SICKLE-CELL ANEMIA AND SEVERE INFECTIONS DUE TO ENCAPSULATED BACTERIA
SICKLE-CELL ANEMIA AND SEVERE INFECTIONS DUE TO ENCAPSULATED BACTERIA
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DOI：
10.1093/infdis/136.supplement.s25
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发表时间：
1977-01-01
影响因子：
6.4
通讯作者：
PEARSON, HA
中科院分区：
文献类型：
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作者：
PEARSON, HA
由包囊细菌引起的压倒性感染是镰状细胞性贫血儿童发病和死亡的重要原因。对这种感染易感性增加的最重要的促成因素是由于补体激活的替代途径的异常导致的调理吞噬缺陷、功能性脾功能减退的状态以及作为发育现象的特异性循环抗体的缺乏。如果要预防与镰状细胞性贫血相关的异常高的早期死亡率，对受影响的婴儿进行早期诊断至关重要。鉴于大多数致病微生物对青霉素敏感，因此提倡使用青霉素进行预防性治疗。然而，没有对照研究证明这种疗法的有效性。使用广泛的多价疫苗免疫肺炎链球菌、流感嗜血杆菌B型和脑膜炎奈瑟菌最终代表了减少灾难性感染发生率的最有效方法。
Overwhelming infections caused by encapsulated bacteria are an important cause of morbidity and death in children with sickle cell anemia. The most important contributing factors to this increased susceptibility to infection are an opsonophagocytic defect due to an abnormality of the alternate pathway of complement activation, a state of functional hyposplenia, and a lack of specific circulating antibodies as a developmental phenomenon. If the inordinately high, early mortality rate associated with sickle cell anemia is to be prevented, early diagnosis of affected infants is crucial. Prophylactic therapy with penicillin has been advocated in recognition of the fact that a majority of the causative organisms are sensitive to penicillin. However, no controlled studies have proved the effectiveness of such therapy. Immunization with broadly polyvalent vaccines againstStreptococcus pneumoniae, Haemophilus influenzaetype b, andNeisseria meningitidismay ultimately represent the most effective way to reduce the incidence of catastrophic infections.