Szczepionka bcg przeciwko gruźlicy
Diagnostyka i diagnoza

Szczepionka BCG, będąca żywą atenuowaną szczepionką na bazie Mycobacterium bovis, stosowana jest od ponad 100 lat jako jedyna dostępna profilaktyka przeciwko gruźlicy. Jej podanie może powodować fałszywie dodatnie wyniki testu skórnego tuberkulinowego (TST), co stanowi istotne wyzwanie diagnostyczne. W związku z tym u osób szczepionych BCG preferowane są testy IGRA (Interferon-Gamma Release Assays), które wykorzystują swoiste antygeny M. tuberculosis (ESAT-6, CFP-10) i charakteryzują się wyższą swoistością (~97% vs. 59% dla TST u szczepionych). Testy IGRA nie są zaburzone przez wcześniejsze szczepienie BCG i wymagają tylko jednej wizyty pacjenta. W przypadku dodatnich wyników IGRA lub TST konieczne jest dalsze badanie w kierunku aktywnej gruźlicy, w tym badanie plwociny i zdjęcia rentgenowskie klatki piersiowej. Szczepionka BCG może powodować powikłania, takie jak limfadenopatia BCG (węzły chłonne o średnicy około 1 cm) oraz BCGitis, szczególnie u pacjentów z niedoborami odporności, które wymagają diagnostyki molekularnej i hodowli w celu potwierdzenia obecności M. bovis BCG.

  1. Diagnostyka szczepionki BCG przeciwko gruźlicy
    1. Wpływ szczepionki BCG na testy diagnostyczne
    2. Testy IGRA w diagnostyce gruźlicy u osób szczepionych BCG
    3. Interpretacja testów skórnych u osób szczepionych BCG
  2. Diagnostyka powikłań po szczepionce BCG
    1. Limfadenopatia BCG
    2. BCGitis
    3. Metody molekularne w diagnostyce powikłań poszczepiennych
  3. Diagnostyka gruźlicy u osób szczepionych BCG
    1. Algorytm diagnostyczny
    2. Diagnostyka różnicowa
  4. Nowe trendy w diagnostyce gruźlicy i rozwój szczepionek
    1. Nowe testy diagnostyczne
    2. Badania nad nowymi szczepionkami
    3. Rola diagnostyki w badaniach klinicznych szczepionek
  5. Wytyczne diagnostyczne dla osób szczepionych BCG
    1. Zalecenia dla lekarzy
  6. Podsumowanie aspektów diagnostycznych
    1. Kolejne rozdziały

Diagnostyka szczepionki BCG przeciwko gruźlicy

Szczepionka BCG (Bacillus Calmette-Guérin) jest jedyną dostępną szczepionką przeciwko gruźlicy (TB), stosowaną od ponad 100 lat. Jest to żywa atenuowana szczepionka otrzymana ze szczepu Mycobacterium bovis, która została opracowana przez Alberta Calmette’a i Camille’a Guérina i po raz pierwszy podana ludziom w 1921 roku12. Chociaż szczepionka BCG jest szeroko stosowana na całym świecie i podawana około 100 milionom noworodków rocznie, jej wpływ na diagnostykę zakażenia gruźlicą wymaga szczegółowego omówienia3.

Wpływ szczepionki BCG na testy diagnostyczne

Jednym z najważniejszych aspektów dotyczących wpływu szczepionki BCG na diagnostykę gruźlicy jest jej oddziaływanie na wyniki testów skórnych4. Szczepionka BCG może powodować fałszywie dodatni wynik skórnego testu tuberkulinowego (TST, znany również jako próba Mantoux)5. Jest to istotna informacja, którą należy przekazać pracownikom służby zdrowia przeprowadzającym badania w kierunku gruźlicy u osób szczepionych wcześniej BCG6.

W przypadku osób szczepionych BCG, które wymagają badania w kierunku gruźlicy, preferowanymi testami są testy krwi na gruźlicę, znane jako testy IGRA (Interferon-Gamma Release Assays)78. W przeciwieństwie do testów skórnych, testy IGRA nie są zaburzane przez wcześniejsze szczepienie BCG9. Wynika to z faktu, że testy IGRA wykorzystują antygeny swoiste dla Mycobacterium tuberculosis, które nie występują w szczepionce BCG10.

Testy IGRA w diagnostyce gruźlicy u osób szczepionych BCG

Testy IGRA mierzą interferon gamma uwolniony przez krążące limfocyty w pełnej krwi po ekspozycji na antygeny specyficzne dla M. tuberculosis, białka ESAT-6 i CFP-1011. Ich zaletami są wyższa swoistość (około 97% w porównaniu do 59% dla TST u osób szczepionych BCG), brak wpływu szczepienia BCG oraz konieczność tylko jednej wizyty pacjenta w laboratorium1213.

QuantiFERON-TB Gold+ jest przykładem testu IGRA używanego do diagnostyki zakażenia organizmami kompleksu Mycobacterium tuberculosis (M. tuberculosis, M. bovis, M. africanum)14. Wspólne wytyczne kliniczne American Thoracic Society, Infectious Diseases Society of America oraz Centers for Disease Control and Prevention zalecają stosowanie IGRA zamiast testów skórnych tuberkulinowych w przypadku badań przesiewowych w kierunku utajonej gruźlicy u pacjentów w wieku pięciu lat lub starszych, którzy mają niskie lub umiarkowane ryzyko progresji do aktywnej gruźlicy lub mają historię szczepienia BCG15.

Interpretacja testów skórnych u osób szczepionych BCG

Mimo że testy IGRA są preferowane, nadal stosuje się testy skórne tuberkulinowe. Ważne jest, aby pamiętać, że historia szczepienia BCG nie powinna być przeciwwskazaniem do przeprowadzenia testu skórnego tuberkulinowego ani leczenia utajonej gruźlicy u osób z dodatnimi wynikami TST16. Reaktywność TST spowodowana szczepionką BCG zazwyczaj słabnie z upływem czasu, jednak okresowe testy skórne mogą przedłużać (wzmacniać) reaktywność u szczepionych osób17.

W niektórych krajach, takich jak Stany Zjednoczone, reakcje TST interpretuje się niezależnie od historii szczepienia BCG18. Wpływ szczepionki BCG na wyniki TST słabnie z czasem i może mieć niewielki lub żaden wpływ na dodatnie wyniki TST u dorosłych, którzy otrzymali szczepionkę jako dzieci19.

Diagnostyka powikłań po szczepionce BCG

Szczepionka BCG jest stosunkowo bezpieczna, ale mogą wystąpić pewne powikłania, które wymagają odpowiedniej diagnostyki20.

Limfadenopatia BCG

Limfadenopatia BCG (powiększenie węzłów chłonnych) jest najczęstszym powikłaniem po szczepieniu BCG21. Termin „limfadenopatia BCG” odnosi się do sytuacji, gdy węzły chłonne stały się na tyle duże, że można je łatwo wyczuć, co stanowi powód do niepokoju dla rodziców, zazwyczaj o średnicy około 1 cm22.

Diagnostyka limfadenopatii BCG opiera się na wywiadzie i badaniu klinicznym. Przypadki są diagnozowane jako ipsilateralne powiększenie miejscowego węzła chłonnego w miejscu szczepienia BCG przy braku jakichkolwiek objawów ogólnoustrojowych i innych identyfikowalnych przyczyn zapalenia węzłów chłonnych23. Biopsja cienkoigłowa (FNA) jako szybki, minimalnie inwazyjny test może pomóc w prawidłowej diagnozie24.

BCGitis

BCGitis jest najpoważniejszym powikłaniem szczepienia BCG. Jest to zakażenie, które dotyka kilku układów narządów i występuje głównie u dzieci z pierwotnym niedoborem odporności, ciężkim złożonym niedoborem odporności, AIDS i mendlowską podatnością na choroby mykobakteryjne25. W przypadku wystąpienia tego powikłania pacjenci powinni zostać przebadani w kierunku niedoborów odporności.

Diagnostyka BCGitis może być przeprowadzona za pomocą hodowli lub metod molekularnych. Izolacja BCG jest obowiązkowa do postawienia diagnozy BCGitis26.

Metody molekularne w diagnostyce powikłań poszczepiennych

Zastosowanie metod genetycznych umożliwia szybką i szczegółową diagnostykę zakażeń spowodowanych przez M. bovis BCG, co pozwala na potwierdzenie lub wykluczenie niepożądanych odczynów poszczepiennych (VAE)27. Identyfikacja M. bovis BCG jako czynnika etiologicznego choroby jest szczególnie ważna ze względu na odmienny schemat leczenia28.

W przypadku szczepów wyhodowanych od dzieci zaleca się przeprowadzenie szczegółowej diagnostyki różnicującej gatunki w obrębie kompleksu M. tuberculosis (MTBC)29. Nowoczesne metody molekularne umożliwiają potwierdzenie lub wykluczenie VAE u dzieci z podejrzeniem gruźlicy30.

Diagnostyka gruźlicy u osób szczepionych BCG

Ważne jest, aby pamiętać, że osoba może mieć lub zachorować na gruźlicę, nawet jeśli otrzymała szczepionkę przeciwko gruźlicy (BCG). Szczepionka BCG nie zawsze chroni ludzi przed zachorowaniem na gruźlicę31.

Algorytm diagnostyczny

Testy IGRA lub TST mogą pokazać, czy osoba była kiedykolwiek zakażona M. tuberculosis, ale nie mogą odróżnić utajonego (uśpionego) zakażenia gruźlicą od aktywnej choroby gruźliczej32. W przypadku dodatniego wyniku testu IGRA lub TST konieczne jest przeprowadzenie dodatkowych testów, takich jak badanie plwociny, aby sprawdzić, czy występuje aktywne zakażenie33.

Wszystkie osoby z dodatnim wynikiem IGRA lub TST powinny zostać przebadane pod kątem możliwości wystąpienia aktywnej gruźlicy34. Testy, które diagnozują aktywne zakażenia gruźlicą, obejmują zdjęcia rentgenowskie klatki piersiowej i badania laboratoryjne próbki plwociny35.

Diagnostyka różnicowa

Limfadenopatia BCG jest często trudna do odróżnienia od gruźliczego zapalenia węzłów chłonnych36. Powikłania po szczepionce BCG, takie jak limfadenopatia i BCGitis, mogą być łatwo mylone z innymi zakażeniami, które są zwykle leczone antybiotykami37. Dlatego ważne jest, aby umieć je rozpoznać, aby rozpocząć odpowiednie leczenie, zwłaszcza obecnie, gdy rośnie oporność na antybiotyki.

Nowe trendy w diagnostyce gruźlicy i rozwój szczepionek

Pomimo prawie stulecia stosowania, szczepionka BCG nadal jest kontrowersyjna, ze znanymi wariacjami w podszczepach BCG i skuteczności szczepionki38. Globalne informacje na temat polityk i praktyk związanych z BCG mogą być przydatne dla klinicznej interpretacji testów diagnostycznych, a także w projektowaniu nowych szczepionek przeciwko gruźlicy, które są w trakcie opracowywania39.

Nowe testy diagnostyczne

Zalecane szybkie testy diagnostyczne są dokładne i opłacalne, umożliwiają szybkie rozpoczęcie leczenia i wpływają na inne wyniki, które są ważne dla pacjenta40. W ostatnich latach opracowano nowe testy diagnostyczne, które pozwalają odróżnić szczepienie BCG od naturalnego zakażenia prątkiem gruźlicy41.

Testy te opierają się na immunogennych białkach, których geny zostały spontanicznie utracone z genomu M. bovis podczas opracowywania szczepionki BCG, dzięki czemu można je wykorzystać do Różnicowania między naturalnym zakażeniem M. bovis a szczepieniem BCG (antygeny DIVA)42.

Badania nad nowymi szczepionkami

Niedawno opracowano określony skórny test diagnostyczny oparty na koktajlu antygenów DIVA, ESAT-6, CFP-10 i Rv3615c, które umożliwiają różnicową diagnozę zwierząt zakażonych M. bovis od zwierząt szczepionych BCG43. Ta kompatybilna, rozszerzona próba skórna DIVA okazała się specyficzna, nie wywołując reakcji skórnych u szczepionych świnek morskich przed wyzwaniem, ale wywołując reakcje po wyzwaniu44.

Obecnie prowadzone są badania nad szczepieniem drogą oddechową, ponieważ naturalne zakażenie i sensybilizacja na Mycobacterium tuberculosis u ludzi ma tendencję do występowania w układzie oddechowym45. W BPRC naukowcy odkryli już, że szczepienie BCG przez drogi oddechowe (śluzówkowo) daje lepszą ochronę w porównaniu z podawaniem go, jak zwykle, w skórę46.

Rola diagnostyki w badaniach klinicznych szczepionek

Opracowanie nowych szczepionek przeciwko gruźlicy i badania kliniczne są znacznie utrudnione przez brak biomarkerów korelujących z ochroną oraz brak idealnego modelu zwierzęcego47. Dlatego ważne jest poprawienie dokładności diagnostycznej wszystkich testów używanych do diagnozowania choroby gruźliczej u dzieci włączonych do badań szczepionek przeciwko gruźlicy48.

Niedawne badanie z Precision Vaccines Program w szpitalu Boston Children’s Hospital wykazało, że szczepionki BCG różnią się dramatycznie, co budzi fundamentalne pytania o to, czy jakość tych szczepionek jest równoważna i czy powinny być uznawane za wymienne49. Badanie wykazało różnice w odpowiedziach cytokinowych wywołanych przez każdą szczepionkę50.

Wytyczne diagnostyczne dla osób szczepionych BCG

Istnieje kilka wytycznych dotyczących diagnostyki gruźlicy u osób, które otrzymały szczepionkę BCG:

  • Testy IGRA są preferowane w stosunku do testów skórnych tuberkulinowych u osób w wieku 5 lat lub starszych, którzy: (1) prawdopodobnie są zakażeni M. tuberculosis, (2) mają niskie lub umiarkowane ryzyko progresji choroby, (3) zdecydowano, że badanie w kierunku utajonej gruźlicy jest uzasadnione, oraz (4) albo mają historię szczepienia BCG, albo jest mało prawdopodobne, że wrócą, aby odczytać wynik testu TST51.
  • Test IGRA jest preferowany dla: Osób urodzonych poza USA, które otrzymały szczepienie BCG52.
  • Osoby, które otrzymały BCG i mają wybór między testem krwi na gruźlicę a testem skórnym na gruźlicę, powinny wybrać test krwi na gruźlicę. Wynika to z faktu, że test krwi na gruźlicę nie jest zaburzany przez szczepionkę BCG53.

Zalecenia dla lekarzy

Lekarze powinni pamiętać, że:

  • Historia szczepienia BCG nie powinna wykluczać osoby z badania w kierunku gruźlicy, chyba że ma ona udokumentowany pozytywny wynik z wcześniejszego testu54.
  • Interpretacja reakcji TST u osób szczepionych BCG powinna być dokonywana przy użyciu tych samych kryteriów, co u osób nieszczepionych BCG55.
  • Testy IGRA, w przeciwieństwie do TST, nie wykrywają obecności BCG i są mniej narażone na fałszywie dodatni wynik56.
  • W Stanach Zjednoczonych dodatnia reakcja na skórny test gruźlicy jest interpretowana jako dodatnia, niezależnie od wcześniejszego szczepienia BCG57.

Wcześniejsze szczepienie BCG NIE powinno powstrzymywać osoby przed przeprowadzeniem testu skórnego na gruźlicę, chyba że miała ona pozytywną reakcję na skórny test gruźlicy w przeszłości58.

Podsumowanie aspektów diagnostycznych

Szczepionka BCG przeciwko gruźlicy, mimo ponad 100-letniej historii stosowania, nadal stanowi wyzwanie w kontekście diagnostyki zakażenia gruźlicą5960. Główne aspekty diagnostyczne związane ze szczepionką BCG to:

  1. Wpływ na testy skórne tuberkulinowe (TST): Szczepionka BCG może powodować fałszywie dodatnie wyniki testu TST61.
  2. Preferencja dla testów IGRA: U osób szczepionych BCG preferowane są testy IGRA (Interferon-Gamma Release Assays), które nie są zaburzane przez wcześniejsze szczepienie BCG62.
  3. Diagnostyka powikłań poszczepiennych: Metody molekularne są kluczowe dla szybkiej i dokładnej diagnostyki powikłań po szczepionce BCG, takich jak limfadenopatia i BCGitis63.
  4. Rozróżnienie między zakażeniem a chorobą: Zarówno TST, jak i IGRA mogą wskazywać na zakażenie M. tuberculosis, ale nie mogą odróżnić aktywnej gruźlicy od utajonej64.

Opracowanie nowych testów diagnostycznych, które mogą odróżnić szczepienie BCG od naturalnego zakażenia prątkiem gruźlicy, jest obiecującym kierunkiem badań, który może poprawić strategie kontroli gruźlicy na całym świecie65.

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  1. 09.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Bacillus Calmette Guerin – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK538185/
    Bacillus Calmette-Guerin (BCG) is the live attenuated vaccine form of Mycobacterium bovis used to prevent tuberculosis and other mycobacterial infections. The vaccine was developed by Calmette and Guerin and was first administered to human beings in 1921. BCG is the only vaccine against tuberculosis. It is the most widely administered vaccine and usually a part of the routine newborn immunization schedule. BCG vaccine also offers protection against non-tuberculous mycobacterial infections like leprosy and Buruli ulcer. […] BCG vaccine is a fairly safe vaccine and it is not associated with severe complications. Prior to the mycobacterial infection, vaccine-induced or acquired naturally can protect against subsequent infection due to mycobacteria including tuberculosis. […] BCG vaccine can be given either intracutaneously or intradermally. Research is currently being conducted on respiratory administration since natural infection, and sensitization to Mycobacterium tuberculosis in humans tend to occur in the respiratory system.
  • #2 Tuberculosis Vaccine BCG Is Developed | EBSCO Research Starters
    https://www.ebsco.com/research-starters/history/tuberculosis-vaccine-bcg-developed
    The BCG vaccine, developed by French microbiologists Albert Calmette and Camille Gurin in 1921, represents a significant advancement in the prevention of tuberculosis (TB), a serious infectious disease caused by the bacterium Mycobacterium tuberculosis. […] The BCG vaccine was first administered to newborns in Paris and quickly became a vital tool in controlling TB, especially in Europe and Asia during the mid-20th century. […] However, the vaccine does present challenges, such as interfering with the tuberculin skin test used for TB diagnosis, which can lead to misinterpretation of results. […] The first vaccine to prevent tuberculosis was developed in 1921 by two French microbiologists, Albert Calmette and Camille Gurin. […] By 1921, they had isolated an avirulent antibody-stimulating tubercle bacillus strain that was harmless to humans, a strain they called Bacillus Calmette-Gurin (BCG).
  • #3 The Other Pandemic: The Promise of TB Vaccines | International Vaccine Access Center
    https://publichealth.jhu.edu/ivac/the-other-pandemic-the-promise-of-tb-vaccines
    The Bacille Calmette-Gurin (BCG) vaccine is the only vaccine currently available to protect against TB. BCG has been in use for a century and provides critical protection to 100 million newborns globally each year. While the BCG vaccine provides good protection for young children, the vaccines efficacy wanes throughout the lifespan, providing negligible protection to those over 5 years old. TB mainly affects adults, leaving millions vulnerable to the devastating effects of this vaccine-preventable disease. To end the TB epidemic, it is critical to develop vaccines that are effective against TB in all age groups. […] Despite its inability to protect adults from TB, BCG is a life-saving vaccine for infants and children under five. […] The fight against AMR and MDR-TB will require a multi-pronged approach, and it will not be easy. TB vaccines can help by reducing the incidence and transmission of TB, which would in turn reduce the need for antimicrobial treatment and help to slow the emergence of AMR. Because vaccines prevent infections in the first place, they play an indispensable role in combatting the global crisis of drug resistance.
  • #4 Tuberculosis Vaccine | Tuberculosis (TB) | CDC
    https://www.cdc.gov/tb/vaccines/index.html
    Bacille Calmette-Gurin (BCG) is a vaccine for tuberculosis (TB) disease. […] The TB vaccine can cause a false positive TB skin test reaction. […] Tell your health care provider if you have received the TB vaccine, especially if you are getting tested for TB infection. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. […] Yes, a person can have or get TB even if they received the TB vaccine (BCG). The BCG TB vaccine does not always protect people from getting TB. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. The vaccine can cause a false positive TB skin test reaction. Unlike the TB skin test, TB blood tests are not affected by BCG vaccination.
  • #5 CDC | TB | Testing & Diagnosis | Testing in BCG-Vaccinated Persons
    http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/tb/topic/testing/testingbcgvaccinated.htm
    Many people born outside of the United States have been given a vaccine called BCG. […] People who were previously vaccinated with BCG may receive a TB skin test to test for TB infection. Vaccination with BCG may cause a false positive reaction to a TB skin test. A positive reaction to a TB skin test may be due to the BCG vaccine itself or due to infection with TB bacteria. […] TB blood tests (IGRAs), unlike the TB skin test, are not affected by prior BCG vaccination and are not expected to give a false-positive result in people who have received BCG. TB blood tests are the preferred method of TB testing for people who have received the BCG vaccine.
  • #6 Tuberculosis Vaccine | Tuberculosis (TB) | CDC
    https://www.cdc.gov/tb/vaccines/index.html
    Bacille Calmette-Gurin (BCG) is a vaccine for tuberculosis (TB) disease. […] The TB vaccine can cause a false positive TB skin test reaction. […] Tell your health care provider if you have received the TB vaccine, especially if you are getting tested for TB infection. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. […] Yes, a person can have or get TB even if they received the TB vaccine (BCG). The BCG TB vaccine does not always protect people from getting TB. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. The vaccine can cause a false positive TB skin test reaction. Unlike the TB skin test, TB blood tests are not affected by BCG vaccination.
  • #7 Tuberculosis Vaccine | Tuberculosis (TB) | CDC
    https://www.cdc.gov/tb/vaccines/index.html
    Bacille Calmette-Gurin (BCG) is a vaccine for tuberculosis (TB) disease. […] The TB vaccine can cause a false positive TB skin test reaction. […] Tell your health care provider if you have received the TB vaccine, especially if you are getting tested for TB infection. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. […] Yes, a person can have or get TB even if they received the TB vaccine (BCG). The BCG TB vaccine does not always protect people from getting TB. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. The vaccine can cause a false positive TB skin test reaction. Unlike the TB skin test, TB blood tests are not affected by BCG vaccination.
  • #8 TB Blood Testing
    https://provider.questdiagnostics.com/tbbloodtesting
    Tuberculosis (TB) is one of the leading causes of infectious disease morbidity and mortality worldwide. TB testing and screening is essential for public health. TB blood testing is an efficient, convenient way to test for tuberculosis. There are 2 types of tests for TB infection: Interferon-gamma release assays (IGRAs) and Mantoux tuberculin skin test (TST). Highly accurate, and unaffected by the Bacillus Calmette-Gurin (BCG) vaccine. Sensitivity of 79% and specificity of 97%, with specificity being as low as 59% in BCG-vaccinated patients (high false positives). According to the CDC, TB blood tests are preferred for BCG-vaccinated patients. Low false-positive rates compared to skin tests in BCG-vaccinated individuals.
  • #9 BCG vaccine and TB tests – King County, Washington
    https://kingcounty.gov/en/dept/dph/health-safety/disease-illness/tuberculosis/community-education/bcg-vaccine-tests
    If you need a TB test it is important to know if you received the BCG vaccine as a child. You can still get TB even if you were vaccinated, especially if you’re now an adult. […] The BCG vaccine protects against the worst kinds of childhood TB. It does not protect you as an adult. […] Test for TB with a blood test. The TB vaccine, also called BCG, does not change the result of a blood test. If you had a BCG vaccine as a child tell your doctor NOT to use a TB skin test. […] A chest x-ray and doctors visit is the next step if your TB blood test is positive. Your doctor will determine if you have inactive TB or active TB disease.
  • #10 Diagnosis of latent tuberculosis infection in healthy young adults in a country with high tuberculosis burden and BCG vaccination at birth | BMC Research Notes | Full Text
    https://bmcresnotes.biomedcentral.com/articles/10.1186/1756-0500-5-415
    One third of the worlds population is thought to have latent tuberculosis infection (LTBI) with the potential for subsequent reactivation of disease. […] The aim of this study was therefore to evaluate the use of QFT-GIT assay as compared with TST in the diagnosis of LTBI in Ethiopia, a country with a high burden of TB and routine BCG vaccination at birth. […] The TST and QFT-GIT assay show similar efficacy for the diagnosis of LTBI in healthy young adults residing in Ethiopia, a country with high TB incidence. […] The BCG vaccine is not expected to have an effect on the QFT-GIT assay since the antigens that are contained in the assay are not present in any BCG strains. […] This study confirms those finding and adds the observation that in countries with a high incidence of TB, where exposure to infection is likely to be substantial, does not appear to lead to significant boosting of BCG-induced PPD sensitivity. […] In conclusion, this study showed strong agreement between TST (TST10mm) and QFT-GIT assay in healthy young adults residing in Ethiopia, a high TB incidence country, in spite of the routine BCG vaccination at birth in this population.
  • #11 Update of diagnostic methods in tuberculosis (TB) | Revista Argentina de Microbiología
    https://www.elsevier.es/en-revista-revista-argentina-microbiologia-372-articulo-update-diagnostic-methods-in-tuberculosis-S0325754124001640
    Update of diagnostic methods in tuberculosis (TB) […] The recommended rapid diagnostic tests are accurate and cost-effective, allow for a prompt start to treatment, and influence other outcomes that are important to the patient. […] Although IGRA is an expensive test, it has greater specificity and is not affected by previous exposure to the BCG vaccine, among other advantages. […] The recommended rapid diagnostic tests (RDTs) recommended by WHO are highly accurate, shorten the time to treatment initiation, influence important patient outcomes and are cost-effective. […] IGRA (interferon-gamma release assay) tests measure the interferon-gamma released by circulating lymphocytes in whole blood upon exposure to M. tuberculosis-specific antigens, ESAT6 and CFP-10 proteins. […] Advantages include their higher specificity, no BCG vaccine involvement and a single patient visit to the laboratory.
  • #12 QuantiFERON-TB Gold+ for the Diagnosis of Mycobacterium tuberculosis Infection | AAFP
    https://www.aafp.org/pubs/afp/issues/2021/0201/p177.html
    QuantiFERON-TB Gold+ is a blood test used for the diagnosis of infection with Mycobacterium tuberculosis complex organisms (M. tuberculosis, M. bovis, M. africanum). […] QuantiFERON-TB Gold+ is more specific than tuberculin skin testing in patients with a history of BCG vaccination, and the BCG vaccine does not affect IGRA results. […] QuantiFERON-TB Gold+ testing for the diagnosis of active or latent TB is easily interpreted and more specific than tuberculin skin testing in BCG-vaccinated populations. […] Joint clinical practice guidelines from the American Thoracic Society, Infectious Diseases Society of America, and the Centers for Disease Control and Prevention recommend IGRA over tuberculin skin testing when latent TB screening is warranted in patients five years or older who are at low to intermediate risk of progression to active TB or who have a history of BCG vaccination.
  • #13 TB Blood Testing
    https://provider.questdiagnostics.com/tbbloodtesting
    Tuberculosis (TB) is one of the leading causes of infectious disease morbidity and mortality worldwide. TB testing and screening is essential for public health. TB blood testing is an efficient, convenient way to test for tuberculosis. There are 2 types of tests for TB infection: Interferon-gamma release assays (IGRAs) and Mantoux tuberculin skin test (TST). Highly accurate, and unaffected by the Bacillus Calmette-Gurin (BCG) vaccine. Sensitivity of 79% and specificity of 97%, with specificity being as low as 59% in BCG-vaccinated patients (high false positives). According to the CDC, TB blood tests are preferred for BCG-vaccinated patients. Low false-positive rates compared to skin tests in BCG-vaccinated individuals.
  • #14 QuantiFERON-TB Gold+ for the Diagnosis of Mycobacterium tuberculosis Infection | AAFP
    https://www.aafp.org/pubs/afp/issues/2021/0201/p177.html
    QuantiFERON-TB Gold+ is a blood test used for the diagnosis of infection with Mycobacterium tuberculosis complex organisms (M. tuberculosis, M. bovis, M. africanum). […] QuantiFERON-TB Gold+ is more specific than tuberculin skin testing in patients with a history of BCG vaccination, and the BCG vaccine does not affect IGRA results. […] QuantiFERON-TB Gold+ testing for the diagnosis of active or latent TB is easily interpreted and more specific than tuberculin skin testing in BCG-vaccinated populations. […] Joint clinical practice guidelines from the American Thoracic Society, Infectious Diseases Society of America, and the Centers for Disease Control and Prevention recommend IGRA over tuberculin skin testing when latent TB screening is warranted in patients five years or older who are at low to intermediate risk of progression to active TB or who have a history of BCG vaccination.
  • #15 QuantiFERON-TB Gold+ for the Diagnosis of Mycobacterium tuberculosis Infection | AAFP
    https://www.aafp.org/pubs/afp/issues/2021/0201/p177.html
    QuantiFERON-TB Gold+ is a blood test used for the diagnosis of infection with Mycobacterium tuberculosis complex organisms (M. tuberculosis, M. bovis, M. africanum). […] QuantiFERON-TB Gold+ is more specific than tuberculin skin testing in patients with a history of BCG vaccination, and the BCG vaccine does not affect IGRA results. […] QuantiFERON-TB Gold+ testing for the diagnosis of active or latent TB is easily interpreted and more specific than tuberculin skin testing in BCG-vaccinated populations. […] Joint clinical practice guidelines from the American Thoracic Society, Infectious Diseases Society of America, and the Centers for Disease Control and Prevention recommend IGRA over tuberculin skin testing when latent TB screening is warranted in patients five years or older who are at low to intermediate risk of progression to active TB or who have a history of BCG vaccination.
  • #16 TB Control Testing & Reporting | Health & Human Services
    https://hhs.iowa.gov/tb/tb-control-testing-reporting
    BCG, or Bacille Calmette-Gurin, is a vaccine for TB disease. Many persons born outside of the United States have been BCG-vaccinated. BCG is used in many countries with a high prevalence of TB to prevent childhood tuberculous meningitis and miliary disease. […] The question of the effect of BCG vaccine on TST results often causes confusion. TST reactivity caused by BCG vaccine generally wanes with the passage of time, but periodic skin testing may prolong (boost) reactivity in vaccinated persons. A history of BCG vaccine is not a contraindication for tuberculin skin testing or treatment for LTBI in persons with positive TST results. TST reactions should be interpreted regardless of BCG vaccination history. […] IGRAs use M. tuberculosis specific antigens and, unlike the TB skin tests, are not affected by prior BCG vaccination and are not expected to give a false-positive result in persons who have received prior BCG vaccination.
  • #17 TB Control Testing & Reporting | Health & Human Services
    https://hhs.iowa.gov/tb/tb-control-testing-reporting
    BCG, or Bacille Calmette-Gurin, is a vaccine for TB disease. Many persons born outside of the United States have been BCG-vaccinated. BCG is used in many countries with a high prevalence of TB to prevent childhood tuberculous meningitis and miliary disease. […] The question of the effect of BCG vaccine on TST results often causes confusion. TST reactivity caused by BCG vaccine generally wanes with the passage of time, but periodic skin testing may prolong (boost) reactivity in vaccinated persons. A history of BCG vaccine is not a contraindication for tuberculin skin testing or treatment for LTBI in persons with positive TST results. TST reactions should be interpreted regardless of BCG vaccination history. […] IGRAs use M. tuberculosis specific antigens and, unlike the TB skin tests, are not affected by prior BCG vaccination and are not expected to give a false-positive result in persons who have received prior BCG vaccination.
  • #18 Frequently Asked Questions About TB | Texas DSHS
    https://www.dshs.texas.gov/tuberculosis-tb/frequently-asked-questions
    […] […] What if someone has received the BCG vaccine (which is given in many countries)? […] In many parts of the world where TB is common, Bacille Calmette-Gurin, (BCG) vaccine is used to protect infants and young children from serious, life-threatening diseases, specifically miliary TB and TB meningitis. However, it does not completely prevent people from getting TB. […] The effect of the BCG vaccine wanes over time and may have little to no effect on positive TST results among adults who received the vaccine as a child. […] A person with a history of BCG vaccination can be tested and treated for TB infection if they react to the TST. TST reactions should be interpreted based on risk stratification regardless of BCG vaccination history. IGRAs use M. tuberculosis-specific antigens that do not cross-react with BCG, and therefore, do not cause false positive reactions in BCG recipients this means a blood test, or IGRA, is preferred for BCG-vaccinated individuals.
  • #19 Frequently Asked Questions About TB | Texas DSHS
    https://www.dshs.texas.gov/tuberculosis-tb/frequently-asked-questions
    […] […] What if someone has received the BCG vaccine (which is given in many countries)? […] In many parts of the world where TB is common, Bacille Calmette-Gurin, (BCG) vaccine is used to protect infants and young children from serious, life-threatening diseases, specifically miliary TB and TB meningitis. However, it does not completely prevent people from getting TB. […] The effect of the BCG vaccine wanes over time and may have little to no effect on positive TST results among adults who received the vaccine as a child. […] A person with a history of BCG vaccination can be tested and treated for TB infection if they react to the TST. TST reactions should be interpreted based on risk stratification regardless of BCG vaccination history. IGRAs use M. tuberculosis-specific antigens that do not cross-react with BCG, and therefore, do not cause false positive reactions in BCG recipients this means a blood test, or IGRA, is preferred for BCG-vaccinated individuals.
  • #20 Bacillus Calmette Guerin – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK538185/
    Bacillus Calmette-Guerin (BCG) is the live attenuated vaccine form of Mycobacterium bovis used to prevent tuberculosis and other mycobacterial infections. The vaccine was developed by Calmette and Guerin and was first administered to human beings in 1921. BCG is the only vaccine against tuberculosis. It is the most widely administered vaccine and usually a part of the routine newborn immunization schedule. BCG vaccine also offers protection against non-tuberculous mycobacterial infections like leprosy and Buruli ulcer. […] BCG vaccine is a fairly safe vaccine and it is not associated with severe complications. Prior to the mycobacterial infection, vaccine-induced or acquired naturally can protect against subsequent infection due to mycobacteria including tuberculosis. […] BCG vaccine can be given either intracutaneously or intradermally. Research is currently being conducted on respiratory administration since natural infection, and sensitization to Mycobacterium tuberculosis in humans tend to occur in the respiratory system.
  • #21
    https://journals.lww.com/joms/fulltext/2018/38050/bacille_calmette_guerin_lymphadenitis_in_infants_.8.aspx
    Bacille CalmetteGuerin (BCG) vaccine containing live-attenuated Mycobacterium bovis was first used in humans to prevent tuberculosis (TB) in 1921. […] BCG-induced lymphadenitis is the most common complication of BCG vaccination. Fine-needle aspiration (FNA) being a rapid minimally invasive test can help in proper diagnosis and the patient can be observed/managed appropriately rather than treated with antitubercular medication. […] BCG vaccination is done by intradermal inoculation of 0.05 ml vaccine at left deltoid region (In India). It causes erythematous induration at the site of inoculation, which follows pustule formation after 2-3 weeks; ulceration, drainage, and crusting at 4-6 weeks after vaccination. Healing occurs with small residual scar 10-12 weeks after vaccination. […] Reported incidence of BCG vaccine-related complications varies from 0.1% to 17% in different studies worldwide. BCG-related lymphadenitis is the most common complication of BCG vaccination.
  • #22
    https://journals.lww.com/joms/fulltext/2018/38050/bacille_calmette_guerin_lymphadenitis_in_infants_.8.aspx
    The term BCG lymphadenitis applies when lymph node(s) have become large enough to be easily palpable and a cause of concern for the parents, likely with a diameter to 1 cm. […] Diagnosis of BCG lymphadenitis depends on the history and clinical examination. Cases are diagnosed as ipsilateral enlargement of local lymph node at the site of BCG vaccination in the absence of any constitutional symptoms with other identifiable cause of adenitis. […] BCG lymphadenitis is often difficult to differentiate from tuberculous lymphadenitis. […] Antimycobacterial drugs cannot prevent suppuration nor shorten the duration of healing, therefore are not recommended. […] Nonsuppurative BCG lymphadenitis is a relatively common benign condition that will regress spontaneously over a matter of weeks to months.
  • #23
    https://journals.lww.com/joms/fulltext/2018/38050/bacille_calmette_guerin_lymphadenitis_in_infants_.8.aspx
    The term BCG lymphadenitis applies when lymph node(s) have become large enough to be easily palpable and a cause of concern for the parents, likely with a diameter to 1 cm. […] Diagnosis of BCG lymphadenitis depends on the history and clinical examination. Cases are diagnosed as ipsilateral enlargement of local lymph node at the site of BCG vaccination in the absence of any constitutional symptoms with other identifiable cause of adenitis. […] BCG lymphadenitis is often difficult to differentiate from tuberculous lymphadenitis. […] Antimycobacterial drugs cannot prevent suppuration nor shorten the duration of healing, therefore are not recommended. […] Nonsuppurative BCG lymphadenitis is a relatively common benign condition that will regress spontaneously over a matter of weeks to months.
  • #24
    https://journals.lww.com/joms/fulltext/2018/38050/bacille_calmette_guerin_lymphadenitis_in_infants_.8.aspx
    Bacille CalmetteGuerin (BCG) vaccine containing live-attenuated Mycobacterium bovis was first used in humans to prevent tuberculosis (TB) in 1921. […] BCG-induced lymphadenitis is the most common complication of BCG vaccination. Fine-needle aspiration (FNA) being a rapid minimally invasive test can help in proper diagnosis and the patient can be observed/managed appropriately rather than treated with antitubercular medication. […] BCG vaccination is done by intradermal inoculation of 0.05 ml vaccine at left deltoid region (In India). It causes erythematous induration at the site of inoculation, which follows pustule formation after 2-3 weeks; ulceration, drainage, and crusting at 4-6 weeks after vaccination. Healing occurs with small residual scar 10-12 weeks after vaccination. […] Reported incidence of BCG vaccine-related complications varies from 0.1% to 17% in different studies worldwide. BCG-related lymphadenitis is the most common complication of BCG vaccination.
  • #25 BCG Vaccine-Related Lymphadenitis and BCGitis | Consultant360
    https://www.consultant360.com/article/bcg-vaccine-related-lymphadenitis-and-bcg-itis
    BCGitis is the most serious complication of BCG vaccination. It is an infection that affects several organ systems and has been found mainly in children with primary immunodeficiency, severe combined immunodeficiency, AIDS, and Mendelian susceptibility to mycobacterial disease, among other immune-system diseases; this is why, when presented with this entity, patients should be evaluated for immunodeficiency. […] The diagnosis can be made by culture or molecular methods. Isolation of BCG is mandatory to make the diagnosis of BCGitis. Treatment usually requires 4 medications; mycobacterial therapeutic regimens include isoniazid, rifampin, ethambutol, and streptomycin. […] BCG is the most administered vaccine worldwide and it is included in most developing countries vaccination programs, since it is included in the global expanded program of immunization recommended by WHO. The frequency of adverse events tends to be very low, but it is important to know that they exist and how to treat them, since they can have serious implications in a child’s quality of life. Lymphadenitis and BCGitis are entities that can be easily mistaken for other infections that are usually treated with antibiotic therapy. Thus it is important to know how to recognize them so that appropriate treatment can be initiated, especially now that antibiotic resistance has been on the rise.
  • #26 BCG Vaccine-Related Lymphadenitis and BCGitis | Consultant360
    https://www.consultant360.com/article/bcg-vaccine-related-lymphadenitis-and-bcg-itis
    BCGitis is the most serious complication of BCG vaccination. It is an infection that affects several organ systems and has been found mainly in children with primary immunodeficiency, severe combined immunodeficiency, AIDS, and Mendelian susceptibility to mycobacterial disease, among other immune-system diseases; this is why, when presented with this entity, patients should be evaluated for immunodeficiency. […] The diagnosis can be made by culture or molecular methods. Isolation of BCG is mandatory to make the diagnosis of BCGitis. Treatment usually requires 4 medications; mycobacterial therapeutic regimens include isoniazid, rifampin, ethambutol, and streptomycin. […] BCG is the most administered vaccine worldwide and it is included in most developing countries vaccination programs, since it is included in the global expanded program of immunization recommended by WHO. The frequency of adverse events tends to be very low, but it is important to know that they exist and how to treat them, since they can have serious implications in a child’s quality of life. Lymphadenitis and BCGitis are entities that can be easily mistaken for other infections that are usually treated with antibiotic therapy. Thus it is important to know how to recognize them so that appropriate treatment can be initiated, especially now that antibiotic resistance has been on the rise.
  • #27 Molecular methods in diagnostics of post-BCG vaccine adverse events
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7792438/
    Bacillus Calmette-Gurin (BCG) is the only tuberculosis vaccine available and although it has been routinely used for more than 80 years, its protective effect varies depending on the age and the form of tuberculosis. […] The aim of the study was to assess usefulness of molecular methods in diagnosis of post-BCG vaccine adverse events (VAEs). […] The use of genetic methods enables quick and detailed diagnostics of infections caused by M. bovis BCG, which allows for the confirmation or exclusion of VAE. […] The diagnosis of M. bovis BCG infection is based on physical examination and the results of microbiological tests. […] The identification of M. bovis BCG as etiological factor of the disease is especially important due to the different treatment scheme. […] Therefore, in the case of strains cultured from children, it is recommended to perform a detailed diagnosis that differentiates species within the MTBC. […] The modern molecular methods enable confirmation or exclusion of VAEs in children with suspected tuberculosis.
  • #28 Molecular methods in diagnostics of post-BCG vaccine adverse events
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7792438/
    Bacillus Calmette-Gurin (BCG) is the only tuberculosis vaccine available and although it has been routinely used for more than 80 years, its protective effect varies depending on the age and the form of tuberculosis. […] The aim of the study was to assess usefulness of molecular methods in diagnosis of post-BCG vaccine adverse events (VAEs). […] The use of genetic methods enables quick and detailed diagnostics of infections caused by M. bovis BCG, which allows for the confirmation or exclusion of VAE. […] The diagnosis of M. bovis BCG infection is based on physical examination and the results of microbiological tests. […] The identification of M. bovis BCG as etiological factor of the disease is especially important due to the different treatment scheme. […] Therefore, in the case of strains cultured from children, it is recommended to perform a detailed diagnosis that differentiates species within the MTBC. […] The modern molecular methods enable confirmation or exclusion of VAEs in children with suspected tuberculosis.
  • #29 Molecular methods in diagnostics of post-BCG vaccine adverse events
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7792438/
    Bacillus Calmette-Gurin (BCG) is the only tuberculosis vaccine available and although it has been routinely used for more than 80 years, its protective effect varies depending on the age and the form of tuberculosis. […] The aim of the study was to assess usefulness of molecular methods in diagnosis of post-BCG vaccine adverse events (VAEs). […] The use of genetic methods enables quick and detailed diagnostics of infections caused by M. bovis BCG, which allows for the confirmation or exclusion of VAE. […] The diagnosis of M. bovis BCG infection is based on physical examination and the results of microbiological tests. […] The identification of M. bovis BCG as etiological factor of the disease is especially important due to the different treatment scheme. […] Therefore, in the case of strains cultured from children, it is recommended to perform a detailed diagnosis that differentiates species within the MTBC. […] The modern molecular methods enable confirmation or exclusion of VAEs in children with suspected tuberculosis.
  • #30 Molecular methods in diagnostics of post-BCG vaccine adverse events
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7792438/
    Bacillus Calmette-Gurin (BCG) is the only tuberculosis vaccine available and although it has been routinely used for more than 80 years, its protective effect varies depending on the age and the form of tuberculosis. […] The aim of the study was to assess usefulness of molecular methods in diagnosis of post-BCG vaccine adverse events (VAEs). […] The use of genetic methods enables quick and detailed diagnostics of infections caused by M. bovis BCG, which allows for the confirmation or exclusion of VAE. […] The diagnosis of M. bovis BCG infection is based on physical examination and the results of microbiological tests. […] The identification of M. bovis BCG as etiological factor of the disease is especially important due to the different treatment scheme. […] Therefore, in the case of strains cultured from children, it is recommended to perform a detailed diagnosis that differentiates species within the MTBC. […] The modern molecular methods enable confirmation or exclusion of VAEs in children with suspected tuberculosis.
  • #31 Tuberculosis Vaccine | Tuberculosis (TB) | CDC
    https://www.cdc.gov/tb/vaccines/index.html
    Bacille Calmette-Gurin (BCG) is a vaccine for tuberculosis (TB) disease. […] The TB vaccine can cause a false positive TB skin test reaction. […] Tell your health care provider if you have received the TB vaccine, especially if you are getting tested for TB infection. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. […] Yes, a person can have or get TB even if they received the TB vaccine (BCG). The BCG TB vaccine does not always protect people from getting TB. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. The vaccine can cause a false positive TB skin test reaction. Unlike the TB skin test, TB blood tests are not affected by BCG vaccination.
  • #32 TB Test: What It Is, How It Works, Results & Side Effects
    https://my.clevelandclinic.org/health/diagnostics/22751-tuberculosis-tb-test
    A TB test checks to see if youve been infected with tuberculosis (TB). There are two types of TB tests: a skin test and a blood test. TB skin and blood tests can show if youve ever been exposed to the bacterium that causes TB, but they cant determine if you have a latent (dormant) or active TB infection. […] A TB skin test is also called a Mantoux test or tuberculin skin test (TST). A TB blood test is also called an Interferon-Gamma Release Assay (IGRA). TB skin tests are more common and are the preferred type for children under age 5. But blood tests for TB are becoming more common, especially for healthcare workers and those who have compromised immune systems or are going to become immunocompromised by medications. […] TB skin and blood tests can show if youve ever been infected with M. tuberculosis complex, but they cant distinguish between a latent (dormant) or active TB infection. Youll need additional tests (like a sputum test) to see if you have an active infection.
  • #33 TB Test: What It Is, How It Works, Results & Side Effects
    https://my.clevelandclinic.org/health/diagnostics/22751-tuberculosis-tb-test
    A TB test checks to see if youve been infected with tuberculosis (TB). There are two types of TB tests: a skin test and a blood test. TB skin and blood tests can show if youve ever been exposed to the bacterium that causes TB, but they cant determine if you have a latent (dormant) or active TB infection. […] A TB skin test is also called a Mantoux test or tuberculin skin test (TST). A TB blood test is also called an Interferon-Gamma Release Assay (IGRA). TB skin tests are more common and are the preferred type for children under age 5. But blood tests for TB are becoming more common, especially for healthcare workers and those who have compromised immune systems or are going to become immunocompromised by medications. […] TB skin and blood tests can show if youve ever been infected with M. tuberculosis complex, but they cant distinguish between a latent (dormant) or active TB infection. Youll need additional tests (like a sputum test) to see if you have an active infection.
  • #34 Testing for Tuberculosis Infection: Guidelines on the Use of Interferon-Gamma Release Assays and the Tuberculin Skin Test in Massachusetts | Mass.gov
    https://www.mass.gov/info-details/testing-for-tuberculosis-infection-guidelines-on-the-use-of-interferon-gamma-release-assays-and-the-tuberculin-skin-test-in-massachusetts
    The interferon-gamma release assays (IGRAs) and tuberculin skin test (TST) are diagnostic tests for Mycobacterium tuberculosis infection. […] An IGRA can be used in most situations in which the TST is indicated, and is preferred for those persons who have received bacille Calmette-Guerin (BCG) vaccine. […] Unlike the TST, IGRAs do not require a return visit and results are less likely to be affected by cross-reactivity with BCG or infection due to most non-tuberculous mycobacteria. […] IGRA is preferred for: Persons born outside the U.S. who have received BCG vaccination. […] All persons with a positive IGRA or TST result should be evaluated for the possibility of active TB disease.
  • #35 TB Test: What It Is, How It Works, Results & Side Effects
    https://my.clevelandclinic.org/health/diagnostics/22751-tuberculosis-tb-test
    The results of a TB skin test or blood test will be either negative or positive. Its important to remember that these tests only show if youve been exposed to the tuberculosis infection not if your infection is active or latent. You might have a false-positive skin test result if youve received a TB vaccine (BCG). […] If your TB skin test or blood test is positive, it probably means youve been exposed to the bacterium that causes TB. Your healthcare provider will likely order more tests to help make a diagnosis. Tests that diagnose active TB infections include chest X-rays and laboratory tests on a sputum sample. […] If your TB skin or blood test is negative, you likely havent been exposed to the TB bacterium. A negative TB skin test means your skin didnt react to the liquid. You may need further testing if your results were negative, but you have symptoms of TB.
  • #36
    https://journals.lww.com/joms/fulltext/2018/38050/bacille_calmette_guerin_lymphadenitis_in_infants_.8.aspx
    The term BCG lymphadenitis applies when lymph node(s) have become large enough to be easily palpable and a cause of concern for the parents, likely with a diameter to 1 cm. […] Diagnosis of BCG lymphadenitis depends on the history and clinical examination. Cases are diagnosed as ipsilateral enlargement of local lymph node at the site of BCG vaccination in the absence of any constitutional symptoms with other identifiable cause of adenitis. […] BCG lymphadenitis is often difficult to differentiate from tuberculous lymphadenitis. […] Antimycobacterial drugs cannot prevent suppuration nor shorten the duration of healing, therefore are not recommended. […] Nonsuppurative BCG lymphadenitis is a relatively common benign condition that will regress spontaneously over a matter of weeks to months.
  • #37 BCG Vaccine-Related Lymphadenitis and BCGitis | Consultant360
    https://www.consultant360.com/article/bcg-vaccine-related-lymphadenitis-and-bcg-itis
    BCGitis is the most serious complication of BCG vaccination. It is an infection that affects several organ systems and has been found mainly in children with primary immunodeficiency, severe combined immunodeficiency, AIDS, and Mendelian susceptibility to mycobacterial disease, among other immune-system diseases; this is why, when presented with this entity, patients should be evaluated for immunodeficiency. […] The diagnosis can be made by culture or molecular methods. Isolation of BCG is mandatory to make the diagnosis of BCGitis. Treatment usually requires 4 medications; mycobacterial therapeutic regimens include isoniazid, rifampin, ethambutol, and streptomycin. […] BCG is the most administered vaccine worldwide and it is included in most developing countries vaccination programs, since it is included in the global expanded program of immunization recommended by WHO. The frequency of adverse events tends to be very low, but it is important to know that they exist and how to treat them, since they can have serious implications in a child’s quality of life. Lymphadenitis and BCGitis are entities that can be easily mistaken for other infections that are usually treated with antibiotic therapy. Thus it is important to know how to recognize them so that appropriate treatment can be initiated, especially now that antibiotic resistance has been on the rise.
  • #38 The BCG World Atlas: A Database of Global BCG Vaccination Policies and Practices | PLOS Medicine
    https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001012
    Despite nearly a century of use, the Bacille Calmette-Gurin (BCG) vaccine continues to be controversial, with known variations in BCG substrains and vaccine efficacy. […] The Atlas is for clinicians, policymakers, and researchers and provides information that may be helpful for better interpretation of tuberculosis (TB) diagnostics as well as design of new TB vaccines. […] Global information on BCG policies and practices may be useful for clinical interpretation of diagnostic tests as well as in the design of novel TB vaccines that are under development. […] Information on diversity of BCG policies between countries and across time may be helpful for better interpretation of TB diagnostics as well as design of new TB vaccines. […] The Atlas may help clinicians interpret TST by providing the information necessary to assess whether the TST is a valid diagnostic tool in a particular patient, or when alternative diagnostics may be preferable.
  • #39 The BCG World Atlas: A Database of Global BCG Vaccination Policies and Practices | PLOS Medicine
    https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001012
    Despite nearly a century of use, the Bacille Calmette-Gurin (BCG) vaccine continues to be controversial, with known variations in BCG substrains and vaccine efficacy. […] The Atlas is for clinicians, policymakers, and researchers and provides information that may be helpful for better interpretation of tuberculosis (TB) diagnostics as well as design of new TB vaccines. […] Global information on BCG policies and practices may be useful for clinical interpretation of diagnostic tests as well as in the design of novel TB vaccines that are under development. […] Information on diversity of BCG policies between countries and across time may be helpful for better interpretation of TB diagnostics as well as design of new TB vaccines. […] The Atlas may help clinicians interpret TST by providing the information necessary to assess whether the TST is a valid diagnostic tool in a particular patient, or when alternative diagnostics may be preferable.
  • #40 Update of diagnostic methods in tuberculosis (TB) | Revista Argentina de Microbiología
    https://www.elsevier.es/en-revista-revista-argentina-microbiologia-372-articulo-update-diagnostic-methods-in-tuberculosis-S0325754124001640
    Update of diagnostic methods in tuberculosis (TB) […] The recommended rapid diagnostic tests are accurate and cost-effective, allow for a prompt start to treatment, and influence other outcomes that are important to the patient. […] Although IGRA is an expensive test, it has greater specificity and is not affected by previous exposure to the BCG vaccine, among other advantages. […] The recommended rapid diagnostic tests (RDTs) recommended by WHO are highly accurate, shorten the time to treatment initiation, influence important patient outcomes and are cost-effective. […] IGRA (interferon-gamma release assay) tests measure the interferon-gamma released by circulating lymphocytes in whole blood upon exposure to M. tuberculosis-specific antigens, ESAT6 and CFP-10 proteins. […] Advantages include their higher specificity, no BCG vaccine involvement and a single patient visit to the laboratory.
  • #41 GtR
    https://gtr.ukri.org/projects?ref=BB/L004569/1
    These tests are based on immunogenic proteins whose genes were spontaneously lost from the genome of M. bovis during the development into the BCG vaccine and so can be used to Differentiate between natural Infection with M. bovis and VAccination with BCG (DIVA antigens). […] Therefore, these studies provided proof of principle that a much more cost-effective control strategy for bovine tuberculosis, particularly in India, would be to implement a combination of a cheap and effective vaccine (such as BCG) together with a cheap and effective skin test diagnostic reagent to identify and segregate infected animals from the rest of the herd. […] The first aim of this project will therefore be to develop a dcBCG deleted in additional immunodominant antigens. […] The combination of dcBCG plus exDIVA will provide an effective vaccine for bovine tuberculosis together with a complementary cheap and effective diagnostic skin test that will be appropriate for developed countries such as the UK but particularly for developing countries such as India that are unable to implement a detection and cull control strategy.
  • #42 GtR
    https://gtr.ukri.org/projects?ref=BB/L004569/1
    These tests are based on immunogenic proteins whose genes were spontaneously lost from the genome of M. bovis during the development into the BCG vaccine and so can be used to Differentiate between natural Infection with M. bovis and VAccination with BCG (DIVA antigens). […] Therefore, these studies provided proof of principle that a much more cost-effective control strategy for bovine tuberculosis, particularly in India, would be to implement a combination of a cheap and effective vaccine (such as BCG) together with a cheap and effective skin test diagnostic reagent to identify and segregate infected animals from the rest of the herd. […] The first aim of this project will therefore be to develop a dcBCG deleted in additional immunodominant antigens. […] The combination of dcBCG plus exDIVA will provide an effective vaccine for bovine tuberculosis together with a complementary cheap and effective diagnostic skin test that will be appropriate for developed countries such as the UK but particularly for developing countries such as India that are unable to implement a detection and cull control strategy.
  • #43 Development of a diagnostic compatible BCG vaccine against Bovine tuberculosis | Scientific Reports
    https://www.nature.com/articles/s41598-019-54108-y
    However, it is not used to control BTB since BCG shares many antigens with M. bovis resulting in the failure of the PPD skin test to distinguish between a BCG-vaccinated and BTB-infected cow. […] The discovery that the development of BCG from M. bovis involved the concomitant deletion of large regions of the BCG chromosome stimulated the search for antigens that have been lost in the BCG genome and may therefore be used in a novel test capable of Differentiating Infected from Vaccinated Animals (DIVA). […] Recently a defined diagnostic skin test was developed based on a cocktail of DIVA antigens, ESAT-6, CFP-10 and Rv3615c, that allow the differential diagnosis of M. bovis-infected from BCG-vaccinated animals. […] Our aim was to develop a new BCG vaccine that is compatible with a sensitive and affordable DIVA skin test.
  • #44 Development of a diagnostic compatible BCG vaccine against Bovine tuberculosis | Scientific Reports
    https://www.nature.com/articles/s41598-019-54108-y
    This study provides a novel approach to development of rationally-designed live vaccines. […] We developed a compatible extended DIVA skin test that proved to be specific in not provoking skin reactions in vaccinated guinea pigs before challenge but provoking reactions post-challenge. […] The test, although specific, was not as sensitive as PPD-B in the Guinea pig model. […] The DIVA cocktail described here is specific and is not affected by vaccination.
  • #45 Bacillus Calmette Guerin – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK538185/
    Bacillus Calmette-Guerin (BCG) is the live attenuated vaccine form of Mycobacterium bovis used to prevent tuberculosis and other mycobacterial infections. The vaccine was developed by Calmette and Guerin and was first administered to human beings in 1921. BCG is the only vaccine against tuberculosis. It is the most widely administered vaccine and usually a part of the routine newborn immunization schedule. BCG vaccine also offers protection against non-tuberculous mycobacterial infections like leprosy and Buruli ulcer. […] BCG vaccine is a fairly safe vaccine and it is not associated with severe complications. Prior to the mycobacterial infection, vaccine-induced or acquired naturally can protect against subsequent infection due to mycobacteria including tuberculosis. […] BCG vaccine can be given either intracutaneously or intradermally. Research is currently being conducted on respiratory administration since natural infection, and sensitization to Mycobacterium tuberculosis in humans tend to occur in the respiratory system.
  • #46 A century of BCG vaccine, but still not good enough! | Biomedical Primate Research Centre
    https://bprc.nl/en/news/a-century-of-bcg-vaccine-but-still-not-good-enough/
    Preventive vaccines are one of the most effective and cost-saving approaches in health care. To combat tuberculosis (TB), the so-called BCG vaccine has been available for exactly a century this year. […] Many research groups are going out of their way on the task of improving the current TB vaccine. BPRC is doing its bit and is, among other things, investigating how alternative vaccination routes can increase the effect of BCG. […] In previous research, BPRCs scientists have already found that vaccination with BCG via the airways (mucosal) results in better protection compared to injecting it, as usual, in the skin. […] If you know exactly how a vaccine is providing protection, you can make good use of this in the clinic and, at an early stage, estimate whether your vaccine program could have the desired effect.
  • #47 Novel concepts in the epidemiology, diagnosis and prevention of childhood tuberculosis
    https://smw.ch/index.php/smw/article/download/1904/2690?inline=1
    More accurate diagnostic tests for TB in children are therefore urgently needed. There is growing recognition that there are fundamental differences in children and adults in relation to the underlying immunology and consequent diagnosis of TB. The recently published roadmap for childhood TB by the WHO highlights that the evaluation of new diagnostics is a research priority with particular emphasis on assays that are suitable for paediatric samples and that have the ability to identify disease progression in children. […] In summary, a number of candidates are currently being evaluated as novel vaccines against TB representing a major achievement in this research field. However, the development of novel TB vaccines and clinical trials are significantly hampered by the absence of biomarkers that correlate with protection and the lack of an ideal animal model. It is therefore important to improve the diagnostic accuracy of all tests used to diagnose TB disease in children included in TB vaccine trials. In the light of these challenges, it is likely that BCG will remain the only licensed TB vaccine for at least the next 10 years.
  • #48 Novel concepts in the epidemiology, diagnosis and prevention of childhood tuberculosis
    https://smw.ch/index.php/smw/article/download/1904/2690?inline=1
    More accurate diagnostic tests for TB in children are therefore urgently needed. There is growing recognition that there are fundamental differences in children and adults in relation to the underlying immunology and consequent diagnosis of TB. The recently published roadmap for childhood TB by the WHO highlights that the evaluation of new diagnostics is a research priority with particular emphasis on assays that are suitable for paediatric samples and that have the ability to identify disease progression in children. […] In summary, a number of candidates are currently being evaluated as novel vaccines against TB representing a major achievement in this research field. However, the development of novel TB vaccines and clinical trials are significantly hampered by the absence of biomarkers that correlate with protection and the lack of an ideal animal model. It is therefore important to improve the diagnostic accuracy of all tests used to diagnose TB disease in children included in TB vaccine trials. In the light of these challenges, it is likely that BCG will remain the only licensed TB vaccine for at least the next 10 years.
  • #49 100 years after the advent of TB vaccines, formulations vary widely – Boston Children’s Answers
    https://answers.childrenshospital.org/bcg-tuberculosis-vaccine/
    Each year, more than 100 million newborns around the world receive vaccinations against Mycobacterium tuberculosis, or TB, which infects about one-quarter of the world’s population. Facilities across the world produce several different formulations of these vaccines, known as Bacille Calmette-Guérin (BCG) vaccines. These are given interchangeably, yet new research from the Precision Vaccines Program at Boston Children’s Hospital calls that practice into question. […] The study, which was published in the journal Vaccine, shows that BCG vaccines vary widely in their characteristics, including their ability to activate cytokines, potent elements of the immune system response. […] “We found that licensed BCG vaccines differ dramatically, raising fundamental questions about whether the quality of these vaccines are equivalent and should be considered interchangeable,” explains co-senior investigator Ofer Levy, MD, PhD, director of the Precision Vaccines Program.
  • #50 100 years after the advent of TB vaccines, formulations vary widely – Boston Children’s Answers
    https://answers.childrenshospital.org/bcg-tuberculosis-vaccine/
    The new study looked at several formulations of the most commonly used licensed BCG vaccines: BCG-Denmark, BCG-India, BCG-Bulgaria, BCG-Japan, and BCG-USA (sourced from the Boston Children’s Hospital pharmacy). […] “The data consistently shows that the Indian and Bulgarian formulations, both derived from the same mother BCG strain (BCG Russia), have more than 1,000-fold lower growth and fewer live bacteria compared to the others,” says Angelidou. […] “We found differences in terms of the cytokine responses each vaccine triggered,” says Angelidou. […] In particular, BCG-India induced significantly less interferon gamma compared to the rest of the strains. […] “Comparing the ability of each BCG formulation to induce interferon gamma production in newborn immune cells was therefore very important.”
  • #51 ATS/CDC/IDSA Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children
    https://www.idsociety.org/practice-guideline/diagnosis-of-tb-in-adults-and-children/
    Individuals infected with Mycobacterium tuberculosis (Mtb) may develop symptoms and signs of disease (tuberculosis disease) or may have no clinical evidence of disease (latent tuberculosis infection [LTBI]). Tuberculosis disease is a leading cause of infectious disease morbidity and mortality worldwide, yet many questions related to its diagnosis remain. […] Our recommendations for diagnostic testing for LTBI are based upon the likelihood of infection with Mtb and the likelihood of progression to TB disease if infected, as illustrated in Figure 1. […] We recommend performing an interferon- release assay (IGRA) rather than a tuberculin skin test (TST) in individuals 5 years or older who meet the following criteria: (1) are likely to be infected with Mtb, (2) have a low or intermediate risk of disease progression, (3) it has been decided that testing for LTBI is warranted, and (4) either have a history of BCG vaccination or are unlikely to return to have their TST read (strong recommendation, moderate-quality evidence).
  • #52 Testing for Tuberculosis Infection: Guidelines on the Use of Interferon-Gamma Release Assays and the Tuberculin Skin Test in Massachusetts | Mass.gov
    https://www.mass.gov/info-details/testing-for-tuberculosis-infection-guidelines-on-the-use-of-interferon-gamma-release-assays-and-the-tuberculin-skin-test-in-massachusetts
    The interferon-gamma release assays (IGRAs) and tuberculin skin test (TST) are diagnostic tests for Mycobacterium tuberculosis infection. […] An IGRA can be used in most situations in which the TST is indicated, and is preferred for those persons who have received bacille Calmette-Guerin (BCG) vaccine. […] Unlike the TST, IGRAs do not require a return visit and results are less likely to be affected by cross-reactivity with BCG or infection due to most non-tuberculous mycobacteria. […] IGRA is preferred for: Persons born outside the U.S. who have received BCG vaccination. […] All persons with a positive IGRA or TST result should be evaluated for the possibility of active TB disease.
  • #53 Tuberculosis (TB) Blood Test (IGRA) – MN Dept. of Health
    https://www.health.state.mn.us/diseases/tb/basics/factsheets/igra.html
    The BCG vaccine (TB vaccine) may help protect young children from getting very sick with TB. This protection goes away as people get older. People who have had BCG vaccine still can get latent TB infection and active TB disease. […] If you had the BCG vaccine and you have a choice of having a TB blood test or a TB skin test, it is better for you to have the TB blood test. This is because the TB blood test is not affected by the BCG vaccine. This means that your TB blood test will be positive only if you have TB germs in your body.
  • #54 Tuberculin Skin Test (TST) – MN Dept. of Health
    https://www.health.state.mn.us/diseases/tb/tst.html
    People who have been vaccinated with Bacille Calmette-Gurin (BCG) should not be exempted from TB skin testing unless they have a documented positive result from a prior test. Disregard BCG history when interpreting TST results. […] BCG, or bacille Calmette-Gurin, is a vaccine for TB. […] However, BCG is not generally recommended for use in the United States because of the low risk of infection with Mycobacterium tuberculosis, the variable effectiveness of the vaccine against adult pulmonary TB, and the vaccine’s potential interference with tuberculin skin test reactivity. […] TSTs and TB blood tests to detect TB infection are not contraindicated for persons who have been vaccinated with BCG. […] Evaluation of TST reactions in persons vaccinated with BCG should be interpreted using the same criteria for those not BCG-vaccinated. […] Unlike the TST, TB blood tests do not detect the presence of BCG and are less likely to give a false-positive result.
  • #55 Tuberculin Skin Test (TST) – MN Dept. of Health
    https://www.health.state.mn.us/diseases/tb/tst.html
    People who have been vaccinated with Bacille Calmette-Gurin (BCG) should not be exempted from TB skin testing unless they have a documented positive result from a prior test. Disregard BCG history when interpreting TST results. […] BCG, or bacille Calmette-Gurin, is a vaccine for TB. […] However, BCG is not generally recommended for use in the United States because of the low risk of infection with Mycobacterium tuberculosis, the variable effectiveness of the vaccine against adult pulmonary TB, and the vaccine’s potential interference with tuberculin skin test reactivity. […] TSTs and TB blood tests to detect TB infection are not contraindicated for persons who have been vaccinated with BCG. […] Evaluation of TST reactions in persons vaccinated with BCG should be interpreted using the same criteria for those not BCG-vaccinated. […] Unlike the TST, TB blood tests do not detect the presence of BCG and are less likely to give a false-positive result.
  • #56 Tuberculin Skin Test (TST) – MN Dept. of Health
    https://www.health.state.mn.us/diseases/tb/tst.html
    People who have been vaccinated with Bacille Calmette-Gurin (BCG) should not be exempted from TB skin testing unless they have a documented positive result from a prior test. Disregard BCG history when interpreting TST results. […] BCG, or bacille Calmette-Gurin, is a vaccine for TB. […] However, BCG is not generally recommended for use in the United States because of the low risk of infection with Mycobacterium tuberculosis, the variable effectiveness of the vaccine against adult pulmonary TB, and the vaccine’s potential interference with tuberculin skin test reactivity. […] TSTs and TB blood tests to detect TB infection are not contraindicated for persons who have been vaccinated with BCG. […] Evaluation of TST reactions in persons vaccinated with BCG should be interpreted using the same criteria for those not BCG-vaccinated. […] Unlike the TST, TB blood tests do not detect the presence of BCG and are less likely to give a false-positive result.
  • #57 Patient education: Tuberculosis (Beyond the Basics) – UpToDate
    https://www.uptodate.com/contents/tuberculosis-beyond-the-basics
    BCG vaccine – A TB vaccine called Bacillus Calmette-Guérin (BCG) is given in many countries to prevent infection with TB. It usually is given to infants, although it may be given again at other times. BCG offers protection against TB in young children but typically does not offer continuing protection. BCG is not routinely used to prevent TB in the United States. […] This vaccine may or may not cause a positive skin test. In the United States, a positive reaction to a TB skin test is interpreted as positive, regardless of prior BCG vaccination. Previous BCG vaccination should NOT stop a person from obtaining a TB skin test unless the person had a positive TB skin test reaction in the past.
  • #58 Patient education: Tuberculosis (Beyond the Basics) – UpToDate
    https://www.uptodate.com/contents/tuberculosis-beyond-the-basics
    BCG vaccine – A TB vaccine called Bacillus Calmette-Guérin (BCG) is given in many countries to prevent infection with TB. It usually is given to infants, although it may be given again at other times. BCG offers protection against TB in young children but typically does not offer continuing protection. BCG is not routinely used to prevent TB in the United States. […] This vaccine may or may not cause a positive skin test. In the United States, a positive reaction to a TB skin test is interpreted as positive, regardless of prior BCG vaccination. Previous BCG vaccination should NOT stop a person from obtaining a TB skin test unless the person had a positive TB skin test reaction in the past.
  • #59 Bacillus Calmette Guerin – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK538185/
    Bacillus Calmette-Guerin (BCG) is the live attenuated vaccine form of Mycobacterium bovis used to prevent tuberculosis and other mycobacterial infections. The vaccine was developed by Calmette and Guerin and was first administered to human beings in 1921. BCG is the only vaccine against tuberculosis. It is the most widely administered vaccine and usually a part of the routine newborn immunization schedule. BCG vaccine also offers protection against non-tuberculous mycobacterial infections like leprosy and Buruli ulcer. […] BCG vaccine is a fairly safe vaccine and it is not associated with severe complications. Prior to the mycobacterial infection, vaccine-induced or acquired naturally can protect against subsequent infection due to mycobacteria including tuberculosis. […] BCG vaccine can be given either intracutaneously or intradermally. Research is currently being conducted on respiratory administration since natural infection, and sensitization to Mycobacterium tuberculosis in humans tend to occur in the respiratory system.
  • #60 The Other Pandemic: The Promise of TB Vaccines | International Vaccine Access Center
    https://publichealth.jhu.edu/ivac/the-other-pandemic-the-promise-of-tb-vaccines
    The Bacille Calmette-Gurin (BCG) vaccine is the only vaccine currently available to protect against TB. BCG has been in use for a century and provides critical protection to 100 million newborns globally each year. While the BCG vaccine provides good protection for young children, the vaccines efficacy wanes throughout the lifespan, providing negligible protection to those over 5 years old. TB mainly affects adults, leaving millions vulnerable to the devastating effects of this vaccine-preventable disease. To end the TB epidemic, it is critical to develop vaccines that are effective against TB in all age groups. […] Despite its inability to protect adults from TB, BCG is a life-saving vaccine for infants and children under five. […] The fight against AMR and MDR-TB will require a multi-pronged approach, and it will not be easy. TB vaccines can help by reducing the incidence and transmission of TB, which would in turn reduce the need for antimicrobial treatment and help to slow the emergence of AMR. Because vaccines prevent infections in the first place, they play an indispensable role in combatting the global crisis of drug resistance.
  • #61 Tuberculosis Vaccine | Tuberculosis (TB) | CDC
    https://www.cdc.gov/tb/vaccines/index.html
    Bacille Calmette-Gurin (BCG) is a vaccine for tuberculosis (TB) disease. […] The TB vaccine can cause a false positive TB skin test reaction. […] Tell your health care provider if you have received the TB vaccine, especially if you are getting tested for TB infection. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. […] Yes, a person can have or get TB even if they received the TB vaccine (BCG). The BCG TB vaccine does not always protect people from getting TB. […] TB blood tests are the preferred tests for people who have received the BCG TB vaccine. The vaccine can cause a false positive TB skin test reaction. Unlike the TB skin test, TB blood tests are not affected by BCG vaccination.
  • #62 CDC | TB | Testing & Diagnosis | Testing in BCG-Vaccinated Persons
    http://medbox.iiab.me/modules/en-cdc/www.cdc.gov/tb/topic/testing/testingbcgvaccinated.htm
    Many people born outside of the United States have been given a vaccine called BCG. […] People who were previously vaccinated with BCG may receive a TB skin test to test for TB infection. Vaccination with BCG may cause a false positive reaction to a TB skin test. A positive reaction to a TB skin test may be due to the BCG vaccine itself or due to infection with TB bacteria. […] TB blood tests (IGRAs), unlike the TB skin test, are not affected by prior BCG vaccination and are not expected to give a false-positive result in people who have received BCG. TB blood tests are the preferred method of TB testing for people who have received the BCG vaccine.
  • #63 Molecular methods in diagnostics of post-BCG vaccine adverse events
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7792438/
    Bacillus Calmette-Gurin (BCG) is the only tuberculosis vaccine available and although it has been routinely used for more than 80 years, its protective effect varies depending on the age and the form of tuberculosis. […] The aim of the study was to assess usefulness of molecular methods in diagnosis of post-BCG vaccine adverse events (VAEs). […] The use of genetic methods enables quick and detailed diagnostics of infections caused by M. bovis BCG, which allows for the confirmation or exclusion of VAE. […] The diagnosis of M. bovis BCG infection is based on physical examination and the results of microbiological tests. […] The identification of M. bovis BCG as etiological factor of the disease is especially important due to the different treatment scheme. […] Therefore, in the case of strains cultured from children, it is recommended to perform a detailed diagnosis that differentiates species within the MTBC. […] The modern molecular methods enable confirmation or exclusion of VAEs in children with suspected tuberculosis.
  • #64 TB Test: What It Is, How It Works, Results & Side Effects
    https://my.clevelandclinic.org/health/diagnostics/22751-tuberculosis-tb-test
    A TB test checks to see if youve been infected with tuberculosis (TB). There are two types of TB tests: a skin test and a blood test. TB skin and blood tests can show if youve ever been exposed to the bacterium that causes TB, but they cant determine if you have a latent (dormant) or active TB infection. […] A TB skin test is also called a Mantoux test or tuberculin skin test (TST). A TB blood test is also called an Interferon-Gamma Release Assay (IGRA). TB skin tests are more common and are the preferred type for children under age 5. But blood tests for TB are becoming more common, especially for healthcare workers and those who have compromised immune systems or are going to become immunocompromised by medications. […] TB skin and blood tests can show if youve ever been infected with M. tuberculosis complex, but they cant distinguish between a latent (dormant) or active TB infection. Youll need additional tests (like a sputum test) to see if you have an active infection.
  • #65 Development of a diagnostic compatible BCG vaccine against Bovine tuberculosis | Scientific Reports
    https://www.nature.com/articles/s41598-019-54108-y
    However, it is not used to control BTB since BCG shares many antigens with M. bovis resulting in the failure of the PPD skin test to distinguish between a BCG-vaccinated and BTB-infected cow. […] The discovery that the development of BCG from M. bovis involved the concomitant deletion of large regions of the BCG chromosome stimulated the search for antigens that have been lost in the BCG genome and may therefore be used in a novel test capable of Differentiating Infected from Vaccinated Animals (DIVA). […] Recently a defined diagnostic skin test was developed based on a cocktail of DIVA antigens, ESAT-6, CFP-10 and Rv3615c, that allow the differential diagnosis of M. bovis-infected from BCG-vaccinated animals. […] Our aim was to develop a new BCG vaccine that is compatible with a sensitive and affordable DIVA skin test.

Zobacz więcej

Mycobacterium bovis plwocina oporność na antybiotyki rtg klatki piersiowej fałszywie dodatni wynik test IGRA biopsja cienkoigłowa zakażenie gruźlicą dysfagia utajona gruźlica kompleks Mycobacterium tuberculosis ciężki złożony niedobór odporności niedobór odporności próba Mantoux skórny test tuberkulinowy gruźlica OUN aktywna gruźlica zapalenie węzłów chłonnych test tuberkulinowy szczepionka BCG