Abstract

BCG vaccine is usually considered to be safe though rarely serious complications have also been reported, often incriminating contamination of the seed strain with pathogenic Mycobacterium tuberculosis. In such circumstances, it becomes prudent to rule out the contamination of the vaccine seed. M. bovis BCG can be confirmed by the absence of nitrate reductase, negative niacin test, and resistance to pyrazinamide and cycloserine. Recently in India, some stocks were found to be niacin positive which led to a national controversy and closer of a vaccine production plant. This prompted us to write this review and the comparative biochemical and genotypic studies were carried out on the these contentious vaccine stocks at the Indian vaccine plant and other seeds and it was found that some BCG vaccine strains and even some strains of M. bovis with eugenic-growth characteristics mainly old laboratory strains may give a positive niacin reaction. Most probably, the repeated subcultures lead to undefined changes at the genetic level in these seed strains. These changing biological characteristics envisage reevaluation of biochemical characters of existing BCG vaccine seeds and framing of newer guidelines for manufacturing, production, safety, and effectiveness of BCG vaccine.

Highlights

  • BCG, an attenuated strain of Mycobacterium bovis (M. bovis), has been used in more than 182 countries or territories as a prophylactic vaccine against tuberculosis (TB), for more than 90 years, albeit amidst a considerable controversy related to its efficacy

  • M. bovis is the etiological agent of bovine tuberculosis and is closely related to Mycobacterium tuberculosis (M. tuberculosis) in the M. tuberculosis complex (MTBC), which consists of M. tuberculosis, M. bovis, M. bovis BCG, M. africanum, M. canettii, M. microti, M. caprae, and M. pinnipedii

  • Almost all cases of tuberculosis are caused by M. tuberculosis, and share of M. bovis is less than 1.4 percent of all pulmonary tuberculosis cases outside of Africa

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Summary

Introduction

BCG, an attenuated strain of Mycobacterium bovis (M. bovis), has been used in more than 182 countries or territories as a prophylactic vaccine against tuberculosis (TB), for more than 90 years, albeit amidst a considerable controversy related to its efficacy. The BCG vaccine undoubtedly provides protection against childhood disseminated form of TB including TB meningitis. Its efficacy against pulmonary TB in adults has been reported to give variable results [4]. In Africa, M. bovis accounts for approximately 2.8 percent of cases of pulmonary tuberculosis, for a crude incidence of 7 cases per 100,000 populations [10], the global proportion of M. bovis is higher among patients with extrapulmonary tuberculosis, since the pathogen is frequently acquired via oral ingestion and gastrointestinal disease is an important clinical manifestation [11]

Historical Aspect of BCG
Biochemical and Genotypic Characteristics of BCG
Complications of BCG Vaccination
BCG Complications in HIV Infected Hosts
Current Understanding of BCG Vaccination
10. Guidelines on Administration of BCG Vaccine
11. Molecular Biology of BCG
Findings
12. Conclusion
Full Text
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