SETTING: In April 1975, the general BCG vaccination of newborns in Sweden was replaced by selective vaccination of groups at increased risk of tuberculosis. OBJECTIVE: To relate the incidence of atypical mycobacterial disease in children to BCG vaccination. DESIGN: A nationwide survey in Sweden during the period 1969-90 disclosed 390 children under 15 years of age with bacteriologically confirmed atypical mycobacteria from extrapulmonary lesions. RESULTS: The average, annual incidence of atypical mycobacterial disease per 100,000 children under 5 years of age increased from 0.06 during the period 1969-74 to a maximum level of 5.7 during 1981-85. Among the cohorts born in Sweden in the period 1975-85, the cumulative incidence rate before 5 years of age was estimated at 26.8 per 100,000 non-BCG-vaccinated children and at 4.6 among those BCG-vaccinated, ratio 5.9 (95% confidence limits 1.6, 48.5). Mycobacterium avium-intracellulare was found in 83%. Disseminated, fatal disease developed in 3 children. The remaining ones suffered from local infections, most often lymph-node or soft-tissue lesions. The observed incidence of bacteriologically confirmed diagnosis was estimated to represent approximately 40% of the 'true' number, if patients with diagnosis based on histological, clinical and epidemiological findings only were included. CONCLUSION: The present study indicates that BCG vaccination plays a role in protection against localized disease caused by atypical mycobacteria in children.
SETTING: In April 1975, the general BCG vaccination of newborns in Sweden was replaced by selective vaccination of groups at increased risk of tuberculosis. OBJECTIVE: To relate the incidence of atypical mycobacterial disease in children to BCG vaccination. DESIGN: A nationwide survey in Sweden during the period 1969-90 disclosed 390 children under 15 years of age with bacteriologically confirmed atypical mycobacteria from extrapulmonary lesions. RESULTS: The average, annual incidence of atypical mycobacterial disease per 100,000 children under 5 years of age increased from 0.06 during the period 1969-74 to a maximum level of 5.7 during 1981-85. Among the cohorts born in Sweden in the period 1975-85, the cumulative incidence rate before 5 years of age was estimated at 26.8 per 100,000 non-BCG-vaccinated children and at 4.6 among those BCG-vaccinated, ratio 5.9 (95% confidence limits 1.6, 48.5). Mycobacterium avium-intracellulare was found in 83%. Disseminated, fatal disease developed in 3 children. The remaining ones suffered from local infections, most often lymph-node or soft-tissue lesions. The observed incidence of bacteriologically confirmed diagnosis was estimated to represent approximately 40% of the 'true' number, if patients with diagnosis based on histological, clinical and epidemiological findings only were included. CONCLUSION: The present study indicates that BCG vaccination plays a role in protection against localized disease caused by atypical mycobacteria in children.
Authors: Shelby Daniel-Wayman; Getahun Abate; Daniel L Barber; Luiz E Bermudez; Rhea N Coler; Michael H Cynamon; Charles L Daley; Rebecca M Davidson; Thomas Dick; R Andres Floto; Emily Henkle; Steven M Holland; Mary Jackson; Richard E Lee; Eric L Nuermberger; Kenneth N Olivier; Diane J Ordway; D Rebecca Prevots; James C Sacchettini; Max Salfinger; Christopher M Sassetti; Christine F Sizemore; Kevin L Winthrop; Adrian M Zelazny Journal: Am J Respir Crit Care Med Date: 2019-04-15 Impact factor: 21.405
Authors: F Stauffer; H Haber; A Rieger; R Mutschlechner; P Hasenberger; V J Tevere; K K Young Journal: J Clin Microbiol Date: 1998-03 Impact factor: 5.948
Authors: E S Bruijnesteijn Van Coppenraet; J A Lindeboom; J M Prins; M F Peeters; E C J Claas; E J Kuijper Journal: J Clin Microbiol Date: 2004-06 Impact factor: 5.948
Authors: Johanna Thegerström; Bodil Jönsson; Lars Brudin; Björn Olsen; Agnes E Wold; Jan Ernerudh; Vanda Friman Journal: PLoS One Date: 2012-04-10 Impact factor: 3.240