Bacille Calmette-Guérin (BCG) 백신 접종 후 림프절염의 발생 빈도
The Incidence Rate of Lymphadenitis after Bacille Calmette-Guérin (BCG) Vaccination
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Purpose: Bacille Calmette-Guérin (BCG) lymphadenitis is a relatively frequent local adverse reactions after BCG vaccination. Its incidence rate is usually <1%. However, this rate may be different according to BCG strain, vaccination method or skill, etc. In the Republic of Korea, two BCG strains are used: intradermal Danish-1331 or percutaneous Tokyo-172. We surveyed the incidence rates of BCG lymphadenitis. Methods: This survey was performed in total 25 centers (5 general hospitals, 20 private pediatric clinics). Immunized type of BCG strain in study subjects was verified by directly observing the scar. The occurrence of BCG lymphadenitis was asked to their parent. In cases of BCG lymphadenitis, location, diameter size, progression of suppuration, and treatment method were investigated, as well. Results: The total number of study subjects was 3,342. Among these, the subjects suitable for enrollment criteria (total 3,222; Tokyo strain 2,501, Danish strain 721) were analyzed. BCG lymphadenitis regardless of its size developed in each five of subjects per strains, therefore, its incidence rate was 0.20% in Tokyo and 0.69% in Danish strain, respectively (P=0.086). However, when applying the WHO criteria - the development of lymph node swelling with diameter 1.5 cm or more, the incidence rate of BCG lymphadenitis was 0.16% (4 cases) in Tokyo and 0.42% (3 cases) in Danish strain, respectively. Conclusions: The incidence rate of lymphadenitis in two BCG types, percutaneous Tokyo and intradermal Danish strain BCG, is 0.20% and 0.69%, respectively. Both rates are acceptable.
Abstract
Purpose: Bacille Calmette-Guérin (BCG) lymphadenitis is a relatively frequent local adverse reactions after BCG vaccination. Its incidence rate is usually <1%. However, this rate may be different according to BCG strain, vaccination method or skill, etc. In the Republic of Korea, two BCG strains are used: intradermal Danish-1331 or percutaneous Tokyo-172. We surveyed the incidence rates of BCG lymphadenitis. Methods: This survey was performed in total 25 centers (5 general hospitals, 20 private pediatric clinics). Immunized type of BCG strain in study subjects was verified by directly observing the scar. The occurrence of BCG lymphadenitis was asked to their parent. In cases of BCG lymphadenitis, location, diameter size, progression of suppuration, and treatment method were investigated, as well. Results: The total number of study subjects was 3,342. Among these, the subjects suitable for enrollment criteria (total 3,222; Tokyo strain 2,501, Danish strain 721) were analyzed. BCG lymphadenitis regardless of its size developed in each five of subjects per strains, therefore, its incidence rate was 0.20% in Tokyo and 0.69% in Danish strain, respectively (P=0.086). However, when applying the WHO criteria - the development of lymph node swelling with diameter 1.5 cm or more, the incidence rate of BCG lymphadenitis was 0.16% (4 cases) in Tokyo and 0.42% (3 cases) in Danish strain, respectively. Conclusions: The incidence rate of lymphadenitis in two BCG types, percutaneous Tokyo and intradermal Danish strain BCG, is 0.20% and 0.69%, respectively. Both rates are acceptable.
참고문헌 (32)
- World Health Organization, "BCG vaccine: WHO position paper", Wkly Epidemiol Rec, 79, pp.27~38 (2004)
- Milstien JB, "Quality control of BCG vaccine by WHO: a review of factors that may influence vaccine effectiveness and safety", Bull World Health Organ, 68, pp.93~108 (1990)
- The Korean Pediatric Society, "Immunization guideline", pp.40~54 (2012), The Korean Pediatric Society
- Lotte A, "A bibliography of the complications of BCG vaccination. A comprehensive list of the world literature since the introduction of BCG up to July 1982, supplemented by over 100 personal communications", Adv Tuberc Res, 21, pp.194~245 (1984)
- World Health Organization, "Immunization safety surveillance. Guidelines for managers of immunization programmes on reporting and investigating adverse events following immunization", Western Pacific Regional Office, WHO, ~ (1999)
- Talbot EA, "Disseminated bacille Calmette-Guérin disease after vaccination: case report and review", Clin Infect Dis, 24, pp.1139~1146 (1997)
- Ustvedt HJ, "Local reactions in BCG vaccination", Bull World Health Organ, 2, pp.441~468 (1950)
- Goraya JS, "Bacille Calmette-Guérin lymphadenitis", Postgrad Med J, 78, pp.327~329 (2002)
- Mori T, "Lymph node swelling due to bacille Camette-Guerin vaccination with multipuncture method", Tuber Lung Dis, 77, pp.269~273 (1996)
- Daoud W, "Control of an outbreak of BCG complications in Gaza", Respirology, 8, pp.376~378 (2003)
- Jeena PM, "Safety of the intradermal Copenhagen 1331 BCG vaccine in neonates in Durban, South Africa", Bull World Health Organ, 79, pp.337~343 (2001)
- "R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria" (2015)[URL]
- Corbel MJ, "Report on a WHO consultation on the characterisation of BCG strains, Imperial College, London 15-16 December 2003", Vaccine, 22, pp.2675~2680 (2004)
- Smith KC, "Vaccines", pp.789~811 (2013), Elsevier Inc
- Fine PEM, "Issues relating to the use of BCG in immunization programmes: a discussion document", WHO, ~ (1999)
- Samileh N, "Immunity status in children with Bacille Calmette-Guerin adenitis. A prospective study in Tehran, Iran", Saudi Med J, 27, pp.1719~1724 (2006)
- Serour F, "Analysis of the interleukin-12", interferongamma pathway in children with non-tuberculous mycobacterial cervical lymphadenitis, 2007, pp.166, 835~841
- Yeganeh M, "Severe combined immunodeficiency:a cohort of 40 patients", Pediatr Allergy Immunol, 19, pp.303~306 (2008)
- Lee PP, "Susceptibility to mycobacterial infections in children with X-linked chronic granulomatous disease: a review of 17patients living in a region endemic for tuberculosis", Pediatr Infect Dis J, 27, pp.224~230 (2008)
- Nyerges G, "Significance of the number of viable units in BCG vaccines", Dev Biol Stand, 58, pp.331~336 (1986)
- Teulieres L, "Comparative trial of administration of half (0.05 mg) and quarter (0.025 mg) dose of intradermal Pasteur BCG on 291 infants from birth to 1 year in French Guyana", Vaccine, 9, pp.521~524 (1991)
- Teo SS, "BCG vaccine-associated suppurative lymphadenitis", Vaccine, 23, pp.2676~2679 (2005)
- Gheorghiu M, "The present and future role of BCG vaccine in tuberculosis control", Biologicals, 18, pp.135~141 (1990)
- Bolger T, "Complications associated with the bacille Calmette-Guerin vaccination in Ireland", Arch Dis Child, 91, pp.594~597 (2006)
- World Health Organization, "Expanded programme on immunization, biologicals unit: lymphadenitis associated with BCG immunization", Wkly Epidemiol Rec, 63, pp.381~388 (1988)
- 백혜성, "피내용 BCG 접종 후 발생한 국소 림프절염", Korean Journal of Pediatrics, 49(1), pp.46~50 (2006), 대한소아과학회
- Hwang JS, "A clinical study on BCG lymphadenitis", Korean J Pediatr, 40, pp.614~618 (1997)
- 이진수, "경피용 건조 B.C.G. 백신(Tokyo 172주) 접종 후 국소 반응과 투베르쿨린 양전율에 관한 연구", Pediatric Infection and Vaccine, 7(2), pp.201~210 (2000), 대한소아감염학회
- Oh MH, "The clinical study on conversion rate of Mantoux test, change of local lesion and complication after multipuncture BCG vaccination in neonates", Korean J Pediatr, 40, pp.1120~1130 (1997)
- Comparison of each strains (Pasteur, Danish, Tokyo) of BCG efficacy using tuberculin test and adverse reactions, "Kim HJ", Korea Center for Diseases Control and Prevention, ~ (2008)
- Goraya JS, "Treatment of Calmette-Guerin Bacillus adenitis: a metaanalysis", Pediatr Infect Dis J, 20, pp.632~634 (2001)
- Banani SA, "Neddle aspiration for suppurative post-BCG adenitis", Arch Dis Child, 71, pp.446~447 (1994)