title: Editor's choice: Implications of isoniazid resistance in Mycobacterium bovis Bacillus Calmette-Guérin used for immunotherapy in bladder cancer.
abstract: We report a case of sepsis from Mycobacterium bovis Bacillus Calmette-Guérin (BCG) with low-level isoniazid resistance following intravesical treatment for bladder cancer. Isoniazid resistance in BCG has therapeutic implications when it causes infections after intravesical instillation. For these circumstances, we propose some modifications to existing treatment guidelines for BCG infection.
authors.affiliation: Centre for Infectious Diseases and Microbiology Laboratory Services, Level 3, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia. matthew.watts@swahs.health.nsw.gov.au
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Watts
authors.forename: Peter C
authors.initials: PC
authors.lastname: Taylor
authors.forename: Vitali
authors.initials: V
authors.lastname: Sintchenko
authors.forename: Clair M
authors.initials: CM
authors.lastname: Whelan
authors.forename: Robert H
authors.initials: RH
authors.lastname: Farnsworth
authors.forename: Philip
authors.initials: P
authors.lastname: Jones
authors.forename: Peter
authors.initials: P
authors.lastname: Jelfs
authors.forename: David
authors.initials: D
authors.lastname: Carr
authors.forename: Hazel
authors.initials: H
authors.lastname: Goldberg
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology; D001691:Biological Therapy / Q000009:adverse effects* / Q000379:methods; D024881:Drug Resistance, Bacterial; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects* / Q000379:methods; D007538:Isoniazid / Q000494:pharmacology*; D008297:Male; D009163:Mycobacterium bovis / Q000187:drug effects* / Q000276:immunology; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid