新生儿卡介苗接种对呼吸道感染和败血症住院的非特异性（异源）保护作用。

Nonspecific (Heterologous) Protection of Neonatal BCG Vaccination Against Hospitalization Due to Respiratory Infection and Sepsis.

机构信息

Translational Pediatrics and Infectious Diseases Section, Pediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela.

Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, La Coruña Unidad de Genética, Instituto de Ciencias Forenses y Departamento de Anatomía Patológica y Ciencias Forenses, Facultad de Medicina, Universidad de Santiago de Compostela, Galicia, Spain.

出版信息

Clin Infect Dis. 2015 Jun 1;60(11):1611-9. doi: 10.1093/cid/civ144. Epub 2015 Feb 27.

DOI:10.1093/cid/civ144

PMID:25725054

Abstract

BACKGROUND

Bacille Calmette-Guerin (BCG) vaccination has been suggested to have nonspecific beneficial effects in children from developing countries, reducing morbidity and mortality caused by unrelated pathogens.

OBJECTIVE

We aimed to assess the heterologous protective effects of BCG vaccination against respiratory infection (RI) and sepsis not attributable to tuberculosis in children born in Spain.

METHODS

We conducted a retrospective epidemiological study using data from the Official Spanish Registry of Hospitalizations (CMBD-HA) to identify differences in hospitalization rates (HR) in BCG-vaccinated children (Basque Country, where neonatal BCG is part of the immunization schedule and has a 100% coverage) as compared to non-BCG-vaccinated children (from the rest of Spain, where BCG is not used).

RESULTS

A total of 464 611 hospitalization episodes from 1992 to 2011 were analyzed. The HR due to RI not attributable to tuberculosis in BCG-vaccinated children was significant lower compared to non-BCG-vaccinated children for all age groups, with a total preventive fraction (PF) of 41.4% (95% confidence interval: 40.3-42.5; P-value <.001). According to age group, PF was 32.4% (30.9-33.9; P-value <.001) for children under 1 year old, 60.1% (58.5-61.7; P-value <.001) for children between 1 and 4 years old, 66.6% (62.8-70.2; P-value <.001) for children between 5 and 9 years old, and 69.6% (63.3-75.0; P-value <.001) for children between 10 and 14 years old. The HR due to sepsis not attributable to tuberculosis in BCG-vaccinated children under 1 year of age was also significantly lower, with a PF of 52.8% (43.8-60.7; P-value <.001).

CONCLUSIONS

BCG vaccination at birth may decrease hospitalization due to RI and sepsis not related to tuberculosis through heterologous protection.

摘要

背景

卡介苗（BCG）接种被认为对发展中国家的儿童具有非特异性有益作用，可降低与结核病无关的病原体引起的发病率和死亡率。

目的

我们旨在评估在西班牙出生的儿童中，BCG 接种对呼吸道感染（RI）和非结核分枝杆菌败血症的异源保护作用。

方法

我们使用官方西班牙住院登记处（CMBD-HA）的数据进行了回顾性流行病学研究，以确定接种卡介苗的儿童（巴斯克地区，新生儿 BCG 是免疫计划的一部分，覆盖率为 100%）与未接种卡介苗的儿童（西班牙其他地区，不使用 BCG）之间的住院率（HR）差异。

结果

共分析了 1992 年至 2011 年期间的 464611 例住院病例。与未接种 BCG 的儿童相比，所有年龄组的非结核分枝杆菌引起的 RI 住院率 HR 在接种 BCG 的儿童中显著降低，总预防分数（PF）为 41.4%（95%置信区间：40.3-42.5；P<0.001）。按年龄组划分，1 岁以下儿童的 PF 为 32.4%（30.9-33.9；P<0.001），1-4 岁儿童为 60.1%（58.5-61.7；P<0.001），5-9 岁儿童为 66.6%（62.8-70.2；P<0.001），10-14 岁儿童为 69.6%（63.3-75.0；P<0.001）。1 岁以下接种 BCG 的儿童因非结核分枝杆菌引起的败血症住院率也显著降低，PF 为 52.8%（43.8-60.7；P<0.001）。