Tetanus immunity status among adult trauma patients in an ED

Ibrahim Toker; Turgay Yılmaz Kılıc; Sukran Kose; Murat Yesilaras; Feriyde Calıskan; Ozge Duman Atilla; Orkun Unek; Serkan Hacar; Aysin Kılınc Toker

doi:10.1016/j.tjem.2017.02.001

Ibrahim Toker¹, Turgay Yılmaz Kılıc¹, Sukran Kose², Murat Yesilaras³, Feriyde Calıskan¹, Ozge Duman Atilla³, Orkun Unek¹, Serkan Hacar⁴, Aysin Kılınc Toker⁵

¹Attending Emergency Physician, Tepecik Training and Education Hospital, Department of Emergency Medicine, İzmir, Turkey
²Associate Professor of Infectious Diseases and Clinical Microbiology, Tepecik Training and Education Hospital, Department of Infectious Diseases and Clinical Microbiology, İzmir, Turkey
³Associate Professor of Emergency Medicine, Tepecik Training and Education Hospital, Department of Emergency Medicine, İzmir, Turkey
⁴Emergency Medicine Resident, Tepecik Training and Education Hospital, Department of Emergency Medicine, İzmir, Turkey
⁵Infectious Diseases and Clinical Microbiology Resident, Tepecik Training and Education Hospital, Department of Infectious Diseases and Clinical Microbiology, İzmir, Turkey

Keywords: Tetanus immunity; Trauma; Emergency medicine

Abstract

Objectives: Tetanus is a vaccine-preventable infectious disease. It is caused by the bacterium Clostridium tetani. The aim of this study was to investigate tetanus immunity among adult trauma patients.

Material and methods: This study was performed with 267 trauma patients who were admitted to the emergency department of Tepecik Training and Research Hospital in Izmir City, Turkey over a six month period. After obtaining a written informed consent from each patient, a questionnaire concerning demographic information and tetanus vaccination history was filled in by the physician. Patients' blood samples (4–5 cc) were drawn into a test tube while creating an intravenous (IV) access prior to making any attempt for therapy. And the tetanus antibody level (IgG) was measured using the enzyme-linked immunosorbent assay method. Tetanus antibody levels ≥0.1 IU/mL were considered protective.

Results: Among 267 patients, 192 and 75 of the cases (71.9% and 28.1%) were male and female, respectively. The median age of the patients was 39 (IQRs = 28–52). Seventy-five percent of the patients (n = 201) had protective immunity rates for tetanus.

Discussion and conclusion: In our study, which was conducted among adults, it was found that the protective ratio of tetanus immunity decreased with age with an additional, significant decline in elderly patients.