Insufficient tetanus vaccination status in patients with chronic leg ulcers. Results of a prospective investigation in 100 patients.
BACKGROUND
Tetanus disease is caused by Clostridium tetani and is one of the most common infectious diseases worldwide. Despite international recommendations for patients with a chronic leg ulcer, there has been a distinctive lack of protection provided by vaccination for these patients in the past decades.


METHODS
Within the context of our prospective clinical investigation we consecutively determined the concentrations of immunoglobulin G antibodies against C. tetani in 100 patients with a chronic leg ulcer between January 2005 and November 2006.


RESULTS
A total of 38 patients were male, and 62 were female. Their mean age was 71 years (25-94). In a total of 47% (n = 47; 13 male, 34 female, mean age: 76 years) of the patients, insufficient immunoglobulin G antibody concentrations were detected. Particularly the subanalysis indicated an insufficient tetanus protection provided by vaccination in 70% of the people aged >or=80 years.


CONCLUSIONS
A chronic wound, e.g. in the form of a leg ulcer, is known as a potential entrance for C. tetani. Unlike acute wounds, however, it is hardly ever considered to be a reason for assessment of the tetanus immune status. The results of our investigation clarify that particularly elderly people suffering from a leg ulcer have to be tested for tetanus protection provided by vaccination more strictly than ever, and if necessary, vaccinations have to be renewed.
Korber
A
A
Dermatology Clinic and Outpatient Clinic, University Duisburg-Essen, Essen, Germany.
Graue
N
N
Rietkotter
J
J
Kreuzfelder
E
E
Grabbe
S
S
Dissemond
J
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D002908:Chronic Disease; D003017:Clostridium tetani / Q000276:immunology*; D005260:Female; D005858:Germany; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007871:Leg Ulcer / Q000150:complications / Q000276:immunology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013742:Tetanus / Q000209:etiology / Q000517:prevention & control*; D013745:Tetanus Toxoid; D014611:Vaccination / Q000706:statistics & numerical data
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D013745:Tetanus Toxoid