Montagnani Carlotta, Esposito Susanna, Galli Luisa, Chiappini Elena, Principi Nicola, de Martino Maurizio
a Pediatric Clinic, Meyer Hospital, University of Florence , Florence , Italy.
b Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy.
Hum Vaccin Immunother. 2016 Mar 3;12(3):644-50. doi: 10.1080/21645515.2015.1106657.
Bacillus Calmette-Guérin (BCG) vaccine is still the only vaccine approved for the prevention of tuberculosis (TB), and is widely used in highly endemic countries, where all newborns receive a single intradermal dose immediately after birth; however, the recommendations concerning its use in Europe vary widely from country to country. This document describes the recommendations of a group of Italian scientific societies concerning its pediatric use in Italy, the persistence of the protection it provides, its safety, its interference with tuberculin skin test (TST) responses, and the children who should be vaccinated. The experts conclude that BCG vaccination provides a good level of protection against tuberculous meningitis and disseminated forms, and a fair level of protection against pulmonary disease; the protective effective lasts at least 10 years, and revaccination offers no advantages over a single administration. The vaccine is safe in immunocompetent subjects, and affects the response to a TST for at least 6 y On the basis of these observations, we recommend its use in Italy in all TST-negative immunocompetent newborns and breastfeeding infants aged <6 months, and all TST-negative children aged between 6 months and 5 y who come from highly epidemic areas, or whose parents come from highly endemic areas, or who have been in contact with a family member with active TB without contracting the disease themselves.
卡介苗（BCG）仍然是唯一被批准用于预防结核病（TB）的疫苗，在结核病高发国家广泛使用，这些国家所有新生儿在出生后立即接受单次皮内注射；然而，欧洲各国关于其使用的建议差异很大。本文描述了一组意大利科学协会关于其在意大利儿科使用的建议，包括它所提供保护的持续性、安全性、对结核菌素皮肤试验（TST）反应的干扰以及应接种疫苗的儿童。专家们得出结论，卡介苗接种对结核性脑膜炎和播散型结核病提供了良好的保护水平，对肺结核提供了一定程度的保护；保护效果至少持续10年，再次接种并不比单次接种更具优势。该疫苗在免疫功能正常的人群中是安全的，并且至少6年内会影响TST反应。基于这些观察结果，我们建议在意大利，对所有TST结果为阴性的免疫功能正常的新生儿和6个月以下的母乳喂养婴儿，以及所有来自结核病高发地区、父母来自结核病高流行地区或曾与活动性结核病家庭成员接触但自身未患病的6个月至5岁TST结果为阴性的儿童接种卡介苗。
