Archives of Pediatric Infectious Diseases

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BCG Vaccination as a Prevention Strategy, Threats and Benefits

Fariba Shirvani 1 , Abdollah Karimi 1 and Maryam Rajabnejad 1 , *
Authors Information
1 Pediatric Infections Research Center, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
Article information
  • Archives of Pediatric Infectious Diseases: April 01, 2016, 4 (2); e30180
  • Published Online: April 1, 2016
  • Article Type: Review Article
  • Received: July 25, 2015
  • Revised: January 13, 2016
  • Accepted: January 13, 2016
  • DOI: 10.5812/pedinfect.30180

To Cite: Shirvani F, Karimi A, Rajabnejad M. BCG Vaccination as a Prevention Strategy, Threats and Benefits, Arch Pediatr Infect Dis. 2016 ; 4(2):e30180. doi: 10.5812/pedinfect.30180.

Copyright © 2016, Pediartric Infections Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Context
2. Objectives
3. Data Sources
4. Study Selection
5. Data Extraction
6. Results
7. Conclusions
  • 1. Global Tuberculosis Report 2014. Executive summary. 2014;
  • 2. Schreiber F, Huo Z, Giemza R, Woodrow M, Fenner N, Stephens Z, et al. An investigation of clinical and immunological events following repeated aerodigestive tract challenge infections with live Mycobacterium bovis Bacille Calmette Guerin. Vaccine. 2010; 28(33): 5427-31[DOI][PubMed]
  • 3. History of BCG vaccine production in IRAN. 2014;
  • 4. Manissero D, Lopalco PL, Levy-Bruhl D, Ciofi Degli Atti ML, Giesecke J. Assessing the impact of different BCG vaccination strategies on severe childhood TB in low-intermediate prevalence settings. Vaccine. 2008; 26(18): 2253-9[DOI][PubMed]
  • 5. Zwerling A, Behr MA, Verma A, Brewer TF, Menzies D, Pai M. The BCG World Atlas: a database of global BCG vaccination policies and practices. PLoS Med. 2011; 8(3)[DOI][PubMed]
  • 6. Tajima Y, Takagi R, Nakajima T, Kominato Y. An infant with asymptomatic hepatic granuloma probably caused by bacillus Calmette-Guerin (BCG) vaccination found incidentally at autopsy: a case report. Cases J. 2008; 1(1): 337[DOI][PubMed]
  • 7. Bernatowska EA, Wolska-Kusnierz B, Pac M, Kurenko-Deptuch M, Zwolska Z, Casanova JL, et al. Disseminated bacillus Calmette-Guerin infection and immunodeficiency. Emerg Infect Dis. 2007; 13(5): 799-801[DOI][PubMed]
  • 8. Sadeghi-Shanbestari M, Ansarin K, Maljaei SH, Rafeey M, Pezeshki Z, Kousha A, et al. Immunologic aspects of patients with disseminated bacille Calmette-Guerin disease in north-west of Iran. Ital J Pediatr. 2009; 35: 42[DOI][PubMed]
  • 9. Karimi A, Nategian A, Mamishi S. Report of 8 cases of disseminated BCG in patients vaccinated in Children Medical Center (1998-2002) Tehran/IRAN. Mazandaran Sci Res J. 2004; 13(38): 67-75
  • 10. Gonzalez B, Moreno S, Burdach R, Valenzuela MT, Henriquez A, Ramos MI, et al. Clinical presentation of Bacillus Calmette-Guerin infections in patients with immunodeficiency syndromes. Pediatr Infect Dis J. 1989; 8(4): 201-6[PubMed]
  • 11. Sadeghi-Shabestari M, Rezaei N. Disseminated bacille Calmette-Guerin in Iranian children with severe combined immunodeficiency. Int J Infect Dis. 2009; 13(6)-3[DOI][PubMed]
  • 12. Casanova JL, Jouanguy E, Lamhamedi S, Blanche S, Fischer A. Immunological conditions of children with BCG disseminated infection. Lancet. 1995; 346(8974): 581[PubMed]
  • 13. Casanova JL, Blanche S, Emile JF, Jouanguy E, Lamhamedi S, Altare F, et al. Idiopathic disseminated bacillus Calmette-Guerin infection: a French national retrospective study. Pediatrics. 1996; 98(4 Pt 1): 774-8[PubMed]
  • 14. Azzopardi P, Bennett CM, Graham SM, Duke T. Bacille Calmette-Guerin vaccine-related disease in HIV-infected children: a systematic review. Int J Tuberc Lung Dis. 2009; 13(11): 1331-44[PubMed]
  • 15. Hesseling AC, Johnson LF, Jaspan H, Cotton MF, Whitelaw A, Schaaf HS, et al. Disseminated bacille Calmette-Guerin disease in HIV-infected South African infants. Bull World Health Organ. 2009; 87(7): 505-11[PubMed]
  • 16. Monajemzadeh M, Shahsiah R, Zarei A, Alamooti AA, Mahjoub F, Mamishi S, et al. Frequency of bacille Calmette-Guerin (BCG) and Mycobacterium tuberculosis in tissue biopsy specimens of children vaccinated with BCG. Am J Clin Pathol. 2010; 133(1): 102-6[DOI][PubMed]
  • 17. Ikinciogullari A, Dogu F, Ciftci E, Unal E, Ertem M, Reisli I, et al. An intensive approach to the treatment of disseminated BCG infection in a SCID patient. Bone Marrow Transplant. 2002; 30(1): 45-7[DOI][PubMed]
  • 18. Jouanguy E, Altare F, Lamhamedi S, Revy P, Emile JF, Newport M, et al. Interferon-gamma-receptor deficiency in an infant with fatal bacille Calmette-Guerin infection. N Engl J Med. 1996; 335(26): 1956-61[DOI][PubMed]
  • 19. Huang LH, Shyur SD, Weng JD, Huang FY, Tzen CY. Disseminated Cutaneous Bacille Calmette‐Guérin Infection Identified by Polymerase Chain Reaction in a Patient with X‐linked Severe Combined Immunodeficiency. Pediatr Dermatol. 2006; 23(6): 560-3
  • 20. Liberek A, Korzon M, Bernatowska E, Kurenko-Deptuch M, Rytlewska M. Vaccination-related Mycobacterium bovis BCG infection. Emerg Infect Dis. 2006; 12(5): 860-2[DOI][PubMed]
  • 21. Alborzi A, Mostafavi N. Retroperitoneal abscess due to disseminated Bacille Calmette-Guerin infection. Jpn J Infect Dis. 2007; 60(6): 392-3[PubMed]
  • 22. Rezai MS, Khotaei G, Mamishi S, Kheirkhah M, Parvaneh N. Disseminated Bacillus Calmette–Guerin Infection after BCG Vaccination. J Trop Pediatr. 2008; 54(6): 413-6
  • 23. Gadiri K, Afsharian M, Vazizi S, Mansori F, Namdari M. Two cases of disseminated BCG infection in Kermanshah and review of literature. Kordestan Med Univ J. 2007; 12: 91-6
  • 24. Sohail S, Afzal M, Anwar V, Shama Q. Disseminated Bacille Calmette-Guerin (BCG) disease in an infant with severe combined immunodeficiency. J Coll Physicians Surg Pak. 2014; 24 Suppl 3-61[PubMed]
  • 25. Bacalhau S, Freitas C, Valente R, Barata D, Neves C, Schafer K, et al. Successful Handling of Disseminated BCG Disease in a Child with Severe Combined Immunodeficiency. Case Rep Med. 2011; 2011: 527569[DOI][PubMed]
  • 26. Norouzi S, Movahedi Z, Mamishi S, Monajemzadeh M, Rezaei N. Disseminated BCG as a unique feature of an infant with severe combined immunodeficiency. Turk J Pediatr. 2011; 53(3): 328-32[PubMed]
  • 27. Shahmohammadi S, Saffar MJ, Rezai MS. BCG-osis after BCG vaccination in immunocompromised children: Case series and review. J Pediatr Rev. 2014; 2(1): 62-74
  • 28. Shirvani F, Chavoshzadeh Z, Arjmand R, Karimi A. Four-Month-Old Boy With Fever, Hepatosplenomegaly and Diffuse Pulmonary Infiltrations. Arch Clin Infect Dis. 2012; 7(2): 72-4
  • 29. Al-Mousa H. An infant with disseminated bacillus Calmette-Guerin infection (BCGitis). Int J Pediatr Adolescent Med. 2014; 1(2): 89-92
  • 30. Deeks SL, Clark M, Scheifele DW, Law BJ, Dawar M, Ahmadipour N, et al. Serious adverse events associated with bacille Calmette-Guerin vaccine in Canada. Pediatr Infect Dis J. 2005; 24(6): 538-41[PubMed]
  • 31. Ghanaie R, Shiari R, Karimi A, Armin S, Fahimzad A, Shiva F, et al. A case series report of Iranian children Hemophagocytic Lymphohistiocytosis syndrome. Arch Pediatr Infect Dis. 2013; 1(1): 31-5
  • 32. Parvaneh N, Pourakbari B, Daneshjoo KH, Ashraf H, Salavati A, Mamishi S. Polymorphism in the First Intron of Interferon-Gamma Gene (+874T/A) in Patients with BCG Adenitis. Iranian J Publ Health. 2009; 38(3): 12-6
  • 33. Prando C, Samarina A, Bustamante J, Boisson-Dupuis S, Cobat A, Picard C, et al. Inherited IL-12p40 deficiency: genetic, immunologic, and clinical features of 49 patients from 30 kindreds. Medicine (Baltimore). 2013; 92(2): 109-22[DOI][PubMed]
  • 34. Filipe-Santos O, Bustamante J, Chapgier A, Vogt G, de Beaucoudrey L, Feinberg J, et al. Inborn errors of IL-12/23- and IFN-gamma-mediated immunity: molecular, cellular, and clinical features. Semin Immunol. 2006; 18(6): 347-61[DOI][PubMed]
  • 35. Newport MJ, Huxley CM, Huston S, Hawrylowicz CM, Oostra BA, Williamson R, et al. A mutation in the interferon-gamma-receptor gene and susceptibility to mycobacterial infection. N Engl J Med. 1996; 335(26): 1941-9[DOI][PubMed]
  • 36. Pierre-Audigier C, Jouanguy E, Lamhamedi S, Altare F, Rauzier J, Vincent V, et al. Fatal disseminated Mycobacterium smegmatis infection in a child with inherited interferon gamma receptor deficiency. Clin Infect Dis. 1997; 24(5): 982-4[PubMed]
  • 37. Chapgier A, Wynn RF, Jouanguy E, Filipe-Santos O, Zhang S, Feinberg J, et al. Human complete Stat-1 deficiency is associated with defective type I and II IFN responses in vitro but immunity to some low virulence viruses in vivo. J Immunol. 2006; 176(8): 5078-83[PubMed]
  • 38. Dupuis S, Jouanguy E, Al-Hajjar S, Fieschi C, Al-Mohsen IZ, Al-Jumaah S, et al. Impaired response to interferon-alpha/beta and lethal viral disease in human STAT1 deficiency. Nat Genet. 2003; 33(3): 388-91[DOI][PubMed]
  • 39. Happel KI, Dubin PJ, Zheng M, Ghilardi N, Lockhart C, Quinton LJ, et al. Divergent roles of IL-23 and IL-12 in host defense against Klebsiella pneumoniae. J Exp Med. 2005; 202(6): 761-9[DOI][PubMed]
  • 40. Trinchieri G. Interleukin-12 and the regulation of innate resistance and adaptive immunity. Nat Rev Immunol. 2003; 3(2): 133-46[DOI][PubMed]
  • 41. Fieschi C, Dupuis S, Catherinot E, Feinberg J, Bustamante J, Breiman A, et al. Low penetrance, broad resistance, and favorable outcome of interleukin 12 receptor beta1 deficiency: medical and immunological implications. J Exp Med. 2003; 197(4): 527-35[PubMed]
  • 42. Rosenfeldt V, Paerregaard A, Valerius NH. Disseminated infection with Bacillus Calmette-Guerin in a child with advanced HIV disease. Scand J Infect Dis. 1997; 29(5): 526-7[PubMed]
  • 43. MacLennan C, Fieschi C, Lammas DA, Picard C, Dorman SE, Sanal O, et al. Interleukin (IL)-12 and IL-23 are key cytokines for immunity against Salmonella in humans. J Infect Dis. 2004; 190(10): 1755-7[DOI][PubMed]
  • 44. van de Vosse E, Haverkamp MH, Ramirez-Alejo N, Martinez-Gallo M, Blancas-Galicia L, Metin A, et al. IL-12Rbeta1 deficiency: mutation update and description of the IL12RB1 variation database. Hum Mutat. 2013; 34(10): 1329-39[DOI][PubMed]
  • 45. Halsey NA, Henderson DA. HIV infection and immunization against other agents. N Engl J Med. 1987; 316(11): 683-5[DOI][PubMed]
  • 46. Fahimzad SA, Ghasemi M, Shiva F, Ghadiri K, Navidinia M, Karimi A. Susceptibility Pattern of Bacille Calmette-Guerin Strains Against Pyrazinamide and Other Major Anti-Mycobacterial Drugs. Arch Pediatr Infect Dis. 2015; 3(1 TB)
  • 47. Heyderman RS, Morgan G, Levinsky RJ, Strobel S. Successful bone marrow transplantation and treatment of BCG infection in two patients with severe combined immunodeficiency. Eur J Pediatr. 1991; 150(7): 477-80[PubMed]
  • 48. Meyer J, McShane H. Global progress in tuberculosis vaccine development. Clin Med. 2012; 12-20
  • 49. Andersen P, Kaufmann SH. Novel vaccination strategies against tuberculosis. Cold Spring Harb Perspect Med. 2014; 4(6)[DOI][PubMed]
  • 50. Venkataswamy MM, Goldberg MF, Baena A, Chan J, Jacobs WJ, Porcelli SA. In vitro culture medium influences the vaccine efficacy of Mycobacterium bovis BCG. Vaccine. 2012; 30(6): 1038-49[DOI][PubMed]
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