@Article{,
AUTHOR = {Prashant Malhotra, Bruce F. Farber},
TITLE = {Isoniazid resistance among Bacillus Calmette Guerin strains: implications on bladder cancer immunotherapy related infections},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {18},
YEAR = {2011},
NUMBER = {3},
PAGES = {5671--5675},
URL = {http://www.techscience.com/CJU/v18n3/61918},
ISSN = {1488-5581},
ABSTRACT = {Bacillus Calmette Guerin (BCG) immunotherapy is widely 
used for treatment of superfi cial bladder transitional cell 
carcinoma. Infectious complications while rare can be 
serious and severe disseminated infections as well as sepsis 
has been reported. There are no standard guidelines to direct 
therapy of these complications. Isoniazid is a commonly and 
widely used component of the various treatment regimens.
Various strains of BCG are used for treatment of bladder 
cancer as well as vaccinations. These strains have evolved 
because of repeated subcultures in various laboratories 
in the world and have been shown to exhibit phenotypic 
differences in their immunogenicity as well as recently in 
susceptibility to various antimycobacterial agents. 
In this article, we review the resistance of BCG strains to 
various antimycobacterial agents. Some of these strains 
including the BCG Connaught strain, which is widely 
used in the United States, Canada and some other parts 
of the world for bladder cancer therapy exhibit intrinsic 
resistance to isoniazid. Although the clinical relevance of 
these differences is unclear, recent studies have questioned 
the role of isoniazid in treatment of infections after 
vaccination with these strains. Also, use of isoniazid 
in combination therapy for these infections may lead to 
the development of resistance to other antimycobacterial 
agents.<br/>
We conclude that isoniazid may not be a suitable 
agent for empiric treatment of infections related to 
intravesical immunotherapy for bladder cancer with 
these strains and further studies are needed to clarify 
its role.},
DOI = {}
}