Aysu AYRANCI, Gülistan KARADENİZ, Görkem VAYISOĞLU ŞAHİN, Enver YALNIZ, Gülru POLAT, Fatma DEMİRCİ ÜÇSULAR, Mutlu Onur GÜÇSAV

Kronik obstrüktif akciğer hastalığı olan hastalarda konjuge pnömokok aşısı öncesi ve sonrası alevlenme ve pnömoni sıklığının karşılaştırılması ve inhale kortikosteroid kullanımının sonuçlara etkisi

Giriş: Kronik obstrüktif akciğer hastalığında (KOAH) pnömokok enfeksiyonları ve alevlenmeleri önemli mortalite ve morbidite nedenleridir. Hastalığın ilerlemesi ve alevlenmelerinin kontrolü için inhaler kortikosteroid kullanımı ve pnömokok aşısı önerilmektedir. Bu çalışmanın amacı inhaler kortikosteroid (İKS) kullanan KOAH hastalarında konjuge pnömokok aşısının pnömoni ve alevlenme üzerine etkisini değerlendirmektir. İkincil amaç ise, İKS kullanımının varlığının ve kullanılıyorsa farklı İKS tiplerinin aşılama öncesi ve sonrası dönemde alevlenme ve pnömoni insidansına etkisini de analiz etmektir. Materyal ve Metod: Konjuge pnömokok aşısı (PCV13) uygulanmış KOAH tanılı 108 erişkin hastanın tıbbi kayıtları retrospektif olarak değerlendirildi. Dahil edilen tüm KOAH hastalarında aşılamadan önceki ve sonraki bir yıl içindeki akut alevlenme ve pnömoni sayıları analiz edildi. Ek olarak alevlenme ve pnömoni insidansına etkisi açısında İKS tipleri ile ilgili karşılaştırma analizi de yapıldı. Bulgular: Aşılama öncesi ve sonrası ortalama pnömoni ve alevlenme sayıları arasında istatistiksel olarak anlamlı farklılıklar vardı (p< 0,05). İKS kullanan ve kullanmayan hastalar arasında ortalama pnömoni atakları ve akut alevlenmeler açısından anlamlı fark yoktu (p> 0,05). Sonuç: Bu çalışmada, PCV13’ün KOAH hastalarında hem alevlenme hem de pnömonide anlamlı bir azalma sağladığı gösterilmiştir. Öte yandan, aşılı KOAH hastalarında İKS kullanımının ve kullanan hastalarda farklı İKS tiplerinin pnömoni ve akut alevlenmeler üzerinde olumsuz etkisi bulunmamıştır.

The comparison of exacerbation and pneumonia before and after conjugated pneumococcal vaccination in patients with chronic obstructive pulmonary disease, and the effect of inhaled corticosteroid use on results

Introduction: Pneumococcal infections and exacerbations are important causes of mortality and morbidity in chronic obstructive pulmonary disease (COPD). The use of inhaled corticosteroids and pneumococcal vaccination are suggested for the control of the disease progression and exacerbations. The aim of this study is to assess the effect of pneumococcal conjugate vaccine on pneumonia and exacerbation in COPD patients using inhaled corticosteroids (ICSs). The secondary aim is to analyze the effect of ICS use and different ICS types, if administered, on exacerbation and pneumonia incidence in the study population. Materials and Methods: Medical records of 108 adult patients with COPD who were vaccinated with the pneumococcal conjugate vaccine (PCV13) were retrospectively evaluated. The number of acute exacerbations and pneumonia within one year before and after vaccination were evaluated in all included COPD patients. The comparison analysis was also performed based on the ICS types. Results: There were statistically significant differences between the mean numbers of pneumonia and exacerbations before and after vaccination (p< 0.05). There were no significant differences in the mean pneumonia attacks and acute exacerbations between patients using ICS and not using ICS (p> 0.05). Conclusion: This study revealed that PCV13 provides a significant decrease in both exacerbation and pneumonia episodes in COPD patients. On the other hand, the use of ICSs and the types of ICSs were not found to have adverse effects on pneumonia and acute exacerbations in vaccinated COPD patients.

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