BCG Infection in Patients With Inborn Errors of Immunity Receiving the Russian BCG Strain.
BCG infection
BCG strain
BCGitis
BCGosis
Bacillus Calmette-Guierin
Chronic granulomatous disease
Inborn errors of immunity
Mendelian susceptibility to mycobacterial disorders
Primary immunodeficiency
Severe combined immunodeficiency
Journal
The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
24
02
2022
revised:
25
03
2022
accepted:
28
03
2022
pubmed:
27
4
2022
medline:
14
7
2022
entrez:
26
4
2022
Statut:
ppublish
Résumé
Bacillus Calmette-Guierin (BCG) vaccination complications are common in inborn errors of immunity (IEI) due to the inability to clear live attenuated Mycobacterium bovis. Various BCG-vaccine strains are used worldwide, and the profile of the Russian BCG strain vaccine complications in IEI is poorly characterized. To evaluate risks of BCG infection in a large cohort of patients with IEI vaccinated with the Russian BCG strain. We evaluated 778 patients with IEI vaccinated with the Russian BCG strain. A total of 114 (15%) developed BCG infection, 41 (36%) with local, 19 (17%) with regional, and 54 with (47%) disseminated disease. BCG infection was seen in 58% of the patients with severe combined immunodeficiency (SCID), 82% with chronic granulomatous disease, 50% with innate immune defects, 5% with combined immunodeficiency, and 2% with other IEI. BCG infection presented at a median age of 4 to 5 months in SCID, chronic granulomatous disease, combined immunodeficiency, and other IEI groups versus 12 months in patients with innate immune defects (P < .005). We found no influence of specific genetic defects, CD3 BCG infection is common in patients with IEI receiving BCG vaccination. Rational early antimycobacterial therapy, combined with anticytokine agents for posttransplant inflammatory syndrome prevention, and treatment in SCID may prevent BCG-related mortality.
Sections du résumé
BACKGROUND
Bacillus Calmette-Guierin (BCG) vaccination complications are common in inborn errors of immunity (IEI) due to the inability to clear live attenuated Mycobacterium bovis. Various BCG-vaccine strains are used worldwide, and the profile of the Russian BCG strain vaccine complications in IEI is poorly characterized.
OBJECTIVE
To evaluate risks of BCG infection in a large cohort of patients with IEI vaccinated with the Russian BCG strain.
METHODS
We evaluated 778 patients with IEI vaccinated with the Russian BCG strain.
RESULTS
A total of 114 (15%) developed BCG infection, 41 (36%) with local, 19 (17%) with regional, and 54 with (47%) disseminated disease. BCG infection was seen in 58% of the patients with severe combined immunodeficiency (SCID), 82% with chronic granulomatous disease, 50% with innate immune defects, 5% with combined immunodeficiency, and 2% with other IEI. BCG infection presented at a median age of 4 to 5 months in SCID, chronic granulomatous disease, combined immunodeficiency, and other IEI groups versus 12 months in patients with innate immune defects (P < .005). We found no influence of specific genetic defects, CD3
CONCLUSIONS
BCG infection is common in patients with IEI receiving BCG vaccination. Rational early antimycobacterial therapy, combined with anticytokine agents for posttransplant inflammatory syndrome prevention, and treatment in SCID may prevent BCG-related mortality.
Identifiants
pubmed: 35470098
pii: S2213-2198(22)00349-X
doi: 10.1016/j.jaip.2022.03.032
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
BCG Vaccine
0
Types de publication
Journal Article
Research Support, N.I.H., Intramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1797-1804.e7Informations de copyright
Copyright © 2022 American Academy of Allergy, Asthma & Immunology. All rights reserved.