title: The immunization status of patients with IBD is alarmingly poor before the introduction of specific guidelines.
abstract: BACKGROUND
  With immunosuppressive therapy of inflammatory bowel diseases (IBDs) becoming more aggressive, the risk of serious infections is increasing. Guidelines are currently being modified in respect to advisable immunizations. The aim of this study was to evaluate the immunization habits of IBD patients in daily practice before the implementation of specific guidelines.
  
  
  METHODS
  Hundred and two consecutive patients attending the outpatients IBD clinic at our hospital were interviewed regarding their immunization record. In addition, hepatitis B and C, HIV, and cytomegalovirus (CMV) serostatus were measured following a European Crohn's and Colitis Organization (ECCO) consensus.
  
  
  RESULTS
  Hundred and two patients with IBD have been included; of these 72% were taking steroids, 46% azathioprine, and 23% anti-TNF medication. Nineteen percent of the study population had been vaccinated against influenza, 3% against pneumoccous pneumonia, 22% against hepatitis B, 5% against varizella, 55% against rubella/mumps/measles, and 63% against tetanus. Of those who had traveled, 9% had been vaccinated for hepatitis A and 1% for yellow fever. Reasons given for not being vaccinated were not being aware of the necessity in 45% of those questioned and being afraid in 17%. While no patient was tested positive for hepatitis B, HIV, and CMV-IgM, one female patient was tested positive for hepatitis C (antibody and PCR positive, genotype I), which was unknown at that point.
  
  
  CONCLUSIONS
  Considering the high number of our patients receiving immunosuppressive therapy, the immunization record is alarmingly poor supporting the need for optimized IBD guidelines, better awareness, and patient education. In addition, the screening for chronic infections appears to be useful as suggested by the positive finding of a previously unknown hepatitis C.
authors.affiliation: Department of Anaesthesiology, University Teaching Hospital Lueneburg, Lueneburg, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Wilckens
authors.forename: Klaus
authors.initials: K
authors.lastname: Kannengiesser
authors.forename: Kerstin
authors.initials: K
authors.lastname: Hoxhold
authors.forename: Christian
authors.initials: C
authors.lastname: Frenkel
authors.forename: Torsten
authors.initials: T
authors.lastname: Kucharzik
authors.forename: Christian
authors.initials: C
authors.lastname: Maaser
mesh_terms: D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000276:immunology*; D003424:Crohn Disease / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006509:Hepatitis B / Q000517:prevention & control; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D013742:Tetanus / Q000517:prevention & control; D014777:Virus Diseases / Q000517:prevention & control; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents