Bielecka Teresa, Augustynowicz-Kopeć Ewa, Gonerko Paweł, Gruszczyński Paweł, Korzeniewska-Koseła Maria, Krasińska Maria, Krenke Katarzyna, Lange Joanna, Pankowska Anna, Popielarz Marek, Pustkowski Andrzej, Stryczyńska-Kazubska Joanna, Doniec Zbigniew
Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Poland.
Adv Respir Med. 2018;86(3). doi: 10.5603/ARM.2018.0023.
Since the second half of the 20th century the incidence of tuberculosis has been declining in Poland. Despite this, current epidemiological data still support the need for the continued mass BCG vaccination in Poland in the near future. Apart from the protection against severe hematogenous forms of tuberculosis, vaccination lowers the risk of infection with Mycobacterium tuberculosis. Primary and acquired immunodeficiency, including immunity disorders associated with an ongoing treatment, are contraindications to BCG vaccination. The most common adverse effects following BCG vaccination are reactions at the site of injection and in regional lymph nodes, which usually does not require treatment. Methods of tuberculosis prevention, particularly recommended in low-incidence countries, include: diagnostic investigations of patients who had contacts with pulmonary tuberculosis as well as an active detection and treatment of latent Mycobacterium tuberculosis infection. Latent tuberculosis infection can be identified on the basis of positive results of the tuberculin skin test or interferon-gamma release assays after the active disease has been ruled out. This condition does require prophylactic treatment.
自20世纪下半叶以来，波兰的结核病发病率一直在下降。尽管如此，目前的流行病学数据仍支持在不久的将来波兰继续进行大规模卡介苗接种的必要性。除了预防严重的血行播散型结核病外，接种疫苗还可降低感染结核分枝杆菌的风险。原发性和获得性免疫缺陷，包括与正在进行的治疗相关的免疫紊乱，是卡介苗接种的禁忌症。卡介苗接种后最常见的不良反应是注射部位和局部淋巴结的反应，通常无需治疗。结核病预防方法，在低发病率国家特别推荐的包括：对与肺结核患者有接触的人进行诊断性调查，以及对潜伏性结核分枝杆菌感染进行主动检测和治疗。在排除活动性疾病后，可根据结核菌素皮肤试验或干扰素-γ释放试验的阳性结果来识别潜伏性结核感染。这种情况确实需要预防性治疗。
