Management of febrile urinary tract infections remains controversial and heterogeneous in Europe. Simple, short, practical and easy-to-remember guidelines and educational strategies to ensure their implementation should be developed.

(P < 0AE01) compared with the BM group. The numbers of proven bacterial and viral infections were equally distributed between the three groups. In conclusion, recipients of allogeneic highly purified CD34 + PBSC or unmanipulated BM have higher lymphocyte subset counts at 6 months after transplantation than recipients of autologous CD34-selected PBSC. Infection rates and outcome, however, were not significantly different.Keywords: immune reconstitution, transplantation, purified blood stem cells, bone marrow, children. Lang et al, 2004). T-cell depletion of the graft, however, is known to impair T-cell reconstitution in the recipient, causing post-engraftment immunodeficiency and increased non-relapse mortality (Ochs et al, 1995;Davison et al, 2000).The aim of the present prospective study was to analyse and compare laboratory data of immunity in children receiving unmanipulated allogeneic BM or CD34-selected autologous or allogeneic PBSC. Patients and methods Patient characteristicsOver a 7-year period, 61 children were enrolled in this study after informed consent was obtained from parents. Eighteen patients died early after HSCT and could not be evaluated. Seven patients were lost to follow-up. Patients receiving autologous unselected PBSC (n ¼ 2), autologous PBSC + autologous BM (n ¼ 1) and unmanipulated UCB (n ¼ 2) were excluded. The remaining 31 patients (female: n ¼ 9, male: n ¼ 22) were diagnosed with severe aplastic anaemia . These patients underwent a total of 31 single HSCT and were studied with respect to immunological reconstitution. All 31 transplantations were grouped according to the different stem cell source used: autologous CD34-selected PBSC (group 1; n ¼ 10), allogeneic CD34-selected PBSC (group 2; n ¼ 12), and allogeneic unmanipulated BM (group 3; n ¼ 9) for statistical analysis. Transplantation characteristicsTransplantation characteristics are depicted in Table I. As conditioning regimen patients received busulfan-based (n ¼ 13), total body irradiation (TBI)-based (n ¼ 4) or other high dose chemotherapy-based regimens (n ¼ 13). In one patient, a reduced intensity immunoablative conditioning regimen was used. Graft manipulationAutologous PBSC were mobilised and harvested according to treatment protocols used. Allogeneic PBSC were mobilised by subcutaneous injection of granulocyte colony-stimulating factor (G-CSF, 5-10 lg/kg body weight/d) once daily for 5 consecutive days. Allogeneic and autologous PBSC were CD34-selected using the CD34 + Progenitor Cell Isolation Kit (Miltenyi Biotec, Bergisch Gladbach, Germany) applying a magnetic cell separation (MACS) technique using the Clini-MACS sorting device (Miltenyi Biotec) according to the manufacturer's instructions. The purity and recovery of the isolated CD34 + cells and the contamination with T-lymphocytes were assessed by flow cytometry. Autologous PBSC were frozen after dilution with a dimethylsulfoxide (DMSO) containing freezing solution using a computerised nitrogen freezer and stored at )193°C in the liquid phase of nitrogen until tran...

Vaccination has a significant impact on morbidity and mortality. High vaccination coverage rates are required to achieve herd protection against vaccine-preventable diseases. However, limited vaccine access and hesitancy among specific communities represent significant obstacles to this goal. This review provides an overview of critical factors associated with vaccination among disadvantaged groups in World Health Organisation European countries. Initial searches yielded 18,109 publications from four databases, and 104 studies from 19 out of 53 countries reporting 22 vaccine-preventable diseases were included. Nine groups representing the populations of interest were identified, and most of the studies focused on asylum seekers, refugees, migrants and deprived communities. Recall of previous vaccinations received was poor, and serology was conducted in some cases to confirm protection for those who received prior vaccinations. Vaccination coverage was lower among study populations compared to the general population or national average. Factors that influenced uptake, which presented differently at different population levels, included health service accessibility, language and vaccine literacy, including risk perception, disease severity and vaccination benefits. Strategies that could be implemented in vaccination policy and programs were also identified. Overall, interventions specific to target communities are vital to improving uptake. More innovative strategies need to be deployed to improve vaccination coverage among disadvantaged groups.

There is marked heterogeneity in the use and functionalities of EHRs used among child primary child healthcare providers in Europe. More importantly, lack of critical paediatric supportive functionalities like growth tracking and vaccination status has been documented in some countries. There is a need to explore the reasons for these findings, and to develop a cross European paediatric EHR standards.

The eradication of smallpox and the elimination of several other infectious diseases from much of the world has provided convincing evidence that vaccines are among the most effective interventions for promoting health. The current scepticism about immunisation among members of the new US administration carries a risk of decreasing immunisation rates also in Europe. While only a small minority of the population are strongly anti-vaccine, their public activities have significantly influenced an uncertainty among the general population about both the safety of and the necessity for vaccination. Therefore, the EAP calls for greater publically available, scientifically supported information on vaccination, particularly targeted at health care providers, for the further development of electronically based immunisation information systems (IIS). We further call on all European countries to work together both in legislative and public health arenas in order to increase vaccination coverage among the paediatric population. In the interest of children and their parents, the EAP expresses its strong support for childhood immunisation and recommended vaccination schedules. We are prepared to work with governments and media and share the extensive evidence demonstrating the effectiveness and safety of vaccines.