title: Intravesical bacillus Calmette-Guérin outcomes in patients with bladder cancer and asymptomatic bacteriuria.
abstract: OBJECTIVE
  The outcome of intravesical bacillus Calmette-Guérin therapy was studied in patients with asymptomatic bacteriuria.
  
  
  METHODS
  A total of 243 patients with high risk, nonmuscle invasive bladder cancer received induction intravesical bacillus Calmette-Guérin therapy. Before starting bacillus Calmette-Guérin they submitted voided urine samples for culture and were treated with bacillus Calmette-Guérin regardless of culture results without antibiotics. Patients were followed every 3 months for tumor recurrence or progression up to 2 years.
  
  
  RESULTS
  Of the 243 patients 61 (25%) had significant bacteriuria (greater than 10(4) or greater than 10(5) cfu/ml single organism). Febrile urinary tract infection developed in 1 patient (1.6%) and 2 overall (0.8%) after completing induction bacillus Calmette-Guérin therapy. No patients were admitted to the hospital for bacillus Calmette-Guérin or bacterial sepsis. The 2-year recurrence-free survival rate was 71% vs 73% in uninfected patients (p = 0.73).
  
  
  CONCLUSIONS
  These data suggest that intravesical bacillus Calmette-Guérin is safe in patients who have asymptomatic bacteriuria and the 2-year disease-free intervals are similar to those of uninfected patients. Such strategy facilitates the timely administration of bacillus Calmette-Guérin therapy and avoids the overuse of antibiotics.
authors.affiliation: Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. herrh@mskcc.org
authors.forename: Harry W
authors.initials: HW
authors.lastname: Herr
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000283:Administration, Intravesical; D000368:Aged; D058345:Asymptomatic Infections / Q000628:therapy*; D001500:BCG Vaccine / Q000008:administration & dosage*; D001437:Bacteriuria / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000188:drug therapy*
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine