A Case of Acquired Rifampin Resistance in Mycobacterium bovis Bacillus Calmette-Guérin-Induced Cystitis: Necessity for Treatment Guidelines. Issue 3 (1st June 2006)

• Record Type: Journal Article
• Authors: Wolfe, Joyce N; Blackwood-Antonation, Kym S; Sharma, Meenu K; Cook, Victoria J
• Is Part Of: Canadian journal of infectious diseases & medical microbiology =. Volume 17:Issue 3(2006)
• Page Start: 183
• Page End: 185
• Publication Date: 2006-06-01
• Subjects: BCG -- Rifampin resistance -- rpoB; Communicable diseases -- Periodicals; Infection -- Periodicals; Communicable diseases; Infection; Communicable Diseases; Communicable Disease Control; Electronic journals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.9
• DOI: 10.1155/2006/263932
• Languages: English
• ISSNs: 1712-9532

Abstract

Abstract : A case of presumed bacillus Calmette-Guérin (BCG) cystitis in an elderly female patient following direct intravesical BCG instillation treatment for papillary transitional cell carcinoma is reported. The organism cultured from urine samples was eventually identified as a rifampin-resistant Mycobacterium bovis BCG isolate. Because the patient had received rifampin monotherapy during the course of treatment for presumed BCG disease, the clinical picture favoured acquired rifampin resistance. Sequencing of the target gene for rifampin ( rpoB ) confirmed a known mutation responsible for conferring high levels of resistance to both rifampin and rifabutin (Ser531Tyr). To the authors' knowledge, this is the first reported case of M bovis BCG disease in a non-HIV patient where the organism had acquired drug resistance to rifampin, and the second reported case of M bovis BCG that had acquired drug resistance. The present case demonstrates the necessity to re-evaluate appropriate guidelines for the effective treatment of BCG disease.