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Effectiveness of Bacillus Calmette-Guerin Vaccine on Drug Resistance in Mycobacterium tuberculosis Patients

Safar Farajnia, Khalil Ansarin, Majid Khalili, Mamak Shariat and Leyla Sahebi.

Aim: Information on the effect of Bacillus Calmette-Guerin (BCG) vaccine in tuberculosis (TB) drug resistance will be useful in planning the application of the BCG vaccine. The aim of this study was to explore BCG vaccine effectiveness on TB drug resistance in pulmonary TB patients. Methods: Patients with pulmonary TB were enrolled and had sputum samples obtained at TB laboratories in five provinces of Iran. Drug susceptibility testing was carried according to the proportion method. BCG vaccination scar were confirmed by medical records. The vaccine effectiveness (VE) was estimated as [100% × (1− adjusted odds ratio)] for TB drug susceptible patients versus TB drug resistance patients. Results: A total of 288 cases (80.8%) had no BCG vaccination scar. The resistance frequency to isoniazid (INH), rifampicin (RMP) and streptomycin (SMP), was 18 (5%), 40 (11.2%) and 12 (5.2%) respectively. Frequency of multiple drug resistant (MDR)-TB was 10 (4%). We analyzed adjusted BCG Vaccine effectiveness (VE) in prevention of TB drug resistance on the basis of first line TB drugs. BCG vaccine showed harm effect against SMP resistance (VE 87.5%) after controlling of age and sex. Conclusion: It was hypothesized, that it may be necessary planning to modify of BCG vaccine strains in favor of the prevention of tuberculosis drug-resistant.