title: Seroprevalence of diphtheria immunity among injured adults in Austria.
abstract: Over a period of 1 year a seroepidemiological study was conducted at the outpatient clinic of a trauma department. Immunity to diphtheria was determined in serum samples from 558 injured patients (205 women and 353 men, age from 18 to 70). Diphtheria-antitoxin concentrations were measured with an enzyme immunoassay and a tissue culture toxin-neutralization assay. Sero-immunity was classified as susceptibility (<0.01 IU/ml), basic protection (0.01-<0.1 IU/ml) and full protection (>/=0.1 IU/ml) against the toxic manifestations of the disease. A total of 27.1% of the subjects were susceptible to diphtheria, 26.5% had basic protection, and 46.4% were fully protected. The median antitoxin concentration reached 0.08 IU/ml (0. 0-0.29; quartiles Q25-Q75). A non linear trend toward decreasing immunity with increasing age was observed (P<0.001) and females proved less protected than males (P=0.006). The country of original immunization (Austria, Western European countries, Eastern European countries and Non European countries) had no influence on sero-immunity (P=0.49). Multiple linear regression analysis revealed that age (P<0.001) and gender (P=0.004) had a significant independent influence on diphtheria immunity level, whereas the country of original immunization was not significant (P=0.72).
authors.affiliation: University Clinic for Trauma Surgery, University of Vienna Medical School, General Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria. stefan.marlovits@akh-wien.ac.at
authors.forename: S
authors.initials: S
authors.lastname: Marlovits
authors.forename: R
authors.initials: R
authors.lastname: Stocker
authors.forename: A
authors.initials: A
authors.lastname: Efstratiou
authors.forename: K
authors.initials: K
authors.lastname: Broughton
authors.forename: A
authors.initials: A
authors.lastname: Kaider
authors.forename: V
authors.initials: V
authors.lastname: Vécsei
authors.forename: G
authors.initials: G
authors.lastname: Wiedermann
authors.forename: H
authors.initials: H
authors.lastname: Kollaritsch
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001317:Austria / Q000453:epidemiology; D004166:Diphtheria Antitoxin / Q000097:blood*; D005260:Female; D006801:Humans; D007114:Immunization; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D016036:Seroepidemiologic Studies; D012737:Sex Factors; D013997:Time Factors; D014947:Wounds and Injuries / Q000276:immunology*
chemical_list: D004166:Diphtheria Antitoxin