AI Article Synopsis

  • The study analyzed the occurrence of the Koch-like phenomenon in infants after receiving Bacillus Calmette-Guérin vaccinations, comparing those who tested positive and negative for interferon-γ release assay (IGRA).
  • Out of 790 reported infants, 10.3% tested IGRA positive; however, they did not show an increasing trend or seasonal patterns like the IGRA negative group, who exhibited more winter cases.
  • The findings suggest a significant correlation between IGRA positive results and tuberculosis infection risk, and it is recommended that pediatricians continue to report these cases and include IGRA results for better tracking and follow-up of potential TB among infants in Japan.

Article Abstract

Background: The epidemiology of infants who exhibited the Koch-like phenomenon after Bacillus Calmette-Guérin vaccination and who subsequently tested positive in interferon-γ release assay (IGRA) was compared to that of those who tested negative. The reports of pediatricians on the phenomenon to the health authorities of Japan were retrieved and analyzed.

Methods: In 2013-2019, 790 infants with such events were reported with IGRA test results available, of whom 81 (10.3%) tested positive and 709 (89.7%) negative.

Results: The infants who were IGRA positive did not show an increasing trend (P = 0.06, P = 0.60), whereas those who were IGRA negative showed a significantly increasing trend (P = 0.42, P = 0.0002). The infants who were IGRA positive did not exhibit seasonality, whereas those who were IGRA negative had a higher number of cases in winter than in summer. The rates of infants who were IGRA positive per 10 million live births showed a significant correlation with the tuberculosis (TB) notification rates by prefecture (P = 0.41, P = 0.004), whereas those who were IGRA negative did not (P = 0.04, P = 0.78).

Conclusion: The IGRA-positive infants were distributed quite differently from those who were IGRA negative and appeared more likely to be infected with TB. Reports of pediatricians on the Koch-like phenomenon should continuously be collected as the reports reflect a risk of TB infection including TB outbreaks among infants in Japan. The reports should include IGRA test results as IGRA is more specific than tuberculin skin testing. Infants with IGRA-positive results should be followed up for 2-3 years to determine their final outcomes.

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Source
http://dx.doi.org/10.4103/ijmy.ijmy_203_22DOI Listing

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