Prevention and treatment of infection in patients with an absent or hypofunctional spleen: A British Society for Haematology guideline.

Autor: Ladhani SN; Centre for Neonatal and Paediatric Infections (CNPI), St. George's University of London, London, UK.; Immunisation and Countermeasures Division, UK Health Security Agency Colindale, London, UK., Fernandes S; Department of Haematology, Dudley Group Foundation NHS Trust, Russell's Hall Hospital, Dudley, UK., Garg M; Leicester Royal Infirmary, Leicester, UK., Borrow R; Vaccine Evaluation Unit, UK Health Security Agency, Manchester Royal Infirmary, Manchester, UK., de Lusignan S; Nuffield Department of Primary Care Health Sciences, Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), University of Oxford, Oxford, UK., Bolton-Maggs PHB; Division of Cardiovascular Sciences, The University of Manchester, Manchester, UK.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2024 May; Vol. 204 (5), pp. 1672-1686. Date of Electronic Publication: 2024 Apr 10.
DOI: 10.1111/bjh.19361
Abstrakt: Guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen were published by the British Committee for Standards in Haematology in 1996 and updated in 2002 and 2011. With advances in vaccinations and changes in patterns of infection, the guidelines required updating. Key aspects included in this guideline are the identification of patients at risk of infection, patient education and information and immunisation schedules. This guideline does not address the non-infective complications of splenectomy or functional hyposplenism (FH). This replaces previous guidelines and significantly revises the recommendations related to immunisation. Patients at risk include those who have undergone surgical removal of the spleen, including partial splenectomy and splenic embolisation, and those with medical conditions that predispose to FH. Immunisations should include those against Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus) and influenza. Haemophilus influenzae type b (Hib) is part of the infant immunisation schedule and is no longer required for older hyposplenic patients. Treatment of suspected or proven infections should be based on local protocols and consider relevant anti-microbial resistance patterns. The education of patients and their medical practitioners is essential, particularly in relation to the risk of serious infection and its prevention. Further research is required to establish the effectiveness of vaccinations in hyposplenic patients; infective episodes should be regularly audited. There is no single group ideally placed to conduct audits into complications arising from hyposplenism, highlighting a need for a national registry, as has proved very successful in Australia or alternatively, the establishment of appropriate multidisciplinary networks.
(© 2024 British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: