barrové prevence a kontrola MeSH
- latentní tuberkulóza prevence a kontrola MeSH
- lidé MeSH
- Mycobacterium tuberculosis MeSH
- očkovací schéma MeSH
- oportunní infekce imunologie prevence a kontrola MeSH
- retrospektivní studie MeSH
- ulcerózní kolitida farmakoterapie imunologie MeSH
- vakcinace normy statistika a číselné údaje MeSH
- virus Epsteinův-Barrové MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND: Vaccine-preventable diseases and opportunistic infections in pediatric inflammatory bowel disease (IBD) are increasingly recognized issues. The aims of this study were to evaluate vaccinations, immunization status, and consequent therapeutic management in children with IBD and to analyze the differences among patients diagnosed before (Group 1) and after June 2012 (Group 2). METHODS: This was a multicenter, retrospective cohort investigation. Between July 2016 and July 2017, 430 children with IBD were enrolled in 13 centers. Diagnosis, therapeutic history, vaccinations, and immunization status screening at diagnosis and at immunosuppressant (IM)/biologic initiation and reasons for incomplete immunization were retrieved. RESULTS: Vaccination rates at diagnosis were unsatisfactory for measles, mumps, and rubella (89.3%), Haemophilus influenzae (81.9%), meningococcus C (23.5%), chickenpox (18.4%), pneumococcus (18.6%), papillomavirus (5.9%), and rotavirus (1.9%). Complete immunization was recorded in 38/430 (8.8%) children, but specific vaccines were recommended in 79/430 patients (18.6%), without differences between the 2 groups. At IM start, 22% of children were tested for Epstein-Barr virus (EBV) status, with 96.2% of EBV-naïve patients starting azathioprine, without differences between Groups 1 and 2. Screening for latent tuberculosis (TB) before start of biologics was performed in 175/190 (92.1%), with up to 9 different screening strategies and numerous inconsistencies. CONCLUSIONS: We demonstrated a poor immunization status at diagnosis in children with IBD, which was not followed by proper vaccination catch-up. EBV status before IM initiation and latent TB before biologics were not adequately assessed. Thus, the overall impact of the current guidelines seems unsatisfactory.
Department of Pediatric Gastroenterology and Nutrition Medical University of Warsaw Warsaw Poland
Department of Pediatrics Medical Academy Lithuanian University of Health Sciences Kaunas Lithuania
Department of Pediatrics Sapienza University Rome Italy
Pediatric Gastroenterology and Cystic Fibrosis Unit University of Messina Messina Italy
Pediatric Gastroenterology and Nutrition Unit Hospital Materno Infantil Málaga Spain
Pediatric Institute AOK University of Debrecen Debrecen Hungary
Vilnius University Clinic of Children's Diseases Vilnius Lithuania
Citace poskytuje Crossref.org
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- $a BACKGROUND: Vaccine-preventable diseases and opportunistic infections in pediatric inflammatory bowel disease (IBD) are increasingly recognized issues. The aims of this study were to evaluate vaccinations, immunization status, and consequent therapeutic management in children with IBD and to analyze the differences among patients diagnosed before (Group 1) and after June 2012 (Group 2). METHODS: This was a multicenter, retrospective cohort investigation. Between July 2016 and July 2017, 430 children with IBD were enrolled in 13 centers. Diagnosis, therapeutic history, vaccinations, and immunization status screening at diagnosis and at immunosuppressant (IM)/biologic initiation and reasons for incomplete immunization were retrieved. RESULTS: Vaccination rates at diagnosis were unsatisfactory for measles, mumps, and rubella (89.3%), Haemophilus influenzae (81.9%), meningococcus C (23.5%), chickenpox (18.4%), pneumococcus (18.6%), papillomavirus (5.9%), and rotavirus (1.9%). Complete immunization was recorded in 38/430 (8.8%) children, but specific vaccines were recommended in 79/430 patients (18.6%), without differences between the 2 groups. At IM start, 22% of children were tested for Epstein-Barr virus (EBV) status, with 96.2% of EBV-naïve patients starting azathioprine, without differences between Groups 1 and 2. Screening for latent tuberculosis (TB) before start of biologics was performed in 175/190 (92.1%), with up to 9 different screening strategies and numerous inconsistencies. CONCLUSIONS: We demonstrated a poor immunization status at diagnosis in children with IBD, which was not followed by proper vaccination catch-up. EBV status before IM initiation and latent TB before biologics were not adequately assessed. Thus, the overall impact of the current guidelines seems unsatisfactory.
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