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中国终止卡介苗加强免疫接种后出生的青少年结核感染检测:基于人群的横断面研究的亚组分析。

Testing of tuberculosis infection among Chinese adolescents born after terminating the Bacillus Calmette-Guérin booster vaccination: subgroup analysis of a population-based cross-sectional study.

机构信息

MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.

Beijing Rehabilitation Hospital of Capital Medical University, Beijing, 100043, China.

出版信息

Front Med. 2017 Dec;11(4):528-535. doi: 10.1007/s11684-017-0573-0. Epub 2017 Nov 3.

Abstract

The prevalence of tuberculosis infection among adolescents born after terminating the Bacillus Calmette-Guérin (BCG) booster vaccination in China was estimated using tuberculin skin testing (TST) and QuantiFERON-TB Gold assay (QFT) to investigate the influence of neonatal BCG vaccination on the performance of TST. Data analysis was conducted for 2831 eligible participants aged 5-15 years from the baseline survey of a population-based multi-center prospective study. The prevalence rates of TST (induration = 10 mm) and QFT positivity were 9.3% (264/2827) and 2.5% (71/2831), respectively. The rate of QFT indeterminate result was 2.2% (62/2831). The overall agreement between TST and QFT was low (concordance = 88.0%; ? coefficient = 0.125). Only TST was positively associated with BCG vaccination with an adjusted odds ratio of 1.71 [95% confidence interval, 1.26-2.31]. A history of close contact with patients of active TB was significantly associated with positivity for TST and QFT. Our results suggested that BCG neonatal vaccination still affects TST performance, and a twostep approach might be considered for TB infection testing among adolescents in China.

摘要

中国终止卡介苗(BCG)加强免疫接种后出生的青少年结核感染流行率,采用结核菌素皮肤试验(TST)和 QuantiFERON-TB Gold 检测(QFT)来研究新生儿 BCG 接种对 TST 性能的影响。对一项基于人群的多中心前瞻性研究基线调查中,2831 名 5-15 岁合格参与者的数据进行了分析。TST(硬结 = 10 毫米)和 QFT 阳性率分别为 9.3%(264/2827)和 2.5%(71/2831),QFT 不确定结果率为 2.2%(62/2831)。TST 和 QFT 之间的总体一致性较低(一致性=88.0%;?系数=0.125)。仅 TST 与 BCG 接种呈正相关,调整后的优势比为 1.71[95%置信区间,1.26-2.31]。与活动性肺结核患者的密切接触史与 TST 和 QFT 阳性显著相关。我们的结果表明,新生儿 BCG 接种仍会影响 TST 性能,中国青少年结核感染检测可能需要两步法。

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