常州市不同等级两所医院新生儿卡介苗接种效果及影响因素研究

目的了解常州市不同等级的两所医院新生儿卡介苗接种效果及其影响因素,为提高接种质量和人群免疫水平提供依据。方法选择1个市级医院、1个县级医院作为哨点,监测2013年1-12月不同批次菌苗对符合条件新生儿的接种情况,3个月后进行结核菌素试验(PPD),观察硬结纵横径和直径,评价接种效果;采用Logistic回归模型,对接种效果进行多因素回归分析。结果共接种卡介苗新生儿2 254例,接种成功2 090人,接种成功率92.7%。单因素分析显示,不同单位、季节、疫苗批次卡介苗接种成功率差异有统计学意义(P0.05);金坛市人民医院接种成功率为95.15%,明显大于市妇幼保健院(90.17%),差异有统计学意义(P0.05);经组间比较,秋季接种成功率(97.94%)明显高于冬季(90.76%,χ2=14.080,P=0.000)。疫苗批号201003a015-1接种成功率明显低于其他各批号,批号201003a012-2接种成功率明显低于批号201101a004-1和201012a083-2,差异均有统计学意义(均P=0.000)。多因素logistic回归分析,疫苗批号(OR=1.754,95%CI:1.477~2.084)是卡介苗接种成功的影响因素。结论常州市市县不同等级医院新生儿卡介苗接种成功率均较高,疫苗不同批次是影响接种成功的影响因素。     

新生儿产房卡介苗接种影响因素调查分析

目的了解产房新生儿卡介苗接种与相关影响因素。方法选择不同接种单位和多批次菌苗在不同季节对新生儿进行接种,3个月后进行PPD试验,测量PPD结果和卡痕直径,以卡痕阳性为接种成功,以PPD阳性为免疫成功,分别与不同接种单位、多批号疫苗、季节变化,以及新生儿性别、户籍、接种时体重和PPD测定月龄等因素,进行单因素和多因素logistic回归分析。结果单因素分析显示接种单位、疫苗批号、季节、PPD测定月龄对接种成功率和免疫成功率均有影响(P0.05)。多因素分析显示,上述4个因素对接种成功率影响均无统计学意义,对免疫成功率影响除接种单位为混杂因素外,其余3个均有统计学意义(P0.05)。结论 PPD测定月龄、疫苗批号和季节变化对卡介苗免疫成功率有影响。     

接种重组乙型肝炎疫苗(酵母)偶合维生素K缺乏致颅内出血1例

患儿男,2005年5月24日生,母乳喂养。出生24h内分别在两上臂接种卡介苗、乙型肝炎(乙肝)疫苗,未见不良反应。7月6日(出生40d)接种第2针5μg重组乙肝疫苗(酵母)(广东省深圳康泰生物制品有限公司生产,批号20050103-1,有效期2008-01-09)。接种前几天,患儿曾患感冒,服用过抗生素。接种疫苗后,接种部位出血较多,按压止血时间较一般儿童长。患儿接种后当天晚上开始哭闹,不吃奶,症状持续未见好转,遂到医院就诊。该门诊同批次疫苗已接种24人次,未见类似反应;全区同批次疫苗共用2 700人次,亦未见类似反应。7月8日上午,接诊医生发现患儿嗜睡,面色苍白,…     

新生儿卡介苗接种成功率的探讨

目的:探讨新生儿卡介苗接种成功率的相关因素.方法:从菌苗保管、运输和对操作者在专业培训前后预防接种方法进行比较,将培训前后接种新生儿人数作资料统计分析.结果:培训后接种成功率显著大于培训前接种成功率.结论:要提高新生儿卡介苗预防接种成功率必须经过专业培训,方能接种成功,从而达到有效的控制和消灭结核病的发生.     

新生儿卡介苗接种质量监测与效果评价

目的 了解沈阳市沈河区新生儿卡介苗接种质量、卡痕大小与结核菌素纯蛋白衍化物(PPD)阳转的关系及接种不良反应的发生情况.方法 对2009-2011年在该区产院出生接种过卡介苗的1 711名新生儿采用PPD检测,测定阳转率;测定卡痕大小及所有新生儿卡介苗接种不良反应进行监测.结果 PPD阳转率达到99.36％,其中强阳性率占15.60％;卡痕的阳性(＞4 mm)有936例与PPD试验阳性结果的配对x2检验,分析看差异有统计学意义(x2=758.05,P＜0.01).发生2例卡介苗接种不良反应.结论 该地区新生儿卡介苗接种成功率达到了90％的标准;对强阳性的儿童建议追踪观察;不能用卡痕大小代替PPD试验判断卡介苗接种成功与否;提高接种人员接种技术和加强健康教育宣传,减少卡介苗接种不良反应.     

3283名新生儿首针乙型肝炎疫苗卡介苗接种情况及未接种原因调查

蓬莱市2003年6月1日将乙型肝炎(乙肝)疫苗纳入儿童计划免疫,为了解首针乙肝疫苗、卡介苗接种情况,掌握影响接种的因素,对在医院出生的3283名新生儿乙肝疫苗、卡介苗接种登记卡进行整理分析,对245名未接种者进行原因调查,现将结果报告如下。1材料与方法1·1资料来源2003年6月1日~2004年10月31日,在蓬莱市人民医院、中医院、解放军405医院出生的3283名新生儿首针乙肝疫苗、卡介苗接种登记报告卡。1·2方法对3所医院所报首针乙肝疫苗、卡介苗接种登记卡进行分类、整理、分析。2种疫苗均接种为完全接种,完成1种疫苗接种为不完全接种;24h内接种为…     

安徽六安市婴儿卡介苗接种效果评价及相关因素分析

目的评价婴儿卡介苗（BCG）接种质量及效果,分析其影响因素。方法在全市8县区中抽取1周岁以内且接种BCG 12周以上的健康婴儿,调查接种时间,测量卡痕径值、进行结核菌素（BCG-PPD）试验并观察结果。结果共调查800名婴儿卡痕率为97.00%,PPD试验阳性率80.13%;单因素分析显示,出生后BCG接种时间（χ2=6.695,P=0.010）、卡痕直径（χ2=61.250,P=0.000）、住址不同（χ2=73.148,P=0.000）的PPD试验阳性率差异有统计学意义（P〈0.05）,不同性别差异无统计学意义（χ2=3.650,P=0.056）。多因素Logistic回归分析显示,卡痕直径〈3 mm与≥3 mm的PPD阳性率差异有统计学意义（P〈0.05）,提示卡痕直径≥3 mm时接种更成功（OR=0.413,95%CI：0.263-0.649）。结论六安市卡介苗接种质量总体较好。卡痕直径、出生后接种时间,医务人员的接种技能是卡介苗接种效果的影响因素。     

不安运动阶段影响婴儿全身运动质量的影响因素分析

目的 分析影响婴儿不安运动阶段全身运动(GMS)质量的相关因素,为临床干预提供理论依据。方法 选取2015年7月-2018年4月接受GMs评估且处于不安运动阶段的高危小婴儿719例,其中,GMs评估正常组571例,异常组148例。对可能会影响小婴儿GMs质量的产前、产时、产后发生的21种危险因素进行调查。结果 单因素分析显示,GMs异常组婴儿出生体重明显低于正常组(P<0.01);而出生胎龄(<30周)、新生儿窒息、缺氧缺血性脑病、新生儿高胆红素血症、颅内出血、新生儿惊厥的比率明显高于正常组(P<0.05)。Logistic回归分析显示,有统计学意义的影响因素有出生体重(OR=0.645,95%CI:0.474~0.878)、出生胎龄(<30周)(OR=4.05,95%CI:1.565~10.484)、缺氧缺血性脑病(OR=3.152,95%CI:1.765~5.629)、新生儿高胆红素血症(OR=5.07,95%CI:3.161~8.132)、新生儿惊厥(OR=3.579,95%CI:1.572~8.146)。结论 出生胎龄(<30周)、缺氧缺血性脑病、新生儿高胆红素血症、新生儿惊厥是影响不安运动阶段婴儿GMs质量的独立危险因素,而出生体重是保护因素;对存在此类高危因素的小婴儿,应给予早期筛查及干预。     

一起卡介苗误种事故的观察分析

1 事件经过 2006年10月18日上午9时20分,我市建设花园20号楼的一位家长携带一名满八月龄的儿童到市疾控中心预防接种门诊接种麻疹疫苗.经询问登记后,家长带该儿童到接种室接种,接种人员经核对按常规用1ml稀释液将疫苗溶解,抽吸0.5ml为该儿童进行左上臂三角肌皮下注射,告知儿童家长休息20min再离开.在接种人员整理接种台时,发现该儿童接种的疫苗不是麻疹疫苗而是卡介苗(生产日期2006.02.05,批号200602a013-3,有效期2008.02.05,成都生物制品研究所).     

接种轮状病毒疫苗偶合轮状病毒腹泻1例报告

患儿,男,2006年12月12日出生.已接种了卡介苗、乙型肝炎(乙肝)疫苗、脊髓灰质炎减毒活疫苗、百日咳-白喉-破伤风联合疫苗、b型流行性感冒嗜血杆菌疫苗,均未见副反应.2007年6月12日,在某预防接种门诊于接种前经体检健康状况良好,无接种禁忌证后,接种乙肝疫苗1剂(北京天坛生物制品有限公司生产,批号2006020303,效期至2009-03);口服轮状病毒疫苗(Rotavirus Vaccine,RotV)1剂(兰州生物制品研究所生产,批号20060804,有效期至2007-10-23).接种后1周内患儿大便次数较平时增多,第11d出现水样便,6月26日在某医住院治疗.     

2008—2011年南通市某医院新生儿乙肝疫苗和卡介苗的接种情况

目的了解南通市第一人民医院新生儿首针乙型肝炎(乙肝)疫苗和卡介苗接种情况和未及时接种原因,探讨提高新生儿乙肝疫苗和卡介苗及时接种率和接种率的对策。方法调查2008—2011年新生儿接种登记资料,对新生儿预防接种情况及未接种原因进行统计分析。结果 2008—2011年6 402名活产新生儿首针乙肝疫苗及时接种率在94.55%～95.18%,乙肝疫苗接种率在94.68%～98.91%;卡介苗及时接种率在90.07%～92.06%,卡介苗接种率在91.98%～94.98%。不同年份乙肝疫苗及时接种率、卡介苗及时接种率比较,差异无统计学意义(P0.05)。不同年份乙肝疫苗接种率、卡介苗接种率比较,差异有统计学意义(P0.01)。2008、2009年乙肝疫苗和卡介苗及时接种率和接种率比较,差异无统计学意义(P0.05)。2010、2011年乙肝疫苗和卡介苗及时接种率和接种率比较,差异有统计学意义(P0.01)。乙肝疫苗未及时接种主要原因是:早产儿和患病儿,分别占未及时接种者的82.98%和12.46%。卡介苗未及时接种主要原因是:早产儿和患病儿,分别占未及时接种者的58.00%和42.00%。结论该院新生儿乙肝疫苗和卡介苗接种工作开展较好,接种率呈逐年上升趋势。由临产室尽早为新生儿接种首针乙肝疫苗,提高外来孕妇产检率,正确把握接种禁忌证,出院前符合接种要求的新生儿由新生儿室补种,是提高新生儿首针乙肝疫苗和卡介苗及时接种率和接种率的有效措施。     

2010-2011年福田区新生儿预防接种情况分析

目的分析福田区产科医院分娩的59527名新生儿首剂乙型肝炎疫苗和卡介苗接种情况及其影响因素。方法对福田区产科医院分娩的59527名新生儿首剂乙型肝炎疫苗和卡介苗接种情况对比分析。结果福田区共有新生儿59527名,2011年首剂乙肝疫苗接种率（95．81％）较2010年（94．31％）有所提高,差异有统计学意义（X^2=71．51,P〈0．01）;2011年母亲H13sAg阳性新生儿乙肝免疫球蛋白接种率（98．27％）较2010年（78．23％）有显著提高,差异有统计学意义（X^2=502．87,P〈0．01）;新生儿卡介苗接种率2011年（84．00％）与2010年（83．43％）无差异,但平均卡介苗接种率（83．71％）较同期平均乙肝疫苗接种率（89．21％）低,差异有统计学意义（X^2=4064．57,P〈0．01）。结论福田区2011年乙肝疫苗及乙肝免疫球蛋白接种率较2010年有明显提高,乙肝免疫球蛋白供应到位以及严格实施《深圳市预防和控制乙型肝炎母婴传播技术指南》是其主要原因,卡介苗接种率有待提高。     

Evaluation of BCG vaccination: an intervention study in Rail Region, Saudi Arabia

Inspection of 300 infants attending a primary health care (PHC) center at Hail region showed that 18.8% of children failed to develop BCG reations. This directed attention to inspect the process of vaccination at hospitals in which 80% of deliveries and BCG vaccination took place. Defects in the process of vaccination and cold chain system were noticed. Reorganization of the process of vaccination in addition to training the staff responsible for vaccination were done. A survey was followed to evaluate failure of BCG vaccination before and after the intervention. We checked 4145 infants two to twelve months of age, for any reaction at the site of BCG vaccination. After intervention vaccination failure dropped from 20.4% to 4.9% for infants vaccinated in hospitals (p = 0.00001), and from 7.9% to 3.2% for those vaccinated in health centers (p = 0.01). Moreover, before intervention success of BCG vaccination was significantly higher in PHC centers (92.1%) than in hospitals (79.6%). This difference became insignificant after intervention because success of BCG vaccination in hospitals has increased up to 95.1% compared to 96.8% in health centers. Inspection of all infants for BCG reaction is continued as a part of routine work at PHC centers, and re-vaccination of those who failed to develop reation to BCG is conducted without any reported complications.     

2008~2009年邹城市新生儿乙肝疫苗首针与卡介苗接种情况分析

[目的]了解新生儿乙肝疫苗与卡介苗接种情况。[方法]2008年9月和2009年9月,对邹城市新生儿乙肝疫苗接种情况进行抽查,2010年1月对2008～2009年各级医疗机构新生儿乙肝疫苗接种情况进行调查。[结果]2008～2009年医疗机构分娩新生儿,乙肝疫苗接种率为94．10％,其中2008年为94．21％,2009年为93．99％（P〉0．05）;乙肝疫苗及时接种率为93．77％,其中2008年为93．87％,2009年为93．67％（P〉O．05）;乙肝疫苗未接种的原因主要是新生儿窒息、缺氧等转儿科治疗（占49．46％）和早产、难产（占23．51％）。卡介苗接种率为92．42％,其中2008年为92．42％,2009年为92．43％（P〉0．05）,未接种原因主要是新生儿窒息、缺氧等转儿科治疗和早产、难产与发热,分别占58．38％、31．26％、22．25％。2008~2009年抽查420人,卡介苗全部接种;乙肝疫苗接种率为99．29％。其中2008年为99．52％,2009年为99．05％（P〉0．05）,未接种者中,2人有禁忌证,1人为计划外生育儿童。[结论]2008～2009年邹城市新生儿乙肝疫苗首针与卡介苗接种率较高。     

Relationship between bacille Calmette-Guérin vaccination, Mantoux test positivity, and geohelminth infection

To investigate the potential protective effects of Bacille Calmette-Guerin (BCG) vaccination scar and sensitization to tuberculin against geohelminth infections, we conducted a cross-sectional study among school age children in rural communities in Pichincha Province in Ecuador where BCG vaccination is routinely given at birth. A total of 944 children aged 8-14 years were evaluated for the presence of BCG scars and sensitization to tuberculin, and underwent faecal examination for geohelminth parasites. BCG scars were present in 88.2% of children and positive Mantoux tests were observed in 19.1% of children. Geohelminth prevalence was high with 70.3% infected with any parasite, 52.1% with Ascaris lumbricoides, 52.3% with Trichuris trichiura, 7.6% with Ancylostoma duodenale, and 3.0% with Strongyloides stercoralis. In multivariate analyses, the presence of BCG vaccine scars was not significantly associated with infections with any geohelminth parasite (adjusted odds ratio [AOR] = 0.74, 95% CI 0.43-1.28, P = 0.28), but an inverse association was observed for infections with S. stercoralis that was of borderline statistical significance (AOR = 0.38, 95% CI 0.15-1.00, P = 0.05). There were no associations between sensitization to tuberculin and infection with geohelminth parasites. The data provide little support for an important protective role of neonatal BCG vaccination or current mycobacterial sensitization against geohelminth infections.     

Safety of the intradermal Copenhagen 1331 BCG vaccine in neonates in Durban, South Africa

OBJECTIVE: To evaluate the safety of the intradermal Copenhagen BCG vaccine in neonates at different levels of delivery and neonatal units of the Durban Functional Region and surrounding regions. METHODS: A prospective study was carried out over a two-year period between July 1997 and June 1999. All neonates who had been vaccinated with the intradermal vaccine were evaluated at immunization clinics six weeks after immunization, or earlier if adverse effects occurred. FINDINGS: In total, 9763 neonates were examined: in 95.4% the vaccination scar had healed and 1.5% had no visible scar. Adverse events occurred in 3.1%. The proportion of neonates with no visible vaccination scars decreased over the study period, as did the number with adverse events. The lowest rate of adverse events and the highest rates of healed vaccination scars were seen in the tertiary hospital and regional and district hospitals that were in close proximity to the academic centre involved in this study. CONCLUSIONS: In the study sites, the transition from the percutaneous to intradermal route of administration of BCG vaccine was successful and took place without incurring unacceptably high rates of adverse events. To minimize adverse events, however, it is essential to continue training health personnel involved in implementing intradermal BCG vaccination programmes.     

A study of the effect of simultaneous vaccination with BCG and smallpox vaccine in newborn infants

In order to determine whether the BCG and smallpox vaccinations of newborn infants could be combined, thus saving staff, time and money, particularly in the developing countries, 696 newborn infants in Taiwan were divided into three groups and vaccinated by one of the following three methods: simultaneous vaccination with BCG and smallpox vaccine, vaccination with BCG only, and vaccination with smallpox vaccine only. On follow-up, no difference was observed between the ”simultaneous” group and the ”smallpox only” group in respect of either no-take rate and frequency distribution by size of vaccination lesions or reactions to smallpox revaccination at 12 weeks. Tuberculin tests at 12 weeks revealed a normal distribution in the size of tuberculin reactions with a mean of 11.94 mm and 12.19 mm respectively in the ”simultaneous” group and the ”BCG only” group; in the ”smallpox only” group all the reactions were below 9 mm, the great majority being 0-3 mm. The author concludes that there is no interaction between primary BCG and smallpox vaccination when both vaccines are administered simultaneously, and that, despite the reported complications, simultaneous administration of BCG and smallpox vaccine in newborn infants is a safe procedure.     

Efficacy of Spirolept vaccine against human leptospirosis as estimated by passive protection of laboratory rodents

OBJECTIVE: This study had for aim to assess the serological response induced by the Spirolept vaccine against human leptospirosis. METHOD: A serological follow-up was made on 31 patients at a risk of occupational exposure. The antibody titers of vaccinated patients were assessed by MAT and ELISA. In a second step, vaccinal protection was studied in vivo by checking the seroprotective effect of the human sera injected in an animal model (Meriones unguiculatus) naturally susceptible to the disease. The passive protection was studied by comparing the death rate on five batches of animals to which the bacterium was inoculated. Thus, four batches of animals were injected subcutaneously with a pooled sera of vaccinated people sampled at D0, D15, D135, and D320 after Spirolept vaccination. One control batch was given PBS. One day after injection, the latter batch was inoculated with the homologous strain Verdun of Leptospira interrogans ss icterohemorrhagiae (serogroup Icterohemorrhagiae) used to make the vaccine. RESULTS: The death rate was significantly decreased as soon as D15 after the first injection, even with pooled sera of vaccinated people negative for the MAT. COMMENTS: The Spirolept vaccine induces a protective response against icterohemorrhagiae, which can be transmitted to the animal model and thus is linked to a humoral response.