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4.
Emerg Med Clin North Am ; 38(2): 383-400, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32336332

RESUMO

More than half of pediatric malpractice cases arise from emergency departments, primarily due to missed or delayed diagnoses. All providers who take care of children in emergency departments should be aware of this risk and the most common diagnoses associated with medicolegal liability. This article focuses on diagnosis and management of high-risk diagnoses in pediatric patients presenting to emergency departments, including meningitis, pneumonia, appendicitis, testicular torsion, and fracture. It highlights challenges and pitfalls that may increase risk of liability. It concludes with a discussion on recognition and management of abuse in children, including when to report and decisions on disposition.


Assuntos
Emergências , Imperícia , Gestão de Riscos , Adolescente , Fatores Etários , Apendicite/diagnóstico , Apendicite/terapia , Criança , Maus-Tratos Infantis/diagnóstico , Maus-Tratos Infantis/terapia , Pré-Escolar , Medicina de Emergência/legislação & jurisprudência , Medicina de Emergência/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Meningite/diagnóstico , Meningite/terapia , Pneumonia/diagnóstico , Pneumonia/terapia , Torção do Cordão Espermático/diagnóstico , Torção do Cordão Espermático/terapia , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/terapia
5.
Zhonghua Yi Xue Za Zhi ; 100(11): 823-827, 2020 Mar 24.
Artigo em Chinês | MEDLINE | ID: mdl-32234152

RESUMO

Objective: To observe the role of cerebrospinal fluid (CSF) TP53 gene mutation in lung cancer associated meningitis. Methods: A retrospective analysis was performed on 35 patients diagnosed with lung cancer associated meningitis at the Second Hospital of Hebei Medical University from December 2015 to December 2018.All patients underwent the next-generation sequencing of CSF, and TP53 gene was found to be mutant or wild type, including 23 patients with TP53 mutant type and 12 patients with TP53 wild type. The clinical characteristics, CSF leukocyte, protein, glucose, chloride, Karnofsky performance (KPS) and overall survival were observed. Results: Headache, nausea and vomiting were the main clinical manifestations in both groups.There were no significant differences in CSF pressure, leukocyte, biochemical indicators and KPS between the two groups. The average time from diagnosis of lung cancer to diagnosis of lung cancer associated meningitis in the TP53 mutant group was significantly shorter than that in the TP53 wild type group (5.79 months vs 25.5 months).The median survival time of patients in the TP53 mutant group from lung cancer diagnosis to the observation endpoint was 19.77 months, while it was 88.73 months in the TP53 wild type group, and the difference was statistically significant (P=0.043). Conclusions: Mutation in the tumor suppressor gene TP53 can be detected in the CSF of patients with lung cancer associated meningitis. Patients with such mutation have earlier meningeal metastasis and shorter median survival time.


Assuntos
Neoplasias Pulmonares , Meningite , Mutação , Proteína Supressora de Tumor p53/genética , Líquido Cefalorraquidiano , Genes p53 , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/genética , Meningite/complicações , Meningite/genética , Metástase Neoplásica , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
7.
N Z Med J ; 133(1511): 14-20, 2020 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-32161418

RESUMO

AIM: To investigate if adult cochlear implant (CI) recipients have received the recommended immunisations as compared to current guidelines and to report instances of meningitis within this population. METHODS: Telephone interview of CI recipient's general practitioner (GP) surgeries for details regarding immunisations received. Subsequent reporting of immunisation rates of adult patients, under the care of the Northern Cochlear Implant Programme (NCIP) in New Zealand, when compared to the recommended guidelines from the Immunisation Advisory Centre (IMAC) and rates of meningitis of CI recipients are presented. RESULTS: It is recommended to immunise against the most common organisms causing meningitis, Streptococcus pneumoniae and Haemophilus influenzae type b (HiB), as well as influenza. Data for 135 CI recipients over the last five years was complete. 14.8% of patients had received a full pneumococcal immunisation schedule. 11.9% had received a HiB immunisation and 62.2% an influenza vaccination. No patient had developed meningitis following CI insertion. CONCLUSION: This paper highlights clear issues with the immunisation of adult CI recipients.


Assuntos
Implante Coclear , Fidelidade a Diretrizes , Infecções por Haemophilus/prevenção & controle , Vacinas Anti-Haemophilus/uso terapêutico , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Meningite Pneumocócica/prevenção & controle , Vacinas Pneumocócicas/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Implantes Cocleares , Feminino , Humanos , Esquemas de Imunização , Masculino , Meningite/prevenção & controle , Pessoa de Meia-Idade , Nova Zelândia , Guias de Prática Clínica como Assunto , Vacinas Conjugadas/uso terapêutico , Adulto Jovem
8.
West Afr J Med ; 37(1): 67-73, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32030715

RESUMO

OBJECTIVE: The purpose of this study was to examine trends in clinical characteristics and in-hospital mortality of HIV patients in a low resource setting in the period 2010 to 2016. METHODS: Data on socio-demographic and clinical characteristics of 313 hospitalized HIV positive patients at the University College Hospital, Ibadan, Nigeria were retrospectively extracted, described and examined for trends. Factors independently associated with mortality were identified using multiple logistic regression. RESULTS: The mean age was 39 years (SD = 9.8) and about two thirds were female. The proportion of females decreased significantly from 83.3% in 2010-2011 to 39.8% in 2016. There was a significant reduction in the diagnosis of disseminated tuberculosis and mortality from 19.4% and 42.9% in 2010-2011 to 4.8% and 27.9% in 2016 respectively. On multiple logistic regression, being male, having neurological features, meningitis, and shorter stay in hospital had significantly higher odds of mortality. CONCLUSION: There was a reduction in in-hospital mortality of HIV patients over the period from 2010 to 2016. Being male and presence of neurological features were associated with mortality. Larger prospective studies are needed to further investigate this observed reduction in mortality among hospitalised patients.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Infecções por HIV/tratamento farmacológico , Pacientes Internados/estatística & dados numéricos , Mortalidade/tendências , Infecções Oportunistas Relacionadas com a AIDS/mortalidade , Adolescente , Adulto , Fármacos Anti-HIV/administração & dosagem , Feminino , Infecções por HIV/mortalidade , Hospitais de Ensino , Hospitais Universitários , Humanos , Tempo de Internação , Masculino , Meningite/complicações , Meningite/mortalidade , Pessoa de Meia-Idade , Nigéria/epidemiologia , Admissão do Paciente/estatística & dados numéricos , Admissão do Paciente/tendências , Estudos Retrospectivos , Distribuição por Sexo , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/mortalidade , Adulto Jovem
9.
PLoS One ; 15(2): e0228799, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32053640

RESUMO

BACKGROUND: Bangladesh introduced the 10-valent pneumococcal conjugate vaccine (PCV-10) in 2015. We measured population-based incidence of invasive pneumococcal disease (IPD) prior to introduction of PCV-10 to provide a benchmark against which the impact of PCV-10 can be assessed. METHODS: We conducted population, facility and laboratory-based surveillance in children 0-59 months of age in three rural sub-districts of Sylhet district of Bangladesh from January 2014 to June 2015. All children received two-monthly home visits with one week recall for morbidity and care seeking. Children attending the three Upazilla Health Complexes (UHC, sub-district hospitals) in the surveillance area were screened for suspected IPD. Blood samples were collected from suspected IPD cases for culture and additionally, cerebrospinal fluid (CSF) was collected from suspected meningitis cases for culture and molecular testing. Pneumococcal isolates were serotyped by Quellung. Serotyping of cases detected by molecular testing was done by sequential multiplex polymerase chain reaction. RESULTS: Children under surveillance contributed to 126,657 child years of observations. Sixty-three thousand three hundred eighty-four illness episodes were assessed in the UHCs. Blood specimens were collected from 8,668 suspected IPD cases and CSF from 177 suspected meningitis cases. Streptococcus pneumoniae was isolated from 46 cases; 32 (70%) were vaccine serotype. The population-based incidence of IPD was 36.3/100,000 child years of observations. About 80% of the cases occurred in children below two years of age. DISCUSSION: IPD was common in rural Bangladesh suggesting the potential benefit of an effective vaccine. Measurement of the burden of IPD requires multiple surveillance modalities.


Assuntos
Infecções Pneumocócicas/diagnóstico , Streptococcus pneumoniae/isolamento & purificação , Bangladesh/epidemiologia , Hemocultura , Pré-Escolar , DNA Bacteriano/metabolismo , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Meningite/diagnóstico , Meningite/epidemiologia , Meningite/microbiologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/imunologia , Sorogrupo , Streptococcus pneumoniae/genética
10.
BMC Infect Dis ; 20(1): 170, 2020 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-32087681

RESUMO

BACKGROUND: Infectious meningitis is a serious disease and patient outcome relies on fast and reliable diagnostics. A syndromic panel testing approach like the FilmArray ME can accelerate diagnosis and therefore decrease the time to pathogen specific therapy. Yet, its clinical utility is controversial, mainly because of a remaining uncertainty in correct interpretation of results, limited data on its performance on clinical specimens and its relatively high costs. The aim of this study was to analyze clinical performance of the assay in a real life setting at a tertiary university hospital using a pragmatic and simple sample selection strategy to reduce the overall cost burden. METHODS: Over a period of 18 months we received 4623 CSF samples (2338 hospitalizations, 1601 individuals). FilmArray ME analysis was restricted to CSF-samples with a high pretest probability of infectious meningitis, e.g. positive Gram-stain, samples in which leukocytes and/or bacteria were evident or urgent suspicion of infection was communicated by clinicians. N = 171 samples matched to our risk criteria and were subjected to FilmArray ME analysis. Those samples were also analyzed by reference methods: culture only (n = 45), PCR only (n = 20) or both methods (n = 106). RESULTS: 56/171 (32.75%) were FilmArray ME positive. Bacterial pathogens were detected in 30/56 (53.57%), viral pathogens were detected in 27/56 (48.21%) and yeast DNA was detected in 1/56 (1.79%) of positive samples. Double detection occurred in 2/56 samples. In 52/56 (92.86%) FilmArray ME positive samples, results could be confirmed by the reference assays (sensitivity = 96.30%, specificity =96.58%). CONCLUSION: The FilmArray ME assay is a fast and reliable diagnostic tool for the management of infectious meningitis and can easily be implemented in routine diagnostic workflows. However, correlation of test results and underlying clinical symptoms requires experienced users and the awareness of potentially false negative or false positive results. Moreover, considering the need for antimicrobial susceptibility testing, the use of molecular tests as a stand-alone diagnostic cannot be recommended.


Assuntos
Testes Diagnósticos de Rotina/métodos , Encefalite/diagnóstico , Meningite/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Reação em Cadeia da Polimerase Multiplex/métodos , Coloração e Rotulagem/métodos , Testes Diagnósticos de Rotina/economia , Encefalite/líquido cefalorraquidiano , Encefalite/microbiologia , Encefalite/virologia , Violeta Genciana , Alemanha , Hospitais Universitários , Humanos , Laboratórios , Meningite/líquido cefalorraquidiano , Meningite/microbiologia , Meningite/virologia , Técnicas de Diagnóstico Molecular/economia , Reação em Cadeia da Polimerase Multiplex/economia , Fenazinas , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Coloração e Rotulagem/economia , Centros de Atenção Terciária
11.
BMC Infect Dis ; 20(1): 56, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31952512

RESUMO

BACKGROUND: Nocardiosis is an uncommon disease caused by aerobic gram-positive bacteria Nocardia spp. Although it is usually an opportunistic infection affecting immunocompromised patients, even one third of cases occur in immunocompetent persons. The aim of the study was to describe the course of chronic meningitis due to Nocardia infection. CASE PRESENTATION: A 52-year-old patient, chalk miner, suffered from a chronic meningitis caused by an extremely rare pathogen. The patient's history was complicated and diagnostic process covered multiple examinations and consultations. Initially Kocuria rosea was cultured, yet after molecular examination the result was verified to Nocardia farcinica. Targeted antibiotic treatment was implemented, which resulted in gradual improvement of patients condition. A full recovery was achieved after one year antibiotic therapy. CONCLUSIONS: 1.Nocardia farcinica is an uncommon but possible cause of chronic meningitis.2.In the case of a chronic meningitis of unknown origin multiple cerebrospinal fluid cultures should be performed as the identification of pathogen may be crucial for patient's recovery.3.In case of unusual culture, such as Kocuria spp. PCR should be performed.


Assuntos
Meningite/diagnóstico , Nocardia/isolamento & purificação , Antibacterianos/uso terapêutico , Encéfalo/diagnóstico por imagem , Doença Crônica , DNA Bacteriano/genética , DNA Bacteriano/metabolismo , Humanos , Hospedeiro Imunocomprometido , Imagem por Ressonância Magnética , Meningite/tratamento farmacológico , Meningite/microbiologia , Pessoa de Meia-Idade , Nocardia/genética
12.
BMC Neurol ; 20(1): 11, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31918670

RESUMO

BACKGROUND: Hypertrophic pachymeningitis (HP) is a rare disorder that involves localized or diffuse thickening of the dura mater. HP is associated with various inflammatory, infectious, and malignant diseases, such as rheumatic arthritis, sarcoidosis, anti-neutrophil cytoplasmic antibody-associated vasculitis, IgG4-related disorders, syphilis, tuberculosis, bacterial and fungal infections, cancer, and idiopathic diseases, when evaluation fails to reveal a cause. Among them, chronic infection with Propionibacterium acnes is a rare etiology of HP, and its pathology remains unclear. CASE PRESENTATION: An 80-year-old man having refractory otitis media with effusion of the right ear presented with progressive right-sided headache and nausea. Post-contrast brain magnetic resonance imaging revealed right mastoiditis and remarkable thickening of the dura mater and enhancement of pia mater extending from the right middle cranial fossa to the temporal lobe. HP secondary to middle ear infection was suspected, and a biopsy of the right mastoid was performed. An anaerobic culture of the biopsied right mastoid showed the growth of P. acnes, and histopathological examination using P. acnes-specific monoclonal antibody (PAB antibody) revealed the infiltration of inflammatory cells with P. acnes. Moreover, using PAB antibody, P. acnes was detected in the biopsy specimen of the thickening dura mater. No granulomas were identified in either specimen. HP was resolved with long-term administration of antibiotics and steroids. CONCLUSION: This is the first documentation of pathologically demonstrated chronic HP associated with P. acnes infection followed by refractory otitis media. This report showed that chronic latent P. acnes infection induces chronic inflammation.


Assuntos
Infecções por Bactérias Gram-Positivas/complicações , Meningite/microbiologia , Otite Média/complicações , Otite Média/microbiologia , Propionibacterium acnes , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Humanos , Hipertrofia , Masculino , Meningite/tratamento farmacológico , Otite Média/tratamento farmacológico , Recidiva
13.
Am J Trop Med Hyg ; 102(3): 574-577, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31933459

RESUMO

Human infection with the trematode Fasciola occurs with a worldwide prevalence of up to 17 million. Sheep and cattle are the normal host. Infection typically results in hepatobiliary disease, but extrahepatic manifestations are occasionally reported. Here, we present the case of a previously healthy 31-year-old Kurdish woman, admitted to hospital with a subarachnoid hemorrhage, eosinophilic meningitis, and lung and liver disease. A diagnosis of Fasciola infection was made based on strongly positive serology in blood and cerebrospinal fluid. The patient improved following treatment with triclabendazole and prednisolone.


Assuntos
Fasciolíase/complicações , Fasciolíase/patologia , Meningite/parasitologia , Hemorragia Subaracnóidea/parasitologia , Adulto , Anticorpos Anti-Helmínticos/sangue , Fasciolíase/tratamento farmacológico , Feminino , Humanos , Imunoglobulina G/sangue , Meningite/diagnóstico , Meningite/patologia , Hemorragia Subaracnóidea/diagnóstico , Hemorragia Subaracnóidea/patologia , Triclabendazol/uso terapêutico
14.
Nat Chem Biol ; 16(3): 337-344, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31932719

RESUMO

Infection by the fungal pathogen Cryptococcus neoformans causes lethal meningitis, primarily in immune-compromised individuals. Colonization of the brain by C. neoformans is dependent on copper (Cu) acquisition from the host, which drives critical virulence mechanisms. While C. neoformans Cu+ import and virulence are dependent on the Ctr1 and Ctr4 proteins, little is known concerning extracellular Cu ligands that participate in this process. We identified a C. neoformans gene, BIM1, that is strongly induced during Cu limitation and which encodes a protein related to lytic polysaccharide monooxygenases (LPMOs). Surprisingly, bim1 mutants are Cu deficient, and Bim1 function in Cu accumulation depends on Cu2+ coordination and cell-surface association via a glycophosphatidyl inositol anchor. Bim1 participates in Cu uptake in concert with Ctr1 and expression of this pathway drives brain colonization in mouse infection models. These studies demonstrate a role for LPMO-like proteins as a critical factor for Cu acquisition in fungal meningitis.


Assuntos
Cobre/metabolismo , Cryptococcus neoformans/metabolismo , Oxigenases de Função Mista/metabolismo , Animais , Criptococose/metabolismo , Cryptococcus neoformans/patogenicidade , Modelos Animais de Doenças , Feminino , Proteínas Fúngicas/genética , Proteínas Fúngicas/metabolismo , Meningite/metabolismo , Meningite/fisiopatologia , Camundongos , Camundongos Endogâmicos A , Polissacarídeos/metabolismo , Virulência
15.
PLoS One ; 15(1): e0226895, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31940319

RESUMO

OBJECTIVE: To estimate healthcare expenditures that could be impacted by advanced diagnostic testing for patients hospitalized with meningitis or encephalitis. METHODS: Patients hospitalized with meningitis (N = 23,933) or encephalitis (N = 7,858) in the U.S. were identified in the 2010-2014 Truven Health MarketScan Commercial Claims and Encounters Database using ICD-9-CM diagnostic codes. The database included an average of 40.8 million commercially insured enrollees under age 65 per year. Clinical, demographic and healthcare utilization criteria were used to identify patient subgroups early in their episode who were at risk to have high inpatient expenditures. Healthcare expenditures of patients within each subgroup were bifurcated: those expenditures that remained five days after the patient could be classified into the subgroup versus those that had occurred previously. RESULTS: The hospitalization episode rate per 100,000 enrollee-years for meningitis was 13.0 (95% CI: 12.9-13.2) and for encephalitis was 4.3 (95% CI: 4.2-4.4), with mean inpatient expenditures of $36,891 (SD = $92,636) and $60,181 (SD = $130,276), respectively. If advanced diagnostic testing had been administered on the day that a patient could be classified into a subgroup, then a test with a five-day turnaround time could impact the following mean inpatient expenditures that remained by subgroup for patients with meningitis or encephalitis, respectively: had a neurosurgical procedure ($83,337 and $56,020), had an ICU stay ($34,221 and $46,051), had HIV-1 infection or a previous organ transplant ($37,702 and $62,222), were age <1 year ($35,371 and $52,812), or had a hospital length of stay >2 days ($18,325 and $30,244). DISCUSSION: Inpatient expenditures for patients hospitalized with meningitis or encephalitis were substantial and varied widely. Patient subgroups who had high healthcare expenditures could be identified early in their stay, raising the potential for advanced diagnostic testing to lower these expenditures.


Assuntos
Encefalite/diagnóstico , Encefalite/economia , Gastos em Saúde/estatística & dados numéricos , Hospitalização , Meningite/diagnóstico , Meningite/economia , Adulto , Criança , Pré-Escolar , Encefalite/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Seguro Saúde , Masculino , Meningite/terapia , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
17.
J Laryngol Otol ; 134(1): 46-51, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31858918

RESUMO

BACKGROUND: Ecchordosis physaliphora is a congenital, benign lesion originating from notochordal remnants along the craniospinal axis, most frequently located at the level of the clivus and sacrum. Sometimes ecchordosis physaliphora is difficult to recognise and treat, with a total of twenty-six cases described in the literature. METHODS: This study reports on three cases of previously undiagnosed ecchordosis physaliphora presenting with cerebrospinal fluid rhinorrhoea and meningitis. CONCLUSION: Endoscopic transclival or transsphenoid surgery including three-layer (fat, fascia and nasoseptal flap) reconstruction was used in all cases with complete resolution of the symptoms.


Assuntos
Rinorreia de Líquido Cefalorraquidiano/etiologia , Hamartoma/cirurgia , Meningite/etiologia , Idoso de 80 Anos ou mais , Rinorreia de Líquido Cefalorraquidiano/cirurgia , Endoscopia , Feminino , Hamartoma/diagnóstico por imagem , Humanos , Masculino , Meningite/cirurgia , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Notocorda/diagnóstico por imagem , Notocorda/patologia , Notocorda/cirurgia
18.
Acta otorrinolaringol. esp ; 70(6): 336-341, nov.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184878

RESUMO

Antecedentes y objetivo: El riesgo de meningitis bacteriana aumenta en los pacientes con implante coclear. Por ello, se indica la vacunación antineumocócica, antigripal y frente a Haemophilus influenzae tipo b en este grupo. El objetivo del presente estudio es conocer el cumplimiento del calendario vacunal en los pacientes implantados en un hospital de referencia. Materiales y métodos: Se incluyeron los pacientes con implante coclear intervenidos entre 2005 y 2015. Se evaluaron las coberturas vacunales frente a gripe estacional, Haemophilus influenzae tipo b, neumococo conjugada de 13 serotipos y neumococo polisacárida de 23 serotipos. Se dividió la muestra en 2 grupos por edad (< 14 años y ≥ 14 años). Se realizó un análisis univariante y bivariante. Resultados: De los 153 pacientes estudiados (28,01% 0-13 años y 71,9% ≥ 14), solo 2 (5,71%) tuvieron un 100% de adherencia al calendario vacunal, mientras que el 65,71% registró un cumplimiento del 50% o menor. Globalmente, la cobertura de vacunación frente a la pauta secuencial de neumococo fue del 48,57%. La población pediátrica superó el 90% de cobertura para la vacuna frente a Haemophilus influenzae tipo b y neumococo conjugada de 13 serotipos, mientras que en los mayores de 14 años apenas superó el 50%. La cobertura frente a gripe estacional fue inferior al 40%. Se obtuvo una correlación inversa entre la edad y el cumplimiento, aunque no estadísticamente significativa. Conclusiones. Las coberturas de vacunación en los pacientes con implante coclear evaluados son más bajas de lo esperado. Se propone la colaboración estrecha entre los servicios de Otorrinolaringología y las Unidades de Vacunas como principal estrategia para la mejora


Background and objective: The risk of bacterial meningitis increases in cochlear implant patients. Therefore, pneumococcal, influenza and Haemophilus influenzae type b vaccination is indicated in this group. The aim of this study was to determine compliance with the vaccination calendar in patients implanted in a referral hospital. Materials and methods: Patients with cochlear implant operated between 2005 and 2015 were included. Vaccine coverage for seasonal influenza, Haemophilus influenzae type b and pneumococcal conjugate 13-serotypes and pneumococcal polysaccharide 23-serotypes was evaluated. The sample was divided into 2 age groups (< 14 years and ≥ 14 years). A univariate and bivariate analysis was performed. Results: Of the 153 patients studied (28.01% 0-13 years old and 71.9% ≥ 14), only 2 (5.71%) had 100% adherence to the vaccination schedule, while 65.71% had compliance of 50% or less. Overall, vaccination coverage against the sequential pneumococcal pattern was 48.57%. The paediatric population exceeded 90% coverage for the vaccine against Haemophilus influenzae type b and pneumococcal conjugate 13-serotypes while in those over 14 years of age it barely exceeded 50%. Influenza coverage was less than 40%. An inverse correlation was obtained between age and compliance, although not statistically significant. Conclusions: Vaccination coverage in patients with cochlear implant is lower than expected. Close collaboration between Otolaryngology departments and the Vaccination Units is proposed as the main strategy for improvement


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Cobertura Vacinal , Implantes Cocleares , Vacinas Pneumocócicas , Cooperação do Paciente , Cooperação e Adesão ao Tratamento , Meningite/imunologia , Meningite/prevenção & controle , Estudos Transversais , Vacinação Obrigatória
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