The Clinical Study on Conversion Rate of Mantoux Test, Change of Local Lesion and Complication after Multipuncture BCG Vaccination in Neonates

ABSTRACT

PURPOSE: Ugly ulcer and keloid formation of injection site has sometimes been a problem in Korea from the cosmetic point of view in intradermal vaccination. Since 3 or 4 years ago, multipuncture BCG vaccination has been used in Korea, there are no data and information about multipuncture BCG vaccination. We therefore performed this study to evaluate of conversion rate, complication and to make criteria of horizontal induration of Mantoux test instead of erythema to use criteria of positive Mantoux test in Japan. METHODS: 124 neonates who were born Kon-Kuk university hospital without family history of tuberculosis were given multipuncture BCG vaccination within 4 weeks after birth between Mar. and Oct. 1995. We observed change of local lesion for 1-3 months after BCG vaccination. All neonates tested a Mantoux test with 5TU of PPD 3 months after multipuncture BCG vaccination. RESULTS: 1) There was no significant difference in conversion rate of Mantoux test by feeding pattern. 2) There was no change of number of puncture site 1-3 months after BCG vaccination. 3) There was no ulcer in change of local lesion. Pusture, scab and redness was decreased 3 months after multipuncture BCG vaccination. Redness of all was replaced pigmentation. 4) The means+/-2SD of diameters of induration, erythema on Mantoux test were 10.4+/-3.0mm in horizontal induration, 13.2+/-4.2mm in horizontal erythema, 8.0+/-3.0mm in vertical induration, 10.9+/-3.5mm in vertical erythema. 5) Criteria for positive tuberculin reaction were diameters of induration, erythema : equal to or greater than 7mm of horizontal induration, equal to or greater than 5mm of vertical induration, equal to or greater than 10mm of horizontal and vertical erythema. 6) The positve conversion tuberculin rate were 87.8% in horizontal induration, 87.5% of vertical induration, 83.8% of horizontal erythema, 69.4% of vertical erythema. 7) Conversion rate of neonates immunized later 21 days after birth were significantly greater than neonates immunized within 21 days after birth. 8) There was no correlate Mantoux test conversion rate and strong reaction of local lesion. 9) There were no specific complication after multipuncture BCG vaccination. 10) There were no severe pain and irritability at multipuncture BCG vaccination. CONCLUSIONS: Multipuncture BCG is a good BCG vaccination that we can use with efficacious effect and slight local lesions instead of intradermal BCG vaccination.