title: Immunization coverage against capsular bacteria in splenectomized patients.
abstract: Splenectomy significantly increases the risk of severe invasive infections caused by capsular bacteria, such as sepsis and meningitis. Immunizations before and after splenectomy reduce the risk and are routinely recommended. Little is known about compliance with actual immunization guidelines in Poland. The aim of this study was to analyze the vaccination rate and the knowledge of splenectomized patients concerning immunizations in Poland. We applied a questionnaire to survey 85 adult patients (F/M 49/36) splenectomized in 2009-2010 and analyzed the patients' medical files and immunization certificates. Patients were also questioned over the phone. We found that the patients were most commonly immunized against Streptococcus pneumoniae (17/85, 20 %), less often against Haemophilus influenzae b (8/85, 9.4 %), and rarely against Niesseria meningitidis C (3/85, 3.5 %). In contrast, hepatitis B immunization coverage rate was as high as 67 % (57/85). The majority of respondents (59/85, 69.4 %) regarded information about the recommended immunizations as insufficient and rated their doctor's reasoning as inconsistent, a smaller number (20/85, 23.5 %) confirmed they received sound information before splenectomy. Both surgeons and primary care physicians did not offer immunizations to the majority of patients (59/85, 69.4 %); as a result, only 30.6 % of patients (26/85) were immunized against any capsular bacteria before splenectomy. In conclusion, the majority of splenectomized patients are not immunized despite current guidelines and do show an inadequate level of knowledge concerning the consequences of splenectomy. It is important that both surgeons and primary care doctors give patients clear instructions about immunizations and antibiotics recommended before and after their splenectomy.
authors.affiliation: Department of Pediatric Infectious Diseases, Wroclaw Medical University, 44 Bujwida St, 50-345, Wroclaw, Poland, ernest.kuchar@gmail.com.
authors.forename: Ernest
authors.initials: E
authors.lastname: Kuchar
authors.forename: Aneta
authors.initials: A
authors.lastname: Nitsch-Osuch
authors.forename: Celina
authors.initials: C
authors.lastname: Stolarczyk
authors.forename: Donata
authors.initials: D
authors.lastname: Kurpas
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Zycinska
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Wardyn
authors.forename: Leszek
authors.initials: L
authors.lastname: Szenborn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000517:prevention & control*; D001428:Bacterial Vaccines / Q000627:therapeutic use*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D018073:Haemophilus Vaccines / Q000627:therapeutic use; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000627:therapeutic use; D011044:Poland; D013156:Splenectomy; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D001428:Bacterial Vaccines; D018073:Haemophilus Vaccines; D022242:Pneumococcal Vaccines