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KMID : 0981820110310030197
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Korean Journal of Laboratory Medicine
2011 Volume.31 No. 3 p.197 ~ p.200
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Mycobacterial Infection after Intravesical Bacillus Calmette-Gu?rin Treatment for Bladder Cancer: A Case Report
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Park Chang-Hun
Jang Mi-Ae
Ahn Yoon-Hee
Hwang Yu-Yean
Ki Chang-Seok
Lee Nam-Yong
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Abstract
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Bacillus Calmette-Gu?rin (BCG) has been traditionally used as a vaccine against tuberculosis. Further, intravesical administration of BCG has been shown to be effective in treating bladder cancer. Although BCG contains a live attenuated strain of Mycobacterium bovis, complications such as M. bovis BCG infection caused by BCG administration are extremely rare. Here, we report a case of BCG infection occurring after intravesical BCG therapy. A 67-yr-old man presented with azotemia and weight loss. He had been diagnosed with bladder cancer 4 yr back, and had undergone transurethral resection of the bladder tumor and intravesical BCG (Tice strain) therapy at that time. An acid-fast bacterial strain was isolated from his urine sample. We did not detect Mycobacterium tuberculosis protein 64 (MPT-64) antigen in the isolates obtained from his sample, and multiplex PCR and PCR-reverse blot hybridization assay indicated that the isolate was a member of the M. tuberculosis complex, but was not M. tuberculosis. Finally, sequence analysis of 16S ribosomal RNA and DNA gyrase, subunit B (gyrB) suggested that the organism was M. bovis or M. bovis BCG. Although we could not confirm that M. bovis BCG was the causative agent, the results of the 3 molecular methods and the MPT-64 antigen assay suggest this finding. This is an important finding, especially because M. bovis BCG cannot be identified using common commercial molecular genetics tools.
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KEYWORD
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BCG, Mycobacterium bovis, Bladder cancer, Multiplex-PCR, Sequence analysis
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