Stanford J L, Shield M J, Rook G A
Tubercle. 1981 Mar;62(1):55-62. doi: 10.1016/0041-3879(81)90037-4.
A proposal is made that there are 2 mechanisms of cell mediated response to mycobacteria, both of which produce positive tuberculin tests and that one of them is more protective against mycobacterial infection than is the other. These are referred to respectively as the Listeria-type and the Koch-type of responses. Contact with environmental mycobacteria will induce one or other of these types of response and BCG vaccination will enhance it. Thus in those places where the environmental species prime for the Listeria-type of response subsequent BCG vaccination will afford good protection from both tuberculosis and leprosy. Where the Koch-type of response frequently results from environmental contact BCG will be ineffective. Evidence if presented that a large contact with Mycobacterium scrofulaceum is prejudicial to at least one marker of BCG efficacy in Burma.
有人提出，细胞介导的针对分枝杆菌的反应存在两种机制，这两种机制都会产生阳性结核菌素试验结果，且其中一种机制比另一种机制对分枝杆菌感染的保护作用更强。它们分别被称为李斯特菌型反应和科赫型反应。与环境中的分枝杆菌接触会诱发这两种反应中的一种，而卡介苗接种会增强这种反应。因此，在那些环境中的分枝杆菌引发李斯特菌型反应的地方，随后接种卡介苗将对结核病和麻风病都提供良好的保护。在因环境接触频繁产生科赫型反应的地方，卡介苗将无效。有证据表明，在缅甸，与瘰疬分枝杆菌大量接触对卡介苗效力的至少一项指标是不利的。
