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2012-2013 流感季节中,母亲和家庭接触者产后流感疫苗接种对预防婴幼儿发热、流感样疾病、就医和抗生素治疗的影响。

Impact of postpartum influenza vaccination of mothers and household contacts in preventing febrile episodes, influenza-like illness, healthcare seeking, and administration of antibiotics in young infants during the 2012-2013 influenza season.

机构信息

Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention.

出版信息

Clin Infect Dis. 2013 Dec;57(11):1520-6. doi: 10.1093/cid/cit599. Epub 2013 Sep 17.

Abstract

BACKGROUND

Influenza is associated with an increased risk for serious illness, hospitalization, and mortality in infants aged <6 months. However, influenza vaccines are not licensed for administration in this age group. The study evaluated the effectiveness of postpartum influenza vaccination of mothers and household members in infants.

METHODS

The influenza vaccine was offered to mothers and household members of neonates born or hospitalized in 3 hospitals prior to the 2012-2013 season. Mothers were contacted every 2 weeks during the influenza season, and data regarding the onset of fever and/or respiratory symptoms in infants, healthcare seeking, hospitalization, and administration of antibiotics were collected.

RESULTS

The study group consisted of 553 mothers who delivered 573 neonates. The influenza vaccine was administered to 841 of 1844 (45.6%) household contacts. Vaccination coverage rates ranged between 41.9% for neonates siblings and 49% for mothers. Five hundred thirty infants were analyzed for vaccine effectiveness. For outcomes in the infant, postpartum maternal vaccination had 37.7% effectiveness against acute respiratory illness (ARI), 50.3% against a febrile episode, 53.5% against influenza-like illness (ILI), 41.8% against related healthcare seeking, and 45.4% against administration of antibiotics. Multiple logistic regression analyses showed that maternal influenza vaccination was significantly associated with a decreased probability for febrile episodes, ARIs, and/or ILIs in infants, related healthcare seeking, and/or administration of antibiotics during the influenza season. Vaccination of other household contacts had no impact.

CONCLUSIONS

Maternal postpartum vaccination against influenza was associated with a significant reduction of influenza-related morbidity, healthcare seeking, and antibiotic prescription in infants during the influenza season.

摘要

背景

流感可使 <6 月龄婴儿罹患重症、住院和死亡的风险增加。然而,该年龄段并未批准使用流感疫苗。本研究评估了对母亲及其家庭接触者进行产后流感疫苗接种对婴儿的效果。

方法

在 2012-2013 年流感季节前,向在 3 家医院出生或住院的新生儿的母亲及其家庭接触者提供流感疫苗。在流感季节期间,每两周与母亲联系一次,收集婴儿发热和/或呼吸道症状发作、寻求医疗、住院和使用抗生素的数据。

结果

研究组包括 553 名分娩 573 名新生儿的母亲。向 1844 名家庭接触者中的 841 人(45.6%)接种了流感疫苗。疫苗接种覆盖率在新生儿兄弟姐妹中为 41.9%,在母亲中为 49%。对 530 名婴儿进行疫苗效果分析。对于婴儿结局,产后母亲接种疫苗对急性呼吸道疾病(ARI)的有效性为 37.7%,对发热发作的有效性为 50.3%,对流感样疾病(ILI)的有效性为 53.5%,对相关医疗的有效性为 41.8%,对使用抗生素的有效性为 45.4%。多变量逻辑回归分析显示,母亲接种流感疫苗与婴儿发热发作、ARI 和/或 ILI、相关医疗和/或抗生素使用的可能性降低显著相关。接种其他家庭接触者的疫苗无影响。

结论

母亲产后接种流感疫苗可显著降低婴儿在流感季节期间流感相关发病率、医疗需求和抗生素处方。

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