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A 25-year surveillance of disseminated Bacillus Calmette-Guérin disease treatment in children in Southern Iran.

Abstract Disseminated Bacillus Calmette-Guérin (BCG) disease is one of the most serious complications of BCG vaccination, mainly among immunocompromised children with high morbidity and mortality.Currently, there is no any consensus with regard to the standard regimen of antituberculosis (anti-TB) agents and duration of treatment in healthy or immunocompromised host in children. The aim of this study is to investigate the effect of various combination treatment strategies for disseminated BCG disease in children.In this cross-sectional study, the outcome of 3 different combination protocols was investigated in 59 patients.All patients were younger than 6 years old. Both possible immunocompetent and proven immunodeficient children were included in a period of 25 years (1991-2014) in a Nemazee referral teaching hospital.The minimum age was 1 month and the maximum was 60 months. The average age of patients was 8 months (8.26 ± 9.73). Out of 59 cases, 32 (54.2%) were female and 27 (45.8%) were male. Based on the primary work up, 52.5% of cases were classified as definite immunodeficient and 47.5% were classified as possible immunocompetent. Overall mortality rate was 50.8%. Mortality rate of disseminated BCG disease in immunocompetent and immunodeficient children was 28.6% and 71%, respectively. The mortality rate was not statistically different between patients treated with different treatment protocols. These results were not affected by immune status and the type of immunodeficiency.More than 2 anti-TB drugs combination will not change outcome of patient with disseminated BCG disease.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29384896
OWN - NLM
STAT- MEDLINE
DCOM- 20180209
LR  - 20180209
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 52
DP  - 2017 Dec
TI  - A 25-year surveillance of disseminated Bacillus Calmette-Guerin disease treatment
      in children in Southern Iran.
PG  - e9035
LID - 10.1097/MD.0000000000009035 [doi]
AB  - Disseminated Bacillus Calmette-Guerin (BCG) disease is one of the most serious
      complications of BCG vaccination, mainly among immunocompromised children with
      high morbidity and mortality.Currently, there is no any consensus with regard to 
      the standard regimen of antituberculosis (anti-TB) agents and duration of
      treatment in healthy or immunocompromised host in children. The aim of this study
      is to investigate the effect of various combination treatment strategies for
      disseminated BCG disease in children.In this cross-sectional study, the outcome
      of 3 different combination protocols was investigated in 59 patients.All patients
      were younger than 6 years old. Both possible immunocompetent and proven
      immunodeficient children were included in a period of 25 years (1991-2014) in a
      Nemazee referral teaching hospital.The minimum age was 1 month and the maximum
      was 60 months. The average age of patients was 8 months (8.26 +/- 9.73). Out of
      59 cases, 32 (54.2%) were female and 27 (45.8%) were male. Based on the primary
      work up, 52.5% of cases were classified as definite immunodeficient and 47.5%
      were classified as possible immunocompetent. Overall mortality rate was 50.8%.
      Mortality rate of disseminated BCG disease in immunocompetent and immunodeficient
      children was 28.6% and 71%, respectively. The mortality rate was not
      statistically different between patients treated with different treatment
      protocols. These results were not affected by immune status and the type of
      immunodeficiency.More than 2 anti-TB drugs combination will not change outcome of
      patient with disseminated BCG disease.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Amanati, Ali
AU  - Amanati A
AD  - Alborzi Clinical Microbiology Research Center, Shiraz University of Medical
      Sciences.
FAU - Pouladfar, Gholamreza
AU  - Pouladfar G
AD  - Alborzi Clinical Microbiology Research Center, Shiraz University of Medical
      Sciences.
FAU - Kadivar, Mohammad Rahim
AU  - Kadivar MR
AD  - Alborzi Clinical Microbiology Research Center, Shiraz University of Medical
      Sciences.
FAU - Sanaei Dashti, Anahita
AU  - Sanaei Dashti A
AD  - Alborzi Clinical Microbiology Research Center, Shiraz University of Medical
      Sciences.
FAU - Jafarpour, Zahra
AU  - Jafarpour Z
AD  - Alborzi Clinical Microbiology Research Center, Shiraz University of Medical
      Sciences.
FAU - Haghpanah, Sezaneh
AU  - Haghpanah S
AD  - Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
FAU - Alborzi, Abdolvahab
AU  - Alborzi A
AD  - Alborzi Clinical Microbiology Research Center, Shiraz University of Medical
      Sciences.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Adjuvants, Immunologic)
RN  - 0 (Antitubercular Agents)
RN  - 0 (BCG Vaccine)
SB  - AIM
SB  - IM
MH  - Adjuvants, Immunologic/*adverse effects
MH  - Antitubercular Agents/therapeutic use
MH  - BCG Vaccine/*adverse effects
MH  - Child, Preschool
MH  - Clinical Protocols
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Infant
MH  - Iran
MH  - Male
MH  - Mycobacterium bovis/*isolation & purification
MH  - Treatment Outcome
MH  - Tuberculosis/*diagnosis/etiology/*therapy
EDAT- 2018/02/01 06:00
MHDA- 2018/02/10 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/10 06:00 [medline]
AID - 10.1097/MD.0000000000009035 [doi]
AID - 00005792-201712290-00004 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(52):e9035. doi: 10.1097/MD.0000000000009035.