PDF(Pubmed)
Abstract：
According to the World Health Organization (WHO), around 1 million children worldwide are diagnosed with tuberculosis each year. The Bacillus Calmette-Guérin (BCG) vaccine has been used around the world for over 100 years. The complications of the BCG vaccination can occur in about 0,06% of children and include local or systemic adverse reactions. Due to the close analogy between the vaccine strain and other species of the Mycobacterium tuberculosis complex (MTBC), molecular methods are recommended for differential diagnosis of Vaccine adverse events (VAE) after BCG. The ability to quickly and specifically identify BCG is important in view of different treatment regimens. The aim of the study was to assess the usefulness of genetic testing for Mycobacterium bovis BCG in the paraffin-embedded specimens\' methods. We describe two cases of VAE in immune-compromised children presenting with osteoarticular changes that had been clinically suspected of tuberculosis and led to molecular identification through GeneXpert, GenoType MTBC, and Spoligotyping. Results: Mycobacterium bovis BCG was detected in osteoarticular changes embedded in paraffin block of two patients. Conclusion: Genetic tests using paraffin-embedded materials allow for quick identification and differential diagnosis of patients with Tuberculosis and VAE after BCG. This is an important issue, especially in cases where the tissue has only been submitted for histopathological examination without microbiological diagnostics for tuberculosis.
摘要：
根据世界卫生组织（WHO）全世界每年约有100万儿童被诊断患有结核病。卡介苗（BCG）已经在世界各地使用了100多年。卡介苗接种的并发症可发生在约0,06%的儿童中,包括局部或全身性不良反应。由于疫苗株与结核分枝杆菌复合体（MTBC）的其他物种之间的紧密类比，推荐分子方法用于BCG后疫苗不良事件(VAE)的鉴别诊断.鉴于不同的治疗方案,快速且特异性地鉴定BCG的能力是重要的。该研究的目的是评估石蜡包埋标本中牛分枝杆菌BCG基因检测的有效性。我们描述了两例免疫受损儿童的VAE病例，这些儿童表现为临床怀疑为结核病的骨关节变化，并通过GeneXpert进行了分子鉴定。GenoTypeMTBC,和Spoligotyping。结果：在2例石蜡块包埋的骨关节改变中检测到牛分枝杆菌卡介苗。结论：使用石蜡包埋材料的基因测试可以快速识别和鉴别诊断BCG后的结核病和VAE患者。这是一个重要的问题,特别是在组织仅提交组织病理学检查而没有结核病的微生物诊断的情况下。
