Larsson L O, Bentzon M W, Lind A, Magnusson M, Sandegård G, Skoogh B E, Boëthius G
Department of Pulmonary Medicine, University of Göteborg, Sweden.
Tuber Lung Dis. 1993 Dec;74(6):371-6. doi: 10.1016/0962-8479(93)90079-d.
Since 1986 we have tested approximately 7000 non-BCG-vaccinated Swedish children with tuberculin and with Mycobacterium avium or M. scrofulaceum sensitin. In Göteborg, an urban coastal area, 25% of 8-9-year-old school children reacted to M. avium sensitin and 32% of M. scrofulaceum sensitin using a 6 mm cut-off.
To evaluate if geographical factors have an influence on the prevalence of children reacting to tuberculin and sensitins.
2000 schoolchildren of the same age as those in Göteborg but living in an inland rural area were Mantoux-tested in a similar way (simultaneously on separate arms with PPD RT23 and either of the two sensitins).
15% reacted to PPD RT23, 9.7% to M. avium and 13.9% to M. scrofulaceum sensitin. None of the children with a PPD RT23 reaction > = 6 mm showed signs of tuberculosis or had any known exposure. A reaction to PPD RT23 was usually combined with a still larger sensitin reaction.
There was a considerable geographic difference in sensitin reactivity, low in an inland rural area compared to a coastal urban area. Children reacting to PPD RT23 had probably not been infected by M. tuberculosis but more likely by atypical mycobacteria. The reactions should be interpreted as cross-reactions.
自1986年以来，我们对约7000名未接种卡介苗的瑞典儿童进行了结核菌素以及鸟分枝杆菌或瘰疬分枝杆菌变应原检测。在沿海城市哥德堡，8至9岁学龄儿童中有25%对鸟分枝杆菌变应原产生反应，32%对瘰疬分枝杆菌变应原产生反应（判定标准为硬结直径≥6毫米）。
评估地理因素是否会对儿童结核菌素及变应原反应的患病率产生影响。
对2000名与哥德堡儿童年龄相同但生活在内陆农村地区的学童进行了类似的结核菌素试验（分别在不同手臂同时接种PPD RT23以及两种变应原中的一种）。
15%的儿童对PPD RT23产生反应，9.7%对鸟分枝杆菌变应原产生反应，13.9%对瘰疬分枝杆菌变应原产生反应。PPD RT23反应≥6毫米的儿童均未出现结核病迹象或有已知的接触史。对PPD RT23的反应通常会伴有更大的变应原反应。
变应原反应性存在显著的地理差异，内陆农村地区低于沿海城市地区。对PPD RT23产生反应的儿童可能未感染结核分枝杆菌，而更可能感染了非典型分枝杆菌。这些反应应被解释为交叉反应。
