Effectiveness and immunogenicity of pneumococcal vaccination in splenectomized and functionally asplenic patients C. Forstner, S. Plefka, S. Tobudic, H.M. Winkler, K. Burgmann, H. Burgmann Department of Internal Medicine I Division of Infectious Diseases and Tropical Medicine Medical University of Vienna Dr. Stephanie Plefka
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Effectiveness and immunogenicity of pneumococcal vaccination in splenectomized and functionally asplenic patients C. Forstner, S. Plefka, S. Tobudic, H.M.
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Effectiveness and immunogenicity of
pneumococcal vaccination in splenectomized and
functionally asplenic patients
C. Forstner, S. Plefka, S. Tobudic, H.M. Winkler, K. Burgmann,
H. Burgmann
Department of Internal Medicine IDivision of Infectious Diseases and Tropical Medicine
Splenectomized and functionally asplenic patients are at an increased risk of overwhelming post-splenectomy infection (OPSI) and invasive pneumococcal disease (IPD) caused particularly by Streptococcus pneumoniae1:
Sepsis
Meningitis
Pneumonia
1 - Di Carlo I, Primo S, Pulvirenti E, Toro A. Should all splenectomised patients be vaccinated to avoid OPSI? Revisiting an old concept: an Italian retrospective
- Waghorn DJ. Overwhelming infection in asplenic patients: current best practice preventive measures ar not being followed. J Clin Pathol 2001; 54:214-8
- Ejstrud P, Kristensen ´B, Hansen JB, Madsen KM, Schonheyder HC, Sorensen HT. Risk and patterns of bacteremia after splenectomy: a population-based study. Scand J Infect Dis 2000; 32:521-5
- Kyaw MH, Holmes EM, Toolis F, Wayne B, Chalmers J, Jones IG, et al. Evaluation of severe infection and survival after splenectomy. Am J Med 2006; 110:276e1-7e.
Background
Current guidelines2:
Vaccination with the 23-valent pneumococcal
polysaccaride vaccine (PPV23) after SPE
Revaccination after 3-5 years
2 Davies JM, Lewis MPN, Wimperis J, Rafi I, Ladhani S, Bolton-Maggs HB, Rewiewof guidelines for the prevention andtreatment of infection in patients with an absent or dysfunctional spleen: prepared on behalf of the British committee for standards in haematology by a working part if the haemato-oncology task force. Br J Haematol 2011; 155:308-17.
Aims
Investigation of the effectiveness of pneumococcal vaccination, using PPV23 and PCV7, in preventing OPSI and IPD among patients after splenectomy and patients with a congenitally absent or dysfunctional spleen.
Induction of serological response
Methods
Study Design
Single-centre observational trial
a. Retrospective analysis
b. Prospective determination
Ad a.) OPSI or IPD in post-splenectomized patients?