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Updated: Sep 26, 2026
A Functional Whole Blood Assay to Measure Viability of Mycobacteria, using Reporter-Gene Tagged BCG or M.Tb (BCG lux/M.Tb lux)
Published on: September 14, 2011
Detection of bloodstream pathogens in a bacille Calmette-Guérin (BCG)-vaccinated pediatric population in Malawi: a
L K Archibald1, O Nwanyanwu, P N Kazembe
1CDC Mailstop A-35, 1600 Clifton Road, Atlanta, GA 30333, USA. LCA6@CDC.GOV
Insights
Malawian children receiving the bacille Calmette-Guérin (BCG) vaccine are not particularly vulnerable to BCG dissemination, even if infected with the human immunodeficiency virus type 1 (HIV-1). Bloodstream dissemination of the BCG Mycobacterium bovis strain is uncommon in HIV-1-infected children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Bacille Calmette-Guérin (BCG) vaccination is administered to Malawian newborns within 3 days of life.
- Human immunodeficiency virus type 1 (HIV-1) infection may increase vulnerability to disseminated BCG disease.
Purpose of the Study:
- To investigate the hypothesis that Malawian children infected with HIV-1 are more susceptible to disseminated BCG disease.
- To determine the incidence of BCG dissemination in HIV-1-infected children.
Main Methods:
- Prospective study of acutely ill children admitted to a Malawi general hospital during wet and dry seasons.
- Blood cultures for bacteria (including mycobacteria) and fungi.
- Testing for anti-HIV-1 antibodies.
Main Results:
- Non-typhi Salmonella and Escherichia coli were the most common bloodstream pathogens.
- Bloodstream dissemination of the BCG Mycobacterium bovis strain was found to be uncommon in HIV-1-infected children.
Conclusions:
- HIV-1 infection does not appear to significantly increase the risk of BCG dissemination in Malawian children.
- BCG vaccination is generally safe in HIV-1-infected infants in this population.
Abstract:
Children in Malawi receive bacille Calmette-Guérin (BCG) vaccination within the first 3 days of life. Thus, we hypothesized that Malawian children infected with the human immunodeficiency type 1 virus (HIV-1) might be particularly vulnerable to dissemination of the BCG Mycobacterium bovis strain with which they were vaccinated. Following informed consent by parents, we studied children admitted to a Malawi general hospital during the 1998 wet and dry seasons. Blood from cohorts of acutely ill children was cultured for bacteria, including mycobacteria, and fungi, and tested for anti-HIV-1 antibodies. It was shown that non-typhi Salmonella and Escherichia coli were the predominant bloodstream pathogens during the wet and dry seasons, and that bloodstream dissemination of the BCG M. bovis strain is uncommon in HIV-1-infected children who receive the BCG vaccine.
