Bacillus Calmette-Guerin infection following intravesical instillation: Does the strain matter?
L I Levi1, F Schlemmer2, N de Castro3
1Fédération d'infectiologie, hôpital Cochin, université Paris-Descartes, Sorbonne Paris Santé, Assistance publique-Hôpitaux de Paris (AP-HP), 75014 Paris, France.
Purpose:
Intravesical BCG is the standard treatment of non-muscle invasive bladder cancer. No difference has yet been reported in the safety profiles of the various BCG strains.
Methods:
A nationwide multidisciplinary retrospective survey was conducted between January 2013 and December 2016 to identify cases of BCG infection and differentiate them based on the type of BCG strain used.
Results:
Forty patients were identified (BCG RIVM 28; other strains 8; unknown 4). Patients treated with BCG RIVM were less severely ill, with fewer occurrences of septic shock (3.6% vs. 50%, P=0.003) and ICU admission (7.1% vs. 62.5%, P=0.003). A higher frequency of pulmonary miliaries (71.4% vs. 12.5%, P=0.005) but lower transaminase levels (mean AST 65 vs. 264 U/L, P=0.001) were observed in these patients. No difference in terms of recovery was reported.
Conclusion:
The type of BCG strain could correlate with the frequency and severity of subsequent BCG infections.
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