Bo Marco, Zotti Carla Maria
a Department of Public Health and Pediatrics , University of Turin , Turin , Italy.
Hum Vaccin Immunother. 2016 Nov;12(11):2753-2764. doi: 10.1080/21645515.2016.1200776. Epub 2016 Jul 7.
National recommendations regarding the immunization of healthcare workers (HCWs) against tuberculosis differ throughout Europe. We searched multiple sources to identify legal acts, guidelines or papers addressing European national policies on BCG immunization for HCWs. For each policy, we reviewed the criteria used to recommend immunization, their level of evidence, the evidence supporting them and the actions required in cases of refusal. Four legal acts, 15 policies and 6 papers from 14 European countries met the inclusion criteria. Among European national agencies, 5 only recommend the immunization of HCWs employed in high-risk sectors, highlighting the lack of evidence of Bacillus Calmette-Guerin (BCG) efficacy in HCWs; 5 recommend BCG vaccination for all previously unvaccinated Mantoux-negative HCWs, underlining that some studies provide arguments of some BCG efficacy in HCWs; and four do not recommend the vaccine. Different interpretations of existing evidence on BCG efficacy and the demographics of HCWs may have influenced national policies.
欧洲各国关于医护人员结核病免疫接种的国家建议各不相同。我们通过多种来源进行检索，以确定涉及欧洲各国医护人员卡介苗免疫政策的法律行为、指南或文件。对于每项政策，我们审查了用于推荐免疫接种的标准、其证据水平、支持这些标准的证据以及拒绝接种情况下所需采取的行动。来自14个欧洲国家的4项法律行为、15项政策和6篇论文符合纳入标准。在欧洲各国机构中，5个机构仅建议对高风险部门的医护人员进行免疫接种，强调缺乏卡介苗在医护人员中有效性的证据；5个机构建议对所有以前未接种且结核菌素试验阴性的医护人员接种卡介苗，强调一些研究提供了卡介苗在医护人员中具有一定有效性的论据；还有4个机构不建议接种该疫苗。对卡介苗有效性现有证据的不同解读以及医护人员的人口统计学特征可能影响了各国政策。
