Prematüre ve term doğan çocuklarda meningokok aşılaması sonrası antikor yanıtının değerlendirmesi
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Maltepe Üniversitesi, Tıp Fakültesi
Erişim Hakkı
Attribution-NonCommercial-ShareAlike 3.0 United States
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Meningokok enfeksiyonları klinik olarak asemptomatik taşıyıcılıktan, gizli bakteremiye sepsisten meningokoksemiye kadar giden geniş bir spektruma sahiptir. Aşılama, çocukları bu agresif hastalığa karşı korumanın en iyi yoludur. Prematür bebekler aşı ile önlenebilir enfeksiyonlar açısından yüksek risk altındadır, ancak yapılan araştırmalar prematür bebeklerde aşılamanın genellikle ertelendiğini göstermiştir. Prematür bebeklerde en uygun aşılanma zamanı ile ilgili yeterli kanıt olmamakla birlikte, mevcut veriler, term bebeklerdekinden farklı olmaksızın 2. aydan (takvim yaşı) itibaren aşılamaya başlanılmasını desteklemektedir. Bu çalışma ile prematüre doğmuş olan çocukların, primer menenjit aşılaması sonucu gelişmiş antikor düzeylerinin belirlenmesi ve bu düzeylerin term doğmuş ve primer menenjit aşılaması tamamlanmış çocukların antikor düzeyleri ile karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışma, Maltepe Üniversitesi Tıp Fakültesi Çocuk Sağlığı Hastalıkları polikliniğine başvuran çocuklarda prospektif klinik çalışma şeklinde yürütülmüştür. Çalışmaya katılan 80 çocuğun meningokok aşısı ile aşılanma yaşları, doğum bilgileri, ek hastalıkları, maternal yaşları sorgulanmıştır ve alınan serum örneklerinden 79 olguda Anti-Men A,C.Y,W135 Ig G antikorları ELISA yöntemi ile çalışılmıştır. Bulgular: Anti-Men A,C,Y,W135 IgG antikoru olguların tamamında pozitif (>10 IU/ml) olarak saptanmıştır. Anti meningokok antikorların geometrik ortalama konsantrasyonları preterm ve term hastalar için sırası ile 111.06 IU/ml ve 128.64 IU/ml bulunmuştur ve her iki grup arasında istatistiksel olarak anlamlı bir fark saptanmamıştır (p=0.07). Term olguların antikor düzeyleri arasında 100 İU/ml nin altında değer bulunmamaktaydı. Ancak preterm olgular arasında 100 IU/ml nin altında ölçülen 4 değer bulunmaktaydı. Bu preterm olgulardan iki tanesini 33. haftada ikiz olarak doğmuş bebekler ve diğer ikisini 35 ve 34 haftada doğmuş olgular oluşturmaktaydı. Bu bebekler sezaryen ile doğmuş olup ek hastalıkları bulunmamaktaydı. Anti-meningokok antikor düzeylerinin cinsiyete (p=0.7) ve doğum şekline (p=0.6) göre farklılık göstermediği görülmüştür. Anne yaşının aşılama sonrası gelişen antikor yanıtlarını etkilemediği görülmüştür (p=0.68). Sadece meningokok ACYW135 aşısı ile aşılananlar ile eş zamanlı olarak diğer aşıların (Meningokok B ve Rotavirus) uygulandığı olgular arasında antikor düzeyleri açısından bir fark saptanmamıştır( p=0.51). Sonuç: Term doğmuş olan olgular ile preterm doğmuş olan olguların primer menenjit aşılaması sonrası antikor yanıtları arasında fark olmadığı görülmüştür. Tekil-çoğul gebelik, sezaryen-normal doğum, anne yaşı gibi doğum özelliklerinin aşılama ile sağlanacak antikor yanıtlarına etkisi olmadığı saptanmıştır.
Introduction and Aim: Meningococcal infections can range from clinically asymptomatic carriage to occult bacteremia; it has a wide spectrum ranging from sepsis to meningococcemia. Vaccination is the best way to protect children against this aggressive disease. Premature infants are at high risk for vaccine-preventable infections, but studies have shown that vaccination in premature infants is often delayed. Although there is insufficient evidence regarding the optimal timing of vaccination in premature infants, current data support initiation of vaccination from the 2nd month (calendar age), not different from that in term infants. In this study, our aim was to determine the antibody levels developed as a result of primary meningitis vaccination series of children born prematurely and to compare these levels with the antibody levels of term born children who completed their primary meningitis vaccination series. Materials and Methods: The study was conducted as a prospective clinical study in children who admitted to Maltepe University Faculty of Medicine Pediatrics outpatient clinics. The ages of children at the time of meningococcal vaccine, birth information, additional diseases, and maternal ages of 80 children participating in the study were questioned and Anti-Men A, C.Y, W135 Ig G antibodies were studied in serum samples of 79 children. Results: Anti-Men A,C,Y,W135 IgG antibody was found to be positive (>10 IU/ml) in all participants. The geometric mean concentrations of antimeningococcal antibodies were 111.06 IU/ml and 128.64 IU/ml for preterm and term patients. No statistically significant difference was found between groups (p=0.07). The antibody levels of all term born children were above 100 IU/ml. However, there were 4 children with antibody levels below 100 IU/ml in the preterm group. Two of these preterm subjects were born as twins at 33 weeks and the other two were born at 35 and 34 weeks. These babies were born by cesarean section and had no additional diseases. It was observed that anti-meningococcal antibody levels did not differ according to gender (p= 0.7) and delivery type (p= 0.6). It was observed that maternal age did not affect the antibody responses developed after vaccination (p=0.68). There was no difference in antibody levels between those who were vaccinated with only meningococcal ACYW135 vaccine (n=13) and those who were administered other vaccines (Meningococcal B and Rotavirus) concurrently with meningococcal ACYW135 vaccine (p=0.51). Conclusion: It was observed that there was no difference between the antibody responses of the subjects born at term and those born preterm after primary meningitis vaccination series. It has been determined that birth characteristics such as single-multiple pregnancy, cesarean-normal birth, maternal age have no effect on antibody responses provided by vaccination.
Introduction and Aim: Meningococcal infections can range from clinically asymptomatic carriage to occult bacteremia; it has a wide spectrum ranging from sepsis to meningococcemia. Vaccination is the best way to protect children against this aggressive disease. Premature infants are at high risk for vaccine-preventable infections, but studies have shown that vaccination in premature infants is often delayed. Although there is insufficient evidence regarding the optimal timing of vaccination in premature infants, current data support initiation of vaccination from the 2nd month (calendar age), not different from that in term infants. In this study, our aim was to determine the antibody levels developed as a result of primary meningitis vaccination series of children born prematurely and to compare these levels with the antibody levels of term born children who completed their primary meningitis vaccination series. Materials and Methods: The study was conducted as a prospective clinical study in children who admitted to Maltepe University Faculty of Medicine Pediatrics outpatient clinics. The ages of children at the time of meningococcal vaccine, birth information, additional diseases, and maternal ages of 80 children participating in the study were questioned and Anti-Men A, C.Y, W135 Ig G antibodies were studied in serum samples of 79 children. Results: Anti-Men A,C,Y,W135 IgG antibody was found to be positive (>10 IU/ml) in all participants. The geometric mean concentrations of antimeningococcal antibodies were 111.06 IU/ml and 128.64 IU/ml for preterm and term patients. No statistically significant difference was found between groups (p=0.07). The antibody levels of all term born children were above 100 IU/ml. However, there were 4 children with antibody levels below 100 IU/ml in the preterm group. Two of these preterm subjects were born as twins at 33 weeks and the other two were born at 35 and 34 weeks. These babies were born by cesarean section and had no additional diseases. It was observed that anti-meningococcal antibody levels did not differ according to gender (p= 0.7) and delivery type (p= 0.6). It was observed that maternal age did not affect the antibody responses developed after vaccination (p=0.68). There was no difference in antibody levels between those who were vaccinated with only meningococcal ACYW135 vaccine (n=13) and those who were administered other vaccines (Meningococcal B and Rotavirus) concurrently with meningococcal ACYW135 vaccine (p=0.51). Conclusion: It was observed that there was no difference between the antibody responses of the subjects born at term and those born preterm after primary meningitis vaccination series. It has been determined that birth characteristics such as single-multiple pregnancy, cesarean-normal birth, maternal age have no effect on antibody responses provided by vaccination.
Açıklama
Anahtar Kelimeler
Neisseria meningitidis, prematürite, aşılama, meningokok enfeksiyonlar, Neisseria meningitidis, prematurity, vaccination, meningococcal infections
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Taniş, G.(2022) Prematüre ve term doğan çocuklarda meningokok aşılaması sonrası antikor yanıtının değerlendirmesi (Yayımlanmamış Uzmanlık Tezi) Maltepe Üniversitesi, Tıp Fakültesi, İstanbul.
