新生儿接种卡介苗后卡痕与结核菌素反应之关系

卡介苗(BCG)接种是我国儿童扩大计划免疫规划中第1个接种的菌苗,常于产后24h在产科完成。为考核西城区各产科卡介苗接种质量,并探索卡痕与结核菌素(结核菌素纯蛋白衍生物PPD)之间的关系,本文针对此进行分析。1资料和方法1.1对象2009年西城区出生3～4月龄的新生儿。1.2资料来源...     

北京市丰台区外来儿童卡介苗接种状况的研究

目的掌握本地区外来儿童卡介苗接种状况。方法对小学二年级学生进行卡介苗接种史、卡痕、户口所在地、出生地情况调查，同时进行人型-PPD试验。结果外来儿童卡介苗接种率、卡痕率明显低于本地儿童。而未接种卡介苗儿童结素阳性率明显高于本地儿童。结论外来儿童的卡介苗接种工作应予加强。     

结核自然感染和卡介苗接种免疫的鉴别观察

结素反应阳性是接种卡介苗所致，还是受到自然感染所致？这个问题至今尚未完全解决。为此，我们对结核病患者与卡介苗初免婴儿进行人型结核菌素纯蛋白衍化物（ＰＰＤ—Ｈ）与卡介菌素纯蛋白衍化物（ＰＰＤ—ＢＣＧ）等量双臂对照皮内试验，旨在鉴别结核自然感染抑或卡介苗...     

北京市丰台区外来儿童卡介苗接种状况的研究

目的　掌握本地区外来儿童卡介苗接种状况。方法 对小学二年级学生进行卡介苗接种史、卡痕、户口所在地、出生地情况调查 ,同时进行人型-PPD试验。结果 外来儿童卡介苗接种率、卡痕率明显低于本地儿童。而未接种卡介苗儿童结素阳性率明显高于本地儿童。结论 外来儿童的卡介苗接种工作应予加强。     

15112名医院新生儿卡介苗接种质量的监测分析

目的了解医院出生新生儿卡介苗的接种率、卡介苗免疫成功率及接种副反应。方法对2001～2008年在新疆医科大学第一附属医院出生的15112名新生儿进行卡介苗接种率、卡介苗纯蛋白衍生物（BCG-PPD）试验阳转率及卡介苗接种副反应的监测。结果新生儿卡介苗接种率平均为90.62%,BCG-PPD试验阳转率平均为90.36%,5例发生卡介苗接种反应。结论医院出生新生儿卡介苗各年份接种率变化不大,平均为90.62%,达到了中国结核病防治规划新生儿卡介苗接种率〉90%的标准。卡介苗阳转率逐年提高,接种质量有所提高,卡介苗接种反应率低,疫苗安全有效。     

吐鲁番市516名城乡儿童结核菌素试验及结核抗体检测分析

目的探讨小儿接种卡介苗后对结核免疫反应建立的情况。方法2004年对吐鲁番市516名接种卡介苗后的小儿进行结核菌纯蛋白衍生物(PPD)试验和PPD抗体检测。结果接种卡介苗后的小儿PPD试验阳性率2.52%。PPD-IgG阳性率15.89%,经统计学处理(χ2检验)表明居住农村的小儿PPD-IgG阳性率低于居住城市的小儿。结论应考虑接种的卡介苗效价是否符合要求(包括运输、储存是否合要求),建议接种卡介苗后3~6月作PPD试验或PPD抗体检测,对阴性者及时补种卡介苗,增强小儿对结核的免疫力。     

新疆奇台县194名儿童卡介苗阳转率调查分析

为了解新疆奇台县儿童卡介苗接种质量,有效地开展免疫接种工作,新疆奇台县疾病预防控制中心疾病控制科于2008年8月12～18日,对奇台县1周岁儿童进行卡介苗纯蛋白衍生物实验调查,现将调查情况报道如下。     

7914例新生儿卡介苗接种情况分析

为了解本地区新生儿卡介苗接种情况,我们于1993～2000年对7914例出生满3个月的新生儿进行了结核菌素纯蛋白衍生物（PPD）试验及卡介苗疤痕测量,现将结果报告如下。     

卡介苗接种效果观察

目的 了解2005年12月～2006年11月新生儿卡介苗接种后阳转率与卡痕大小、复验时间的关系.方法 对2005年12月～2006年11月的健康儿童803例PPD试验的结果进行分析.结果 结核菌素纯蛋白衍化物(TB-PPD)反应程度强阳性组、阳性组较阴性组卡痕大,2岁前PPD试验阳转率较2岁后高.结论 只有保证卡介苗的质量和接种技术,定期复查补种,才能使卡介苗12 w阳转率更进一步提高.     

卫生部生物制品标准化委员会修订PPD试验规程

卫生部生物制品标准化委员会于1992年4月,在北京召开了《中国生物制品规程》一部修订会议。与会专家讨论和修订了结核菌素纯蛋白衍生物(PPD)规程。原规程规定50IU/ml纯蛋白衍生物(PPD)系“专供BCG接种对象选择及接种后质量监测用”,现改为“供卡介苗接种对象选择、卡介苗接种后质量监测及临床诊断用”。根据该修订     

BCG—PPD与TB—PPD皮肤试验在大学生结核病筛查中的差异性分析

目的 比较卡介菌纯蛋白衍生物（purified protein derivative of BCG,BCG-PPD）与结核菌素纯蛋白衍生物（purified protein derivative of tuberculin,TB-PPD）在大学生结核病筛查中的差异。 方法 回顾性分析2012—2013年北京市西城区3所大学2821名学生的结核病筛查数据。根据使用的PPD试剂种类进行分组,BCG-PPD组学生1386名;TB-PPD组学生1435名。对两组观察者分别进行结核菌素试验,72 h查验硬结平均直径,对强阳性者进行胸部X线检查。采用SPSS 11.5软件进行统计分析,用秩和检验对两组硬结平均直径进行比较,用χ^2检验对组间PPD结果分布频度及结核病筛查结果进行比较,当理论值＜1时,采用Fisher确切概率法,卡痕与PPD阳性结果间相关性分析采用logistic回归,P〈0.05为差异有统计学意义。结果 中位硬结平均直径BCG-PPD组（6 mm）大于TB-PPD组（0 mm）,差异有统计学意义（Z=－10.034, P〈0.05）。BCG-PPD组的阳性率（54.8%, 759/1386）明显高于TB-PPD组（32.7%,469/1435）（χ^2=139.818,P〈0.05）;PPD强阳性率BCG-PPD组为6.6%（92/1386）,高于TB-PPD组的3.4%（49/1435）（χ^2=15.425,P〈0.05）;BCG-PPD组的异常反应发生率为1.9%（27/1386）,高于TB-PPD组的0.4%（6/1435）,差异有统计学意义（χ^2=14.274,P〈0.05）。卡痕与PPD阳性结果相关,有卡痕者更容易出现PPD阳性结果（OR=2.046,95％CI=1.630～2.569,P〈0.05）。 结论 TB-PPD和BCG-PPD皮肤试验在大学生结核病筛查中的强阳性率和异常反应发生率上存在差别,有进一步探讨的必要。     

Preliminary observation on tuberculous allergy and cross reaction with atypical mycobacteria PPD (purified protein derivative) in babies immunized by BCG]

In order to know the cross reaction between BCG and Atypical Mycobacteria (AM) antigenicity, 1150 babies immunized by BCG, aged 12-24 week, undertook a bilateral arm control test with H-PPD. type 11 AM-PPD and BCG-PPD. The results showed that all the AM-PPD tested can bring about a delayed allergy in these babies. but the total positive rate (42.87%) and mean reactive diameter (3.87 mm) were the lowest and smallest among the above mentioned three types of PPD. The BCG-PPD derived allergy has highest positive rate and largest reactive diameter, but there is no statistical difference when compared to those of allergy caused by H-PPD.     

Study on BCG vaccination and incidence of children's tuberculous meningitis in Liaoning province

The purpose of this study was to assess the effect of BCG vaccination on the incidence of tuberculous meningitis in children. A retrospective review was undertaken to find out vaccination rate of BCG and positive conversion mantoux rate in newborn infants. The results obtained were as follow: in 1980, vaccination rate was 51.61%, and the positive conversion Mantoux rate was 87.86%; in 1988 vaccination rate was 96.06%, and the positive conversion Mantoux rate was 94.92%. With the increase vaccination rate of BCG the incidence of tuberculous meningitis in children have decreased: in 1980 it was 3.27/100000; in 1988 it was 0.95/100000. The annual average incidence rate decreased by 14.28%.     

北京市新生儿卡介苗接种质量的监测

目的　了解近10年来北京市新生儿卡介苗接种工作的质量情况。方法 对1991～2000年本市各年新生儿卡介苗接种工作记录和质量监控结果记录进行统计,逐年分析。结果 近10年全市新生儿卡介苗接种率(简称接种率)、接种及时率、接种后12周结素试验阳转率(简称阳转率)和卡痕率以及结素反应平均直径、卡痕平均直径等6项指标均比较稳定。城区、近郊区和远郊区的接种率无明显差别,均在97%以上;农村的阳转率和结素反应平均直径两项指标也非常接近城区(包括近郊区)。结论 北京市新生儿卡介苗接种工作质量较高并在近10年中保持了各项监测指标的稳定。     

从第三次流调结果探讨我国卡介苗接种工作

通过对全国第三次结核病流行病学调查资料的再次分析来评价我国卡介苗接种工作。分析结果表明１９９０年调查时０～４岁儿童的卡介苗接种率为６５．０％，低于以往报道。０～４岁有卡介苗接种史儿童的结素阳性率仅为２６．３％，城市的阳性率最高也仅５５．８％，表明接种质量不高，必须找到原因而迅速改进。我国目前卡介苗接种的保护效果对０～４岁儿童是明显的，但对５～９岁儿童即不明显，因此必须进一步调查研究卡介苗复种的必要性。     

The effect of bacille Calmette-Guérin vaccination at birth on tuberculin skin test reactivity in Ugandan children.

SETTING: In Uganda, bacille-Calmette Guerin (BCG) vaccination coverage at birth is between 82 and 84%. OBJECTIVE: To evaluate the effect of neonatal BCG vaccination on tuberculin skin test positivity in Ugandan children exposed to infectious cases. DESIGN: As part of an ongoing prevalence study of household contacts of new tuberculosis cases, 365 children were evaluated to determine if BCG vaccination at birth had an impact on tuberculin skin testing. The children were classified as contacts (179) and non-contacts (186) depending on the presence of a sputum acid-fast bacilli (AFB) smear-positive adult tuberculosis case in the household. RESULTS: Regardless of prior BCG vaccination, children exposed to a smear-positive adult were more likely to have a positive skin test (purified protein derivative >5mm) (68% versus 36%, P < 0.01). BCG-vaccinated children below 1 year of age without a known household contact with active tuberculosis had a lower frequency of tuberculin skin reactions (29%) compared to their counterparts in the contact households (65%, P = 0.031). CONCLUSION: BCG vaccination at birth had no important effect on the interpretation of the tuberculin skin test reactivity in this group of Ugandan children. The tuberculin skin test remains a valuable tool for the evaluation of household contacts and suspected cases of tuberculosis in BCG-vaccinated children.     

Tuberculin reactivity in a chest clinic: the effects of age and prior BCG vaccination

Heaf tests were performed in 834 adults and children seen during one year in a tuberculosis contact clinic in Edinburgh. All subjects with a past history of tuberculosis, or who subsequently developed evidence of tuberculous infection and 63 subjects of Asian origin were excluded to leave 749 'healthy' adults and children broadly representative of the local caucasian population. All Heaf tests in 178 children without BCG vaccination were negative or grade I whereas 16 (73%) of the 22 children with a history of previous BCG vaccination were positive grade I or II. A strongly positive Heaf test (grade III-IV) in any child with or without previous BCG vaccination seen as a tuberculosis contact implies recent infection and merits consideration for chemoprophylaxis or prolonged follow-up. Two hundred and seventy adults without previous BCG vaccination showed an increasing incidence of strongly positive Heaf tests (grade III or IV) with age reaching a peak of 55% in the 45-65 age group; beyond the age of 65 this fell to 37%. Two hundred and eighty-one adults with previous BCG vaccination showed significantly more Heaf grades I and II, fewer negatives and fewer strong positives than the unvaccinated group. A strongly positive Heaf test (III-IV) is a frequent finding in a healthy adult and has little discriminatory value in the diagnosis of active tuberculosis infection in Edinburgh, and by implication elsewhere in the United Kingdom. Positive tuberculin tests should be viewed in the context of the tuberculin profile of the local population.     

Effect of BCG vaccination and non-tuberculous Mycobacterium infection on interferon gamma specific assay and a tuberculin skin test among children with a tuberculosis contact in Surabaya, Indonesia

The tuberculin skin test (TST) as a diagnostic tool for tuberculosis (TB) infection is used in many countries, including Indonesia, but lacks specificity. Interferon-gamma is a highly specific assay because it is not influenced by previous BCG vaccination or non-tuberculous mycobacteria (NTM) infections. We aimed to study the effect of BCG vaccination and NTM infection on the results of the interferon-gamma specific assay and TST among children with a TB contact. We carried out a cross-sectional study of children at an outpatient clinic in Surabaya, Indonesia. We studied 37 children aged 1-15 years having a household contact with an acid-fast bacilli positive adult index case. BCG vaccination was determined by the presence of a BCG scar. A PPD RT23 2 tuberculin test was used for the TST. ESAT-6, CFP-10, and TB 7.7(p4) antigens were used for the interferon-gamma assay by ELISA. Gastric aspirates were cultured in Lowenstein-Jensen media. A comparison of the two diagnostic tools among children aged 1-5 years without a BCG scar, revealed high agreement, while children with a BCG scar it revealed disagreement. Among children aged > 5 years with or without a BCG scar the comparisons revealed disagreement. Among children aged > 5-10 years, a comparison of the two diagnostic tools among NTM positive and negative children, there was a disagreement in results. Among children aged 1-5 years, the TST was influenced by a BCG scar. Infection with NTM had no influence on the results of the TST among children aged > 5-10 years, while in children aged 1-5 years and > 10 years the results could not be determined in this study.     

Tuberculin reactivity in first‐year schoolchildren in Madagascar

Objective The tuberculin skin test (TST) is an important tool in the diagnosis of tuberculosis infection in children. However, the interpretation of TST may be complicated by prior Bacillus Calmette‐Guerin (BCG) vaccination. We evaluated the effect of vaccination with BCG on TST reactivity in first‐year pupils attending state schools in Antananarivo. Methods STs were performed on 376 first‐year schoolchildren, aged 6 and 7, attending two state primary schools. The relationships between epidemiological information, BCG status (vaccination, BCG scars) and TST reactivity were assessed to compare TST sensitivity between children with and without BCG vaccination and between those with and without a BCG scar. Result The prevalence of positive TST results of ≥5, ≥10 and ≥ 15 mm was 20.2% (76/376), 18.3% (69/376) and 11.4% (43/376), respectively. BCG vaccination was not associated with TST reactivity, whatever the threshold used: ≥5 mm (odds ratio (OR, 1.2; 95% confidence interval (CI), 0.7–2.0); ≥10 mm (OR, 0.9; 95% CI, 0.6–1.7); ≥15 mm (OR, 0.6; 95% CI, 0.3–1.2). Conclusion These results suggest that in Madagascar, a positive TST result indicates TB infection (active or latent) rather than past BCG vaccination. Therefore, high BCG vaccination coverage does not appear to impair the usefulness of the TST as a tool for diagnosing tuberculosis.