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背景:卡介苗性骨炎(BCGOST)在拉美各国均未报告。目的:对智利圣地亚哥市一个人口最稠密区的卡介苗性骨炎病人的发病率、临床特征和预后进行评价。设计:对为期20年(1976-1995)的医学统计资料进行回顾性分析。结果:10名患儿(其中近5年占4名)的卡介苗性骨炎诊断达标。其中6名为男孩,平均年龄为11个月(范围在6.5-21个月之间),症状出现时间平均在诊断前31日(范围在15-60日之间),骨炎好发部位在下肢(8/10例)。1例培养结果阳性,9例可见典型的组织病理学病变(2例抗酸杆菌阳性)。胸部X线检查均正常。4例作了皮内试验(平均21.5mm,范围在16-28mm之间)。10人中无一有潜在的免疫缺陷史。该区全体新生儿卡介苗接种的覆盖率为90.2±9.7％,年结核病感染危险率为24.6/10万。结论:本研究表明该地区卡介苗性骨炎的估计发病率为3.2/10万已接种新生儿。根据智利结核病流行现状(29.5/10万),应鼓励对新生儿普种卡介苗。
Background: BCGOST is not reported in all Latin American countries. OBJECTIVE: To evaluate the incidence, clinical characteristics and prognosis of BCG-infected patients with osteitis in a most densely populated area in Santiago de Chile. Design: A retrospective analysis of medical statistics over a period of 20 years (1976-1995). Results: The diagnosis of BCG vaccine in 10 children (4 in the past 5 years) was confirmed. Six of them were boys, with an average age of 11 months (range, 6.5-21 months). The mean time to symptom onset was on the 31st day before diagnosis (range 15-60 days) Lower limbs (8/10 cases). One case had a positive culture result, and nine cases showed typical histopathological lesions (two were acid-fast bacilli positive). Chest X-ray examination were normal. Four patients underwent an intradermal test (average 21.5 mm, range 16-28 mm). None of 10 have a history of potential immunodeficiency. The coverage of neonatal BCG vaccination in this area was 90.2 ± 9.7% and the annual risk of tuberculosis infection was 24.6 / 100,000. Conclusions: This study shows that the estimated incidence of BCG in the area is 3.2 per 100,000 live-in infants. According to the current status of tuberculosis in Chile (29.5 / 100,000), BCG should be encouraged for newborns.