24 5

313

Pasteur strain 1173 P2 1979

Tokyo strain 172 1969 1982
Tokyo 172 Pasteur 1173 P2
1998
14 6 5
1 Disseminated BCG infection
2002 2006
3.68
0.9

Bacillus Calmette- GurinBCG Calmette Gurin

Mycobacterium bovis

3 13 230
2008 3 20 2008 4 3
161
e-mailgcsheu@cdc.gov.tw

 314

2008 5 25

11921 BCG
1923 1927
BCG
2

progressive primary tuberculosis

1.2.
3.4. 2500 5.
6.7.
HIV 8.

714
46

23

 24 5

315

0.0117.2 5

12 5

WHO 2000 2
:
suppurative lymphadentitis
100-1000

6
/BCG osteitis/osteomyelitis
1-700
7
8
Prague strain Russian strain
351971
Gothenbury strain
30001
Copenhagen 1331 strain
1994Kroger919711978
1015-73 1992 Dittmann
100.1-30[10]
PasteurTokyo
disseminated BCG infection

 316

2008 5 25

2
11,12 Multicenter
SCID
Di George syndrome interferon 13,14
5

1980 Mande 15
30195319541980
34Lotte
2.19 161998

isoniazidrifampin17

1921

-monosodium
glutamate

WHO
1Pasteur strain 1173 P2
2Danish strain 1331
3Glaxo strain 1077
4Tokyo strain 172
1996Tokyo strain 172
Tokyo strain 172
902WHO

 24 5

317

5x1043x106

Pasteur strain 1173 P2

WHO 20002 1980

Glaxo strain 1077

Pasteur strain 1173 P2

18
Pasteur strain 11735%
2.5%1%1%
2004 Canada Communicable Disease Report
vol.30 1996-2000 Pasteur strain 1173
19Pasteur strain 1173

Danish strain Copenhagen 1331

19791991Danish strain Copenhagen 1331
retrospective analysis17
10001.9
139,0004
Glaxo strain 1077
1990 Milstien 20 Pasteur Danish
Copenhagen 1331 TokyoGlaxo Brazilian(Moreau)

 318

2008 5 25

Pasteur strain
efficacy2
Glaxo 1077
Tokyo strain 172
1984 Lotte 1000
161948-1974
/0.01
0.01
BCG
Tokyo strain 172
200312WHO 21

Pasteur> Russia >Glaxo

Pasteur > Glaxo > Russia
PasteurDanishTokyo, Glaxo Moreau

Pasteur , Danish Goteborg

Moreau
0.170.39
Pasteur
0.59
okyo 172
WHO
20001WHO intradermal;ID 2

 24 5

319

multiple puncture(percutaneous ;PC)

3 BCG
Tokyo 172 PC Danish 1331ID
200622Danish 1331
IDTokyo 172 PC
858866
IDPC
4.7% & 8.6%BCG

0.1mg/0.1ml19521953

Pasteur Instituteold Pasteur Strain1956new Pasteur Strain

0.05mg/0.1ml0.1mg/0.1ml1971930
1251 Tween 80
Tween 80 197296
0.05mg0.025mg
0.1mg0.05mg
1979 3 Tokyo 172
7 1980
0.05mg/0.1ml 30
1-5 20-30

 320

2008 5 25

19691982
Pasteur strain 1173 P2
1.7-17.71977Tokyo strain 172
1977,1978,1982 0.4, 1.1,0.1Tokyo strain
172 Pasteur strain 1173 P2
19821991

199814
65
20022006
108
BCG
3.68
0.92WHO1-700
21948-1974
0.014

2002-2006

62.25

Lotte [16] 1984 1000 187

Lotte

 24 5

321

Pasteur
Copenhagen Glaxo Tokyo
/
8
Tokyo172
multiple puncture
2006 22
multiple puncture
Tokyo 172

well- trained
1969 1982

1. Andersen P, Doherty TM. The success and failure of BCG - implications for a
novel tuberculosis vaccine. Nat Rev Microbiol 2005; 3: 656-62.
2. WHO 2000. Supplementary information on vaccine safety by WHOPart2

 322

2008 5 25

Background and rates of adverse events following immunization.

3. Tripathy SP. Fifteen-year follow-up of the Indian BCG prevention trial. Bull
Int Union Tuberc Lung Dis 1987; 62: 69-73.
4. Victoria MS, Shah BR. Bacillus Calmette- Gurin lymphadenitis: a case
report and review of the literature. Pediatr Infect Dis J 1985; 4: 295-6.
5. Lotte A, Wasz-Hockert O, Poisson N, et al. BCG complications: estimates of
the risks among vaccinated subjects and statistical analysis of their main
characteristics. Adv Tuberc Res 1984; 21: 107-93.
6. Kabra SK, Jain Y, Seth MV. BCG associated adenitis. Lancet 1993, 341: 970.
7. Bolger T, O'Connell M, Menon A, et al. Complications associated with the
Bacille Calmette- Gurin vaccination in Ireland. Arch Dis Child 2006; 91:
594-7.
8. Lotte A, Dam HG, Henderson R. Second IUATLD study on complications
induced by intradermal BCG vaccination. Bull Int Union Tuberc Lung Dis
1988; 63: 47-59.
9. Krger L, Brander E, Korppi M, et al. Osteitis after newborn vaccination with
three different Bacillus Calmette-Gurin vaccines: twenty nine years of
experience. Pediatr Infecti Dis J 1994; 13: 11322.
10. Dittmann S. Immunological preparations. Meyers side effect of drugs, 12th
Ed. MNG Dukes ed. Elsevier Science Publishers 1992; 791840.
11. Afshar PS, Siadati A, Mamishi S, et al. Disseminated Mycobacterium bovis
Infectionafter BCG vaccination. Iran J Allergy Asthma Immunol 2006; 5:
133-7.
12. Talbot E, Perkins MD, Silva SFM, et al. Disseminated Bacille
Calmette-Gurin disease after vaccination: case report and review. Clin
Infecti Dis 1997; 24 : 1139-46.
13. Jouanguy E, Altare F, Lamhamedi S, et al. Interferon-receptor deficiency in

 24 5

323

an infant with fatal Bacille Galmette Gurin infection. NEJM 1996; 335:
1956-1961.
14. Jouanguy E, Lamhamedi-Cherradi S, Altare F, et al. Partial interferon by
receptor 1 deficiency in a child with tuberculoid bacillus Calmette Guerin
infection and a sibling with clinical tuberculosis. J Clin Invest 1997; 100:
265864.
15. Mande R. Bcgites gnralises mortelles. Sem Hp Paris 1980; 56: 470-2.
16. Lotte A, Wasz-Hockert O, Poisson N, et al. A bibliography of the
complications of BCG vaccination: a comprehensive list of the world
literature since the introduction of BCG up to July 1982. Adv Tub Res 1984;
21: 194-245.
17. Romanus V, Fasth A, Tordai P, et al. Adverse reactions in healthy and
immunocompromised children under six years of age vaccinated with the
Danish BCG vaccine, strain Copenhagen 1331: implications for the
vaccination policy in Sweden. Acta Paediatr 1993; 82: 1043-52.
18. The Australian Immunization 2004 Handbook 8th Edition.
19. Canada Communicable Disease Report 2004; 30: ACS-5.
20. Milstien JB, Gibson JJ. Quality control of BCG vaccine by WHO. The view
of factors that influence vaccine effectiveness and safety. Bull World Health
Organ 1990; 68: 93-108.
21. WHO 2004. Supplementary information on vaccine safety by WHO.
Consulation on the Characterization of BCG strain.
22. Mahomed H, Kibel M, Hawkridge T, et al. The impact of a change in bacille
Calmette-Gurin vaccine policy on tuberculosis incidence in children in Cape
Town, South Africa. Pediatr Infect Dis J 2006; 25: 1167-72.

 324

2008 5 25

Vaccine
BCG

Reaction

Onset Interval

Suppurative lymphadentis
BCG osteitis
Disseminated BCG-itis

2-6 months
1-12 months
1-12 months

Rate per million dose

100-1000
1-700
2

1969-1982

1969

Pasteur 1173P2

1970

1971

0.05mg

9227

158

1.7

139

19

Pasteur 1173P2

0.05mg

4547

349

7.7

315

34

Pasteur 1173P2

0.05mg

5193

170

3.3

159

11

1972

Pasteur 1173P2

0.05mg

5157

908

17.7 853

52

18

1973

Pasteur 1173P2 0.025mg

3693

188

5.1

168

20

1974

Pasteur 1173P2 0.025mg

3343

148

4.4

133

16

1975

Pasteur 1173P2 0.025mg

4803

129

2.7

117

13

1977

Pasteur 1173P2 0.025mg

1237

105

8.5

1977

Tokyo

172

0.05mg

827

0.4

1978

Tokyo

172

0.05mg

856

1.1

1982

Tokyo

172

0.05mg

1266

0.1

 24 5

325

2002

240959

4.1501

2003

222492

8.9891

2004

213053

2005

204400

4.8924

2006

204400

4.8924

1085304

3.6856

0.9214