Resistant Mycobacterium bovis Bacillus Calmette-Guérin Disease: Implications for Management of Bacillus Calmette-Guérin Disease in Human Immunodeficiency Virus-Infected Children
Date
2004
Authors
Hesseling A.C.
Schaaf H.S.
Victor T.
Beyers N.
Marais B.J.
Cotton M.F.
Wiid I.
Gie R.P.
Van Helden P.
Warren R.M.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Guidelines for the diagnosis and management of Bacillus Calmette-Guérin (BCG) disease in children are lacking, and there are limited data on drug resistance of Mycobacterium bovis BCG. A 6-month-old HIV-infected infant presented with right axillary adenitis ipsilateral to the site of BCG immunization. M. tuberculosis complex was cultured from axillary lymph nodes and gastric aspirates, and M. bovis BCG was isolated. Susceptibility testing before initiation of therapy demonstrated inherent resistance to isoniazid. The organism acquired rifampin resistance during therapy. This was confirmed by the presence of a mutation in codon 531 (Ser531Tyr) of the rpoB gene. Treatment guidelines for BCG disease with consideration of inherent and possible acquired drug resistance should be established in settings with high rates of vertical HIV transmission and routine BCG vaccination.
Description
Keywords
amikacin, BCG vaccine, ciprofloxacin, ethambutol, ethionamide, isoniazid, ofloxacin, pyrazinamide, rifampicin, RNA polymerase beta subunit, antibiotic sensitivity, article, axillary lymph node, Bacillus Calmette Guerin disease, bacterium culture, BCG vaccination, case report, codon, gene, gene mutation, human, Human immunodeficiency virus, human tissue, infant, infection, lymph node biopsy, male, Mycobacterium bovis, nonhuman, practice guideline, priority journal, rpoB gene, stomach suction, vertical transmission, Animals, Antitubercular Agents, BCG Vaccine, Cattle, DNA-Directed RNA Polymerases, Drug Resistance, Bacterial, HIV Infections, Humans, Infant, Isoniazid, Mutation, Mycobacterium bovis, Rifampin, Tuberculosis, Pulmonary
Citation
Pediatric Infectious Disease Journal
23
5
23
5