A Case of Acquired Rifampin Resistance in Mycobacterium bovis Bacillus Calmette-Guérin-Induced Cystitis: Necessity for Treatment Guidelines

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 Mycobacte...

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Main Authors: Joyce N Wolfe, Kym S Blackwood-Antonation, Meenu K Sharma, Victoria J Cook
Format: Article
Language:English
Published: Wiley 2006-01-01
Series:Canadian Journal of Infectious Diseases and Medical Microbiology
Online Access:http://dx.doi.org/10.1155/2006/263932
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author Joyce N Wolfe
Kym S Blackwood-Antonation
Meenu K Sharma
Victoria J Cook
author_facet Joyce N Wolfe
Kym S Blackwood-Antonation
Meenu K Sharma
Victoria J Cook
author_sort Joyce N Wolfe
collection DOAJ
description 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.
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series Canadian Journal of Infectious Diseases and Medical Microbiology
spelling doaj-art-0a0f097253f14140ba0bd04342517d212025-08-20T02:03:16ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95322006-01-0117318318510.1155/2006/263932A Case of Acquired Rifampin Resistance in Mycobacterium bovis Bacillus Calmette-Guérin-Induced Cystitis: Necessity for Treatment GuidelinesJoyce N Wolfe0Kym S Blackwood-Antonation1Meenu K Sharma2Victoria J Cook3National Reference Centre for Mycobacteriology, National Microbiology Laboratory, Public Health Agency of Canada, CanadaNational Reference Centre for Mycobacteriology, National Microbiology Laboratory, Public Health Agency of Canada, CanadaNational Reference Centre for Mycobacteriology, National Microbiology Laboratory, Public Health Agency of Canada, CanadaTB Control, British Columbia Centre for Disease Control, CanadaA 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.http://dx.doi.org/10.1155/2006/263932
spellingShingle Joyce N Wolfe
Kym S Blackwood-Antonation
Meenu K Sharma
Victoria J Cook
A Case of Acquired Rifampin Resistance in Mycobacterium bovis Bacillus Calmette-Guérin-Induced Cystitis: Necessity for Treatment Guidelines
Canadian Journal of Infectious Diseases and Medical Microbiology
title A Case of Acquired Rifampin Resistance in Mycobacterium bovis Bacillus Calmette-Guérin-Induced Cystitis: Necessity for Treatment Guidelines
title_full A Case of Acquired Rifampin Resistance in Mycobacterium bovis Bacillus Calmette-Guérin-Induced Cystitis: Necessity for Treatment Guidelines
title_fullStr A Case of Acquired Rifampin Resistance in Mycobacterium bovis Bacillus Calmette-Guérin-Induced Cystitis: Necessity for Treatment Guidelines
title_full_unstemmed A Case of Acquired Rifampin Resistance in Mycobacterium bovis Bacillus Calmette-Guérin-Induced Cystitis: Necessity for Treatment Guidelines
title_short A Case of Acquired Rifampin Resistance in Mycobacterium bovis Bacillus Calmette-Guérin-Induced Cystitis: Necessity for Treatment Guidelines
title_sort case of acquired rifampin resistance in mycobacterium bovis bacillus calmette guerin induced cystitis necessity for treatment guidelines
url http://dx.doi.org/10.1155/2006/263932
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