Children with lymphadenitis associated with Bacillus Calmette-Guérin (BCG) vaccination do not experience more infections when compared with BCG-vaccinated children without lymphadenitis: a three years paired-cohort in Mexico

Autor: Chacon-Cruz, Enrique, Arellano-Estrada, Jorge Luis, Lopatynsky-Reyes, Erika, Alvelais-Palacios, Jorge, Becka, Chandra
Zdroj: Therapeutic Advances in Vaccines; August 2017, Vol. 5 Issue: 4-5 p103-107, 5p
Abstrakt: Objectives: Vaccination against tuberculosis with live-attenuated Bacillus Calmette-Guérin (BCG) is widely used even though its effectiveness is controversial. BCG-lymphadenitis (BCG-LA) is its most common complication. Some studies have proposed that BCG-LA can be associated with primary immunodeficiencies (PIs). This study’s aim is to see whether patients who developed BCG-LA (named as ‘LA’) developed more infections than BCG-vaccinated children without BCG-LA (named as ‘NON-LA’).Methods: From January 2009 to April 2014, 31 LA children were seen at the outpatient clinic of the General Hospital of Tijuana, Mexico. Among them, 22 (70.97%), 5 (16.13%) and 4 (12.9%) had axillary, supraclavicular, or both BCG-LA, respectively. No treatment was given and complications were not seen. Per LA subject, a NON-LA not >1 month of age difference and same gender was paired and followed for 3 years to look for ambulatory infections (AINFs), acute otitis media (AOM) and hospitalizations. Surveillance per patient was performed by phone monthly, and they were seen at the clinic every 4 months. All patients were HIV-negative and had no family history of PI. Statistical analyses used were relative risk (RR) with confidence intervals (CI), ttest for independent variables and ztest.Results: In total 62 subjects were enrolled: 31 LA paired with 31 NON-LA. Between them, there were no differences in age, day care attendance and breastfeeding. There were no differences in the total number of AINF per patient (LA: 18.61 avg. ± 5.03 SD versusNON-LA: 18.19 avg. ± 4.17 SD, RR = 1.06, 95% CI = 0.33–0.66), AOM total episodes (LA: 30 versusNON-LA: 26, RR = 0.87, 95% CI = 0.31–0.68) and hospitalizations (LA: 5 versusNON-LA: 4, RR = 1, 95% CI = 0.25–0.74).Conclusions: This cohort strongly suggests that BCG-LA in healthy children is not associated with more episodes of AINF and hospitalizations, when paired and compared with children BCG-vaccinated without BCG-LA.
Databáze: Supplemental Index