Position statement of the Spanish Society of Pediatric Rheumatology on infection screening, prophylaxis, and vaccination of pediatric patients with rheumatic diseases and immunosuppressive therapies: Part 1 (screening)

Zeitschrift für Kinderheilkunde - Tập 181 - Trang 2343-2354 - 2022
Esmeralda Núñez Cuadros1, Joan Calzada-Hernández2, Daniel Clemente3, Sara Guillén Martín4, Laura Fernández Silveira5, María José Lirola-Cruz6, Alfredo Tagarro7, Marisol Camacho Lovillo5, Rosa María Alcobendas Rueda8, Agustín López López9, Miren Satrustegi Aritziturri10, Cristina Calvo11,12
1Pediatric Rheumatology Unit, UGC Pediatría, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
2Unitat de Reumatologia Pediàtrica, Servei de Pediatria, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
3Pediatric Rheumatology Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
4Department of Paediatrics, Hospital Universitario de Getafe, CIBERINFEC. ISCIII, Getafe, Madrid, Spain
5Servicio de Inmunología, Reumatología e Infectología Pediátricas, Hospital Universitario Virgen del Rocío, Sevilla, Spain
6Department of Paediatríc Rheumatology, Instituto Hispalense de Pediatría, Seville, Spain
7Pediatrics Department, Instituto de Investigación 12 de Octubre (imas12), Hospital Universitario Infanta Sofía, Universidad Europea, Madrid, Spain
8Department of Pediatric Rheumatology, La Paz Children’s Hospital, Madrid, Spain
9Department of Paediatrics, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
10Servicio de Pediatría, Hospital Universitario Donostia, San Sebastián, Spain
11Department of Pediatrics, Infectious and Tropical Diseases, Hospital Universitario La Paz, and La Paz Research Institute (IdiPaz). CIBERINFEC. ISCIII, Madrid, Spain
12Translational Research Network of Pediatric Infectious Diseases (RITIP), Madrid, Spain

Tóm tắt

This study provides practical recommendations on infection screening in pediatric patients with immune-mediated rheumatic diseases and immunosuppressive therapies. For this reason, a qualitative approach was applied. A narrative literature review was performed via Medline. Primary searches were conducted using Mesh and free texts to identify articles that analyzed data on infections and vaccinations in pediatric patients with immune-mediated rheumatic diseases and immunosuppressive therapies. The results were presented and discussed in a nominal group meeting, comprising a committee of 12 pediatric rheumatologists from the infections prevention and treatment working group of the Spanish Society of Pediatric Rheumatology. Several recommendations were generated. A consensus procedure was implemented via a Delphi process that was extended to members of the Spanish Society of Pediatric Rheumatology and Vaccine Advisory Committee of the Spanish Association of Pediatrics. Participants to the process produced a score ranging from 0 = totally disagree to 10 = totally agree. Agreement was considered if at least 70% of participants voted ≥ 7. The literature review included more than 400 articles. Overall, 63 recommendations were generated (21 on infection screening) voted by 59 pediatric rheumatologists and other pediatric specialists, all of them achieving the pre-established agreement level. The recommendations on screening cover all the procedures (serology, assessment of risk factors, and other clinical activities) connected with the screening for infections including tuberculosis; hepatitis A, B, and C viruses; measles; mumps; rubella; diphtheria; and other infections.  Conclusion: Screening for infections is an essential part of risk management in pediatric patients with immune-mediated rheumatic diseases and immunosuppressive therapies.

Tài liệu tham khảo

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