Prevention of infection in asplenic adult patients by general practitioners in France between 2013 and 2016 : Care for the asplenic patient in general practice.
General practice
Infections
Splenectomy
Vaccination
Journal
BMC family practice
ISSN: 1471-2296
Titre abrégé: BMC Fam Pract
Pays: England
ID NLM: 100967792
Informations de publication
Date de publication:
12 08 2020
12 08 2020
Historique:
received:
17
04
2020
accepted:
29
07
2020
entrez:
14
8
2020
pubmed:
14
8
2020
medline:
25
9
2021
Statut:
epublish
Résumé
Guidelines that detail preventive measures against Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type b, and influenza are published annually in France to decrease the risk of severe infections in immunocompromised patients. We aimed at describing adherence to these guidelines by GPs in the management of their asplenic patients in France between 2013 and 2016. We conducted a multicenter retrospective study between January 2013 and December 2016 in three French hospitals: asplenic adults were identified and their GPs were questioned. A descriptive analysis was performed to identify the immunization coverage, type and length of antibiotic prophylaxis, number of infectious episodes, and education of patients. 103 patients were finally included in this study: only 57% were adequately vaccinated against Streptococcus pneumoniae or Neisseria meningitidis, 74% against Haemophilus influenzae type b, and 59% against influenza. Only 24% of patients received a combination of all four vaccinations. Two-thirds of patients received prophylactic antibiotics for at least 2 years. Overall, this study found that 50% of splenectomized patients experienced at least one pulmonary or otorhinolaryngological infection, or contracted influenza. These data match those reported in other countries, including Australia and the United Kingdom, meaning a still insufficient coverage of preventive measures in asplenic patients. Improved medical data sharing strategies between healthcare professionals, along with educational measures to keep patients and physicians up to date in the prevention of infections after splenectomy would improve health outcomes of asplenic patients.
Sections du résumé
BACKGROUND
Guidelines that detail preventive measures against Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type b, and influenza are published annually in France to decrease the risk of severe infections in immunocompromised patients. We aimed at describing adherence to these guidelines by GPs in the management of their asplenic patients in France between 2013 and 2016.
METHOD
We conducted a multicenter retrospective study between January 2013 and December 2016 in three French hospitals: asplenic adults were identified and their GPs were questioned. A descriptive analysis was performed to identify the immunization coverage, type and length of antibiotic prophylaxis, number of infectious episodes, and education of patients.
RESULTS
103 patients were finally included in this study: only 57% were adequately vaccinated against Streptococcus pneumoniae or Neisseria meningitidis, 74% against Haemophilus influenzae type b, and 59% against influenza. Only 24% of patients received a combination of all four vaccinations. Two-thirds of patients received prophylactic antibiotics for at least 2 years. Overall, this study found that 50% of splenectomized patients experienced at least one pulmonary or otorhinolaryngological infection, or contracted influenza.
CONCLUSIONS
These data match those reported in other countries, including Australia and the United Kingdom, meaning a still insufficient coverage of preventive measures in asplenic patients. Improved medical data sharing strategies between healthcare professionals, along with educational measures to keep patients and physicians up to date in the prevention of infections after splenectomy would improve health outcomes of asplenic patients.
Identifiants
pubmed: 32787857
doi: 10.1186/s12875-020-01237-3
pii: 10.1186/s12875-020-01237-3
pmc: PMC7425533
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
163Références
Vaccine. 2015 Mar 30;33(14):1688-94
pubmed: 25707692
Ned Tijdschr Geneeskd. 2012;156(44):A4857
pubmed: 23114171
J Healthc Qual Res. 2018 Nov - Dec;33(6):343-351
pubmed: 30482647
Ir J Med Sci. 2004 Jul-Sep;173(3):136-40
pubmed: 15693382
Hum Vaccin Immunother. 2016 May 3;12(5):1277-9
pubmed: 26890256
Ann Surg. 2014 Dec;260(6):1081-7
pubmed: 24374533
Med J Aust. 2014 May 19;200(9):538-40
pubmed: 24835718
Lancet. 2011 Jul 2;378(9785):86-97
pubmed: 21474172
Ann Fam Med. 2012 Nov-Dec;10(6):538-46
pubmed: 23149531
Rev Med Interne. 2017 Jul;38(7):436-443
pubmed: 28190612
Chest. 2016 Dec;150(6):1394-1402
pubmed: 27068019
Ann Fam Med. 2017 Nov;15(6):507-514
pubmed: 29133488
Swiss Med Wkly. 2005 May 14;135(19-20):291-6
pubmed: 15986267
Can J Surg. 2011 Aug;54(4):232-6
pubmed: 21651833
Clin Infect Dis. 2018 Aug 1;67(4):557-561
pubmed: 29471470
J Infect Public Health. 2011 Sep;4(4):187-94
pubmed: 22000846
J Surg Res. 2015 Dec;199(2):580-5
pubmed: 26163332
J Infect Public Health. 2017 Nov - Dec;10(6):803-808
pubmed: 28189514
Acad Med. 2014 Mar;89(3):380-6
pubmed: 24448045
Br J Haematol. 2011 Nov;155(3):308-17
pubmed: 21988145
Hematol J. 2004;5(1):77-80
pubmed: 14745434
Hum Vaccin Immunother. 2018;14(12):2894-2899
pubmed: 30020861
Am J Hematol. 2000 Sep;65(1):25-9
pubmed: 10936859
Intern Med J. 2017 Aug;47(8):848-855
pubmed: 27925427
Epidemiol Infect. 2006 Aug;134(4):837-44
pubmed: 16371179
Ir J Med Sci. 2011 Sep;180(3):655-9
pubmed: 21298492
Am J Med. 2012 May;125(5):454-6
pubmed: 22386974
Br J Gen Pract. 2020 Feb 27;70(692):e215-e220
pubmed: 32107248
Am J Med. 2017 Jul;130(7):856-861
pubmed: 28213046
Hematol J. 2000;1(5):357-9
pubmed: 11920213
J Visc Surg. 2016 Aug;153(4):277-86
pubmed: 27289254
N Engl J Med. 2014 Jul 24;371(4):349-56
pubmed: 25054718
Immunity. 2013 Nov 14;39(5):806-18
pubmed: 24238338
Am J Med. 2006 Mar;119(3):276.e1-7
pubmed: 16490477
Ann Intern Med. 2006 May 16;144(10):742-52
pubmed: 16702590
J Thromb Haemost. 2017 Apr;15(4):785-791
pubmed: 28078756
ANZ J Surg. 2006 Jul;76(7):542-7
pubmed: 16813615