铜陵市新生儿卡介苗接种质量监测结果分析

目的 探讨提高和确保新生儿BCG接种工作质量的方法和途径。方法 采取完善全市组织管理体系、全员培训、设常年新生儿BCG监测门诊、扩大监测面等措施。结果1999-2001年，新生儿BCG接种率、接种后12周末PPD阳转率、卡痕率、PPD反应平均直径、卡痕平均直径等监测指标均稳定达标，及时发现消除不利因素，对接种无效的102名进行了补种。结论 强化组织管理体系，全员培训，连续、动态、全覆盖监测有利于BCG接种质量的恒定提高。     

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。     

武钢新生儿卡介苗质量监测评价

目的分析武钢20年新生儿卡介苗接种质量监测情况。方法对1985-2004年武钢医院各年新生儿卡介苗接种和质量监测的原始记录进行统计分析。结果20年武钢的新生儿卡介苗及时接种率、卡介苗接种12周末阳转率、PPD平均直径、有卡痕率、合格卡痕率、卡痕大小的分布频率均逐年稳步提高到理想水平,对接种无效的506名进行了补种。结论武钢新生儿卡介苗接种质量稳步提高到较高水平,为预防儿童结核病发挥了重要作用。     

汕头市新生儿卡介苗接种质量的监测

目的了解6年来汕头市新生儿卡介苗接种工作的质量。方法逐年分析,6年来本市新生儿卡介苗接种工作和质量监控结果记录。结果1999~2004年新生儿卡介苗接种率98.38%,接种后12周末PPD阳转率89.37%,卡痕率87.57%,结素反应平均直径6.8±1.8mm,卡痕平均直径2.8±1.2mm,对接种无效的1783名新生儿进行补种。结论应加强疫苗的质量管理,强化培训,提高新生儿卡介苗接种质量。     

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。     

云南省红河州哈尼族结核病疫情调查分析

目的　调查云南省哈尼族肺结核流行情况。方法 出生满3个月以上婴儿至15周岁以下儿童作结核菌素试验(PPD)及卡介苗接种的卡痕检查,PPD强阳性者进行胸部摄片检查,有症状者进行痰菌检查。结果 402名哈尼族人中检出活动性肺结核23例,检出率5.7%,痰菌阳性3人,涂阳率746.27/10万。PPD强阳性反应25名,强阳性率4.0%。结论 云南省红河州哈尼族肺结核疫情严峻。     

停止卡介苗复种后儿童青少年结核感染及发病的研究

目的　观察停止卡介苗 (BCG)复种后,儿童青少年结核感染及发病情况。方法 1998年分别对北京市房山区12岁学生 (停止BCG复种组)和北京市通州区12岁学生 (未停BCG复种组)行结核菌素 (PPD)试验,72小时测量PPD反应——凡硬结平均直径≥6mm者行胸部X线检查,发现肺部阴影者查痰抗酸菌等。然后,依据PPD反应强度及活动性肺结核病人检出情况测算结核感染率及患病率。结果 停止BCG复种组与未停BCG复种组活动性肺结核病患病率分别为14.8/10万和18.6/10万 (P＞0.05)。结核感染率：以直径≥15mm为结核感染标准,分别为7.9%和19.6% (P＜0.05);以直径≥20mm为标准,分别为3.9%和4.2% (P＞0.05)。由此可见,用于反映停止BCG复种组结核感染与发病的两项主要指标均不高于甚至低于未停BCG复种组。结论 停止BCG复种后不会引起儿童青少年结核感染及发病的增加。同时可节省大量人力、物力和财力,更好实施其它有效的结核病控制措施。     

监测封闭社区结核病患者接触者结核感染状况二年的结果分析

目的 监测封闭社区(强制隔离戒毒所)中结核病患者接触者(简称“接触者”)的结核感染状况,并初步分析可能对该社区接触者受结核感染的影响因素。方法 采用结核菌素试验(PPD试验),对封闭社区中2016年10—11月确诊的5例结核病患者的所有接触者(共计792名)每6个月进行1次PPD试验,连续观察2年,其中有25名因各种原因未进行PPD试验,接受PPD试验者767名。依据《WS 288—2017 肺结核诊断》,有卡介苗接种卡痕者硬结平均直径≥10mm、无卡痕者硬结平均直径≥5mm判断为接触者结核感染。分析不同接触程度的767名接触者受MTB感染状况的变化情况。并用logistic回归模型进行社区接触者结核感染的危险因素分析。结果 在调查的封闭社区中,接触者第一次PPD试验结果被判断为结核感染者444例,感染率为57.9%(444/767)。在后续2年的结核感染监测中,323名未感染者中有54例(占16.7%,54/323)接触者变为结核感染;2年中社区接触者受结核感染者共498例,感染率64.9%(498/767)。有54名社区接触者在2年中PPD试验硬结直径减小或消失,由受结核感染变为未感染状态,占10.8%(54/498)。年龄(Wald χ ²=10.942,P=0.001,OR=1.04, 95%CI为1.02~1.06)、接种卡介苗(Wald χ ²=4.533,P=0.033,OR=1.41, 95%CI 为1.03~1.93)、与患者密切接触(Wald χ ²=6.343,P=0.012,OR=1.68, 95%CI 为1.12~2.52),是导致社区接触者结核感染风险增加的相关因素。讨论 封闭社区(强制隔离戒毒所)中结核病患者接触者MTB感染率较高,首次PPD试验筛查未感染者中有近1/6的接触者在2年间转为结核感染;有1/10结核感染者在2年间转为未感染状态。年龄增长、接种卡介苗、与结核病患者密切接触者受结核感染的比例增高。     

大庆市辖区10年新生儿卡介苗接种质量监测报告

卡介苗接种的预防效果及投入/产出的效益虽然存在着争议,但在结核病疫情较重的地区,新生儿卡介苗接种仍是预防儿童结核病特别是结核性脑膜炎的重要措施之一。而卡介苗的接种质量直接影响着它的预防效果,低质量的卡介苗接种,不但不能达到应有的效果。相反会造成大量的人力、物力资源的浪费。因此,对卡介苗接种工作进行连续的、系统的质量监测,发现问题、提高接种质量是非常重要的。大庆市辖区于1976年逐步开展卡介苗接种工作,1980年形成预防接种网络,1983年建立了卡介苗接种常规报告制度,1986年开始探索卡介苗接种的质量监测,1991年得以完善,1998年建立了卡介苗接种强反应监测体系。本文是对1991—2000年10年大庆市辖区新生儿卡介苗接种工作进行监测分析。资料与方法1.收集1991—2000年大庆市各年新生儿卡介苗接种工作报表、质量监测表、强反应记录和结核病人登记本、结核病统计年报表及《大庆市统计年鉴》。以此为基础,统计新生儿卡介苗接种率、接种后12周阳转调查率、阳转率、结素反应平均直径、卡痕率、卡痕平均直径等6项指标以及0~14岁儿童的结脑、肺结核及肺外结核登记新发情况。2.卡介苗为冻干卡介苗,12周阳转调查采用BCG...     

结核菌感染者微卡菌苗预防作用的研究

目的　观察、评价母牛分支杆菌菌苗(微卡苗)对结核菌感染健康人群PPD皮试强阳性者预防性治疗的效果。方法 对18～45岁PPD皮试强阳性健康人群分为微卡苗注射组、口服INH组和未处理对照组,观察对比治疗前、后的PPD皮试反应变化及发病情况。结果 治疗后较治疗前PPD反应:微卡苗组硬结平均直径显著减小(P<0.01),出现水泡、坏死者显著减少(P<0.01),INH预防组和未处理对照组二者变化较小(P>0.05)。观察1年微卡苗预防组无1人发病,INH预防组发病1例,未处理对照组发病4例。结论 微卡菌苗对结核菌感染者有较好的预防性治疗作用。     

Evaluation of BCG at birth in the United Arab Emirates

A total of 387 healthy full term infants who received BCG vaccination at birth were evaluated by the tuberculin PPD test at 6-8 weeks post vaccination. A total of 92% of these infants had visible BCG scars at that time. All infants were tested with PPD but only 264 returned for the test to be read. The tuberculin test was negative in 37 (14%) and of less than 5 mm induration in another 60 (23%) of the infants. The same pattern was observed in different nationalities. Of 11 infants with no BCG scar after vaccination, 3 had positive PPD reactions of more than 5 mm induration. There was a significant correlation between the size of the BCG scar and induration of tuberculin test P less than 0.001. The complications of the vaccination were minimal. We have observed 3 sterile abscesses at the site of BCG vaccination which resolved spontaneously. We think the available vaccine is safe and potent, and that the rate of BCG scar formation and of tuberculin conversion is higher than in most studies.     

Comparative skin testing with PPD tuberculin,Mycobacterium avium and M. scrofulaceum sensitin in schoolchildren in Saudi Arabia

Setting: Jizan region, Saudi Arabia.Objective: To test methodology for studies of tuberculin sensitivity and effectiveness of BCG vaccination programme.Design: School children (n = 315) aged 6–12 years simultaneously tested intradermally with PPD tuberculin RT23, 2TU and 0.1 μg Mycobacterium avium or M. scrofulaceum sensitin. Presence of BCG scar as evidence of previous BCG vaccination. Cervical lymph nodes palpated.Results: BCG coverage was 75%. The prevalences of positive reactions (induration ⪰ 6mm) were higher among children with than without scar. Prevalences of positive reactions to PPD and M. scrofulaceum sensitin were higher among girls than boys. In children with scar, the mean size of positive reactions to PPD was larger among girls than boys, and the prevalence of positive reactions was smaller in this group among children with than without palpable cervical lymph nodes. The sizes of reactions both to M. avium and to M. scrofulaceum sensitin were correlated to the size of the tuberculin reactions. Previous admission to hospital was reported less often by children with than without scar.Conclusions: The technique applied and training of staff was satisfactory. In further studies, however, we will apply three simultaneous tests to each person.     

Tuberculin skin testing: Determinants and reaction

Mantoux purified protein derivative (PPD) skin testing was performed in schoolchildren who were grouped according to positive (Group I, n = 205) and negative (Group II, n = 79) exposure to recent acid-fast bacilli (AFB) smear-positive tuberculosis (TB) family contact. A prospective case-control study was undertaken to evaluate whether repeat bacille Calmette-Guérin (BCG) vaccination, nutritional state, presence/absence of BCG scar, and degree of AFB positivity of sputum of adult TB cases affect PPD skin reactivity in these two groups. Group I with TB contacts had larger induration (13.00 +/- 11.29 mm) than the Group II control group of 4.52 +/- 6.20; P = 0.000. Purified protein derivative reaction as to the number of BCG vaccination(s) received showed an increase in size as the BCG vaccination is repeated with significantly larger induration in Group I than in Group II (P = 0.048). The nutritional status was subgrouped into A (weight < 10 percentile), B (weight 50-75 percentile), and C (weight > 90 percentile), which were comparable for both groups. The mean PPD induration of subgroup A in Groups I and II was not statistically different. However, the mean PPD induration was highly significant between Groups I and II in subgroup B (12.46 +/- 10.70 vs 3.80 +/- 5.71 mm; P = 0.000) and subgroup C (14.31 +/- 11.54 vs 5.42 +/- 6.70 mm; P = 0.000). Children in group I with the BCG scar were noted to have significantly greater PPD induration size than in group II (14.14 +/- 11.23 vs 5.05 +/- 6.24 mm; P = 0.000). The degree of AFB positivity of sputum of TB adult cases (1+ to 4+ and cavitary TB) has no effect on PPD size (P = 0.766). Close contact with individuals with active TB (AFB smear positive) is a very important factor for PPD skin conversion. Repeat BCG vaccination, malnutrition, and BCG with scars present difficulties in making a diagnosis of TB infection but did not affect PPD reactivity and did highlight the need for thorough clinical evaluation.     

铜陵市婴幼儿卡介菌纯蛋白衍生物试验结果分析

目的了解卡介苗（BCG）预防接种质量,分析存在的问题及其影响因素,提出改进措施,促进预防接种规范、安全、有效地开展。方法用卡介菌纯蛋白衍生物（BCG-PPD）试验方法,随机调查300名儿童接种卡介苗3个月后的阳转率。结果卡介菌纯蛋白衍生物试验总阳性率86.33%,城市儿童卡介菌纯蛋白衍生物试验阳性率高于农村儿童。卡痕大小与卡介菌纯蛋白衍生物试验阳性率呈正相关;县级及以上医院产科接种卡介苗的儿童卡介菌纯蛋白衍生物试验阳性率高于乡镇级医院产科和预防接种门诊接种卡介苗的儿童。结论加强对卡介苗接种人员,尤其要加强农村乡镇卫生院和接种门诊的接种人员的技术培训,提高接种质量。     

卡介苗接种对体液免疫的影响及其临床意义

目的观察卡介苗接种(简称种卡)与体内抗结核抗体变化间的关系?方法测定53例新兵种卡前及种卡后第12周和第24周时血清中抗PPD抗体(PPD IgG)的OD值并与种卡前进行对比分析?结果53例新兵种卡前PPD IgG2例(3.8%)阳性,种卡12周后15例(28.3%)阳性,种卡24周后9例(17.0%)阳性,抗PPD抗体OD值种卡后第12周较种卡前明显升高(P<0.001)?结论接种卡介苗后PPD IgG水平升高说明种卡可以提高机体对结核菌的体液免疫水平,且可在较长时间内维持,这对于儿童活动性结核病的血清学诊断结果可能会产生干扰作用。     

T细胞酶联免疫斑点法对风湿病患者潜伏性结核感染筛查诊断价值的再研究

目的 比较T细胞酶联免疫斑点法(TSPOT)与结核菌素纯蛋白衍生物(TB-PPD)试验对风湿病患者潜伏结核感染(LTBI)的诊断价值.方法 对260例明确诊断的风湿病患者进行LTBI的筛查.包括询问病史、胸部X线片、PPD试验及应用TSPOT-TB试剂盒对血液标本进行结核分枝杆菌(Mtb)特异性T细胞应答的检测,同时对所有病例进行联合分析.结果 TSPOT检测阳性率24.1%,PPD试验阳性率为39.4%,两者一致率为61.0%.其中PPD阴性/TSPOT阳性29例,PPD阳性/TSPOT阴性67例.卡介苗(BCG)接种史/既往结核病史的患者PPD试验的阳性率显著增高(P<0.05/P<0.01),但两者在TSPOT检测的阳性率上差异无统计学意义(P>0.05.其中127例患者使用生物制剂,9例使用异烟肼预防抗结核治疗,27例因PPD或TSPOT阳性放弃生物制剂治疗.TSPOT(-)PPD(++)的23例患者均在未预防抗结核下按计划接受了生物制剂治疗,上述患者在随访6～18个月期间尚无活动性结核发生.结论 TSPOT技术可能对风湿病(尤其拟接受生物制剂)患者LTBI的诊断提供帮助.     

The frequency profile of tuberculin skin testing among students in nursing school]

The frequency profile of tuberculin skin testing (TST) among students in nursing school was studied. Students received a TST upon matriculation. The TST was done by the method of Mantoux, in which 0.1 ml of PPDs was administered intradermally, and the diameters of skin rash and induration were read by the medical doctor at 48 hours. When TST results are negative--that is, the diameter of skin rash is below 10 mm (in Japan, the TST results are judged by skin rash diameter rather than that of induration)-BCG vaccination is given. Those receiving the BCG vaccination are retested with a TST one year later. When the second TST was also negative both the BCG vaccination and TST were followed for two more years. Those students testing TST-negative are not permitted to take clinical training in the tuberculosis ward. Student's mean age on entrance was 18.6 +/- 2.1 years old, and all but three were female. About 70% of students entering in 1996 to 1998 had a history of previous BCG vaccination. In 14% their positive TSTs could be attributed to probable infection with tuberculosis in childhood. In the remaining 16%, details as to TST and BCG vaccination status are unknown. The frequency distribution of TST results was bimodal, showing one peak at 6 mm and another at 12 mm (skin rash diameter). The percentage of negative and positive reactors are 47.1% and 52.9%, respectively. The TST-negative students entering in 1994 to 1996 were given the BCG vaccination. Twenty-four of 134 students (17.9%) remained negative at the second TST, and 6 students (4.5%) at the third year, even after two repeated BCG vaccinations. The TST results were chronologically observed in the above 6 students after BCG vaccination. The TST results of two students showed positive in September, 1996 and June, 1997. While four students showed positive in September, 1996, all ultimately reverted to negative when retested in June, 1997. Those students had negative results for TST at the initial test in 1998 had the two step-tuberculin skin testing. All eight students with negative TST had the history of BCG vaccination. The second TST showed positive except one student whose scar after BCG vaccination was not observed on the arm. The TST is currently recommended in hospital tuberculosis-control programs. If TST-negative, medical staff and students may not work in the tuberculosis ward. However, after BCG vaccinations is given, and subsequent TST conversion is confirmed, they are then able to work or to have training in the ward. From our results, there is 4.5% non-convertors even after 2 years of repeated BCG vaccinations. However, these non-converters turned positive four months after BCG vaccination, only to revert to negative nine months later. These students are considered to have delayed hypersensitivity to PPD after BCG vaccination. However, their reactivity waned in the short period of nine months after the conversion of their TST's. Therefore, it is concluded that non converters after repeated BCG vaccinations are able to have clinical training in the tuberculosis ward as long as their BCG vaccinations are correctly administered and any immunological deficiencies are ruled out.