Commun Dis Intell Q Rep. 2006;30(1):109-15. doi: 10.33321/cdi.2006.30.5.
The Bacille Calmette-Guérin (BCG) vaccine since its first use in 1921 has been the subject of much controversy as to its effectiveness and applicability. BCG vaccination is still considered an important strategy in the National Tuberculosis Programs of countries with a high burden of tuberculosis (TB) because of its benefit to infants but its effect on the control of TB has been limited. By contrast, in countries with a low prevalence of TB, significant policy differences exist both within and between countries. BCG vaccination does not prevent transmission of infection to the individual. In immune-competent neonates and infants it is accepted that BCG reduces the likelihood of TB infection progressing to disease or if disease occurs, substantially lessens the chance of a severe outcome. The benefit in older agegroups is less clear. In the Australian health worker, the BCG strategy is no longer recommended as the primary means of health care worker (HCW) protection. The preferred strategy is appropriate infection control measures, staff education and a tuberculin skin testing program that identifies and treats the at-risk infected HCW. The emergence of multi-drug resistant strains has however renewed interest in BCG in the HCW. This document provides recommendations for use of the BCG vaccine in the Australian community based on the best available evidence and consensus opinion. State and Territory TB Control Units should be consulted with regard to their BCG vaccination guidelines.
卡介苗（BCG）自1921年首次使用以来，其有效性和适用性一直备受争议。卡介苗接种在结核病负担较重国家的国家结核病规划中仍被视为一项重要策略，因为它对婴儿有益，但其对结核病控制的效果有限。相比之下，在结核病患病率较低的国家，国家内部和国家之间存在显著的政策差异。卡介苗接种并不能防止个体感染传播。在免疫功能正常的新生儿和婴儿中，人们认为卡介苗可降低结核病感染发展为疾病的可能性，或者如果疾病发生，可大幅降低出现严重后果的几率。在年龄较大人群中的益处尚不清楚。在澳大利亚卫生工作者中，不再推荐将卡介苗接种策略作为医护人员（HCW）防护的主要手段。首选策略是采取适当的感染控制措施、开展人员教育以及实施结核菌素皮肤试验项目，以识别和治疗有感染风险的医护人员。然而，多重耐药菌株的出现重新引发了人们对医护人员接种卡介苗的兴趣。本文档根据现有最佳证据和共识意见，提供了澳大利亚社区使用卡介苗的建议。应就其卡介苗接种指南咨询各州和领地的结核病控制单位。
