269. Diabetic Foot Wounds: Which Patients are More Prone to Tetanus?
Session: Poster Abstract Session: Clinical: Skin and Soft Tissue
Thursday, October 5, 2017
Room: Poster Hall CD

Background:

Patients who have diabetes and chronic wounds are more prone to tetanus than the other populations. The prevalence of diabetes among patients diagnosed with tetanus was 15%, nearly three times the average expected prevalence of diabetes in the United States. In this study we aimed to evaluate the tetanus immunization status of the patients with diabetic foot wounds (DFW) and to determine the factors, which may predict to immunity against tetanus.

Methods:

Patients who admitted to outpatient clinics with DFW were included between 1 January and 31 December 2016. Tetanus antibody levels were measured by a commercial Clostridium tetani 5S IgG ELISA kit. Antibody levels below 0,1 IU/ml were defined as "No reliable protection" and levels above 0,1 IU/ml were defined as "Reliable protection". A questionnare applied to all patients for detailed diabetes and vaccinating history about tetanus.

Results:

Ninety-one patients were enrolled to the study, 66 (72,5%) of them were male and 25 (%27,5) of them were female. Mean age was 62±11 years. Sixty-five (71,4%) of the patients had no reliable protection while 26 (28,6%) of them had reliable protection. Tetanus IgG titers were decreasing by the age (Figure). Univariate analysis results between the immune and non-immune groups were demonstrated in Table. In the logistic regression analysis, only patients' age was found statistically significant predictive factor for immunity against tetanus (OR:1,114 95% CI:1,047-1,185).

Conclusion:

We found that elderly patients with DFW have very low rate of immunization against tetanus. Therefore, tetanus vaccination should be given particularly to the elderly patients with DFW without any serological control.

 

CHARACTERISTICS

Immune Patients

(n=26)

None-Immune Patients

(n=65)

 

 

p

Age, year

(Mean± SD)

53,3±12,1

65,1±8,6

0,0001

Age of Diabetes, year

(Mean± SD)

12,6±8,1

16,4±8,1

0,043

GENDER

Male, n(%)

Female, n(%)

21 (31,8)

5 (20)

45 (68,2)

20 (80)

0,265

RESIDENCY STATUS

Urban, n(%)

Rural, n(%)

24 (34,3)

2 (9,5)

46 (65,7)

19 (90,5)

0,028

EDUCATIONAL STATUS

Primary-Secondary School, n(%)

High School-Universityn(%)

20 (24,7)

6 (60)

61 (75,3)

4 (40)

 

0,029

KNOWLEDGE ABOUT VACCINATION HISTORY

Full covered,n(%)

Not covered, n(%)

Unknown, n(%)

3 (50)

4 (30,8)

19 (26,4)

3 (50)

9 (69,2)

53 (73,6)

0,461

             

Ferit Kuscu, MD1, Behice Kurtaran, Associate Professor2, Aslihan Ulu, Assistant professor3, Mehtap Evran, Assistant Professor2, Seza Inal, Assistant Professor4, Suheyla Komur, Assistant Professor3, Salih Cetiner, Associated Professor2, Yesim Tasova, Professor3 and Hasan Salih Zeki Aksu, professor3, (1)Cukurova University, Infectious Diseases, Turkey, Adana, Turkey, (2)Cukurova University, Adana, Turkey, (3)Infectious Diseases, Cukurova University, Adana, Turkey, (4)cukurova University, Adana, Turkey

Disclosures:

F. Kuscu, None

B. Kurtaran, None

A. Ulu, None

M. Evran, None

S. Inal, None

S. Komur, None

S. Cetiner, None

Y. Tasova, None

H. S. Z. Aksu, None

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