Accelerated Bacille Calmette-Guérin reactions : More than meets the eye
Villanueva, Paola (The University of Melbourne)
Crawford, Nigel W. (The University of Melbourne)
Garcia Croda, Mariana (Federal University of Mato Grosso do Sul)
Croda, Julio (Federal University of Mato Grosso do Sul)
Dalcolmo, Margareth (Oswaldo Cruz Foundation Ministry of Health)
Jardim, Bruno (Carlos Borborema Clinical Research Institute)
Pinto Jardim, Tyane de Almeida (Carlos Borborema Clinical Research Institute)
Marshall, Helen (The University of Adelaide and Department of Paediatrics)
Prat i Aymerich, Cristina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Sawka, Alice (Royal Adelaide Hospital)
Sharma, Ketaki (The Children's Hospital at Westmead)
Troeman, Darren (Utrecht University)
Warris, Adilia (University of Exeter)
Wood, Nicholas (University of Sydney)
Messina, Nicole L (The University of Melbourne)
Pittet, Laure F (The University of Melbourne)
Curtis, Nigel (The University of Melbourne)

Data:	2024
Resum:	An accelerated local injection site reaction following Bacille Calmette-Guérin (BCG) vaccination has been associated with underlying active tuberculosis (TB) in high TB-prevalence settings. The clinical significance of this accelerated BCG reaction in individuals without TB symptoms, particularly in low TB-prevalence countries, is unclear. Using safety surveillance data and baseline interferon-gamma release assays (IGRA) within an international randomised trial of BCG vaccination in healthcare workers (the BRACE trial), we aimed to determine the incidence, and investigate for clinical implications, of an accelerated BCG reaction in asymptomatic adults in low and high TB-prevalence settings. An accelerated BCG reaction occurred in 755/1984 (38 %) of BCG-vaccinees. Although more frequently painful, tender, erythematous and/or swollen within the first fourteen days of vaccination, compared with non-accelerated reactions, the majority of injection site reactions were mild and did not meet criteria for an adverse event. Prior mycobacterial exposure, through prior BCG vaccination (OR 2. 46, 95%CI 1. 93-3. 13, p < 0. 001) or latent TB infection (OR 4. 17, 95%CI 1. 16-14. 93, p = 0. 03), and female sex (OR 1. 27, 95%CI 1. 03-1. 57, p = 0. 02), were key determinants for the occurrence of an accelerated BCG reaction. The development of an accelerated local reaction to BCG vaccination in an individual without prior history of BCG vaccination, should prompt consideration of further investigations for potential underlying TB infection.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	BCG ; Accelerated BCG reaction ; BCG test ; Latent tuberculosis infection
Publicat a:	Heliyon, Vol. 10 Núm. 13 (June 2024) , p. e32510, ISSN 2405-8440

DOI: 10.1016/j.heliyon.2024.e32510
PMID: 39027494

10 p, 1.8 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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