Investigation of primary immune deficiency after severe bacterial infection in children: A population-based study in western France.

Autor: Flatrès C; Brest University Hospital, Pediatrics Department, Brest, France. Electronic address: charlotte.flatres@gmail.com., Roué JM; Brest University Hospital, neonatal Intensive Care Unit, Brest, France., Picard C; Laboratory of Lymphocyte Activation and Susceptibility to EBV infection, Inserm UMR 1163, Paris, University Paris Descartes Sorbonne Paris Cité, Imagine Institute, Paris, France., Carausu L; Brest University Hospital, Pediatrics Department, Brest, France., Thomas C; CHU de Nantes, Pediatric Hematology-Oncology Unit, Nantes, France., Pellier I; University Hospital of Angers, Department of Pediatric Onco-hematology, Angers, France., Millot F; Department of Pediatric Onco-Hematology, Poitiers University Hospital, Poitiers, France., Gandemer V; Department of Pediatric Hematology/Oncology, University Hospital of Rennes, Rennes, France., Chantreuil J; Centre Hospitalo-universitaire de Tours, Service de réanimation pédiatrique, Tours, France., Lorton F; CHU de Nantes, Department of Pediatric Emergency, Nantes, France., Gras Le Guen C; CHU de Nantes, Department of Pediatric Emergency, Nantes, France; CHU de Nantes, Department of Pediatrics, Nantes, France., Launay E; CHU de Nantes, Department of Pediatrics, Nantes, France.
Jazyk: angličtina
Zdroj: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie [Arch Pediatr] 2021 Jul; Vol. 28 (5), pp. 398-404. Date of Electronic Publication: 2021 Apr 24.
DOI: 10.1016/j.arcped.2021.03.009
Abstrakt: Background: Infectious diseases are still an important cause of morbidity and mortality in high-income countries and may preferentially affect predisposed children, especially immunocompromised children. We aimed to evaluate the frequency of recommended immunological tests in children with community-onset severe bacterial infection (COSBI) admitted to a pediatric intensive care unit. We also assessed the frequency and described the typology of diagnosed primary immune deficiency (PID).
Methods: We conducted a retrospective observational epidemiological study in six university hospitals in western France. All children from 1 month to 16 years of age admitted to hospital for bacterial meningitis, purpura fulminans, or meningococcal disease between August 2009 and January 2014 were included. We analyzed the frequency, type, and results of the immunological tests performed on children with meningitis, purpura fulminans, or a meningococcemia episode.
Results: Among the 143 children included (144 episodes), 84 (59%) and 60 (41%) had bacterial meningitis and purpura fulminans or meningococcemia, respectively: 72 (50%) had immunological tests and 8% had a complete immunological investigation as recommended. Among the 72 children examined for PID, 11 (15%) had at least one anomaly in the immunological test results. Two children had a diagnosis of PID (one with C2 deficit and the other with C8 deficit) and seven other children had possible PID. Thus, the prevalence of a definite or possible diagnosis of PID was 12% among the children examined.
Conclusion: PID is rarely investigated after COSBI. We raise awareness of the need for immunological investigations after a severe infection requiring PICU admission.
(Copyright © 2021 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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