From the Department of Pediatrics, Royal Hospital, Muscat, Oman.
From the Department of Orthopedics, Khoula Hospital, Mina Al Fahal, Muscat, Oman.
Ann Saudi Med. 2021 Jan-Feb;41(1):24-30. doi: 10.5144/0256-4947.2021.24. Epub 2021 Feb 4.
Bacillus Calmette-Guérin (BCG) vaccine-related complications are frequently observed in children in Oman. There are a few regional studies on BCG complications, but none from Oman.
Evaluate the spectrum of BCG-vaccine related complications and immune status in Omani children.
Retrospective cross-sectional study.
Referral tertiary hospital.
Children aged younger than 13 years old and with complications of BCG vaccination recorded from 2006-2018 were included in this study. Clinical characteristics, treatment, immune workup and outcome were reviewed from hospital records.
Different BCG vaccine-related complications categorized by the site of involvement.
Of the 226 children had BCG-vaccine related complications, 99% received BCG vaccine immediately after birth. The median age of presentation was 4 months. The most common complication was isolated BCG lymphadenitis (85%, n=192), followed by BCG-related osteomyelitis (10.2%, n=23) and disseminated BCG infection (4.9%, n=11). The median age of presentation of disseminated BCG was 5 months, with different organs involved. Out of 11 children with disseminated BCG infection, 72.7% (n=8) had primary immune deficiency (PID), including chronic granulomatous disease (CGD, n=5), severe combined immunodeficiency (SCID) (n=2); 1 patient had Mendelian susceptibility to mycobacterial disease (IFNGR2 deficiency); 2 patients with PID not yet identified and the 1 with a non-specific PID had blood or saliva samples sent for whole-exome sequencing.
Because of the spectrum of BCG vaccine-related complications, including the most severe in children with PID, we suggest that delaying the BCG vaccine from birth to 6 months may prevent disseminated BCG diseases and their complications in children with PID because any PID will have been identified before 6 months. Further studies are needed to guide this recommendation.
Single center-based study that may not provide a full overview of all BCG vaccine-related complications in Oman. Unavailability of details of some microbiological results and an inability to determine the detailed management for all patients.
None.
在阿曼，卡介苗（BCG）疫苗相关并发症在儿童中经常观察到。有一些关于 BCG 并发症的区域性研究，但没有来自阿曼的研究。
评估阿曼儿童中 BCG 疫苗相关并发症的范围和免疫状况。
回顾性横断面研究。
转诊 tertiary 医院。
纳入 2006 年至 2018 年记录的患有 BCG 疫苗接种并发症且年龄小于 13 岁的儿童。从医院记录中回顾临床特征、治疗、免疫检查和结局。
根据受累部位分类的不同 BCG 疫苗相关并发症。
226。
226 例儿童中有 BCG 疫苗相关并发症，99%在出生后立即接种 BCG 疫苗。就诊时的中位年龄为 4 个月。最常见的并发症是孤立的 BCG 淋巴结炎（85%，n=192），其次是 BCG 相关性骨髓炎（10.2%，n=23）和播散性 BCG 感染（4.9%，n=11）。播散性 BCG 的中位发病年龄为 5 个月，涉及不同的器官。11 例播散性 BCG 感染者中，72.7%（n=8）有原发性免疫缺陷（PID），包括慢性肉芽肿病（CGD，n=5）、严重联合免疫缺陷（SCID）（n=2）；1 例患者有孟德尔易感性分枝杆菌病（IFNGR2 缺陷）；2 例 PID 未确定的患者和 1 例非特异性 PID 患者的血液或唾液样本被送去进行全外显子组测序。
由于 BCG 疫苗相关并发症的范围很广，包括 PID 儿童中最严重的并发症，我们建议将 BCG 疫苗从出生推迟到 6 个月，可以预防 PID 儿童中播散性 BCG 疾病及其并发症，因为在 6 个月前会发现任何 PID。需要进一步研究来指导这一建议。
单中心研究可能无法全面了解阿曼所有 BCG 疫苗相关并发症。有些微生物学结果的详细信息不可用，无法确定所有患者的详细治疗方法。
无。
