Background The mainstay for the diagnosis of prostate cancer is transrectal ultrasound-guided prostate biopsy. However, prostate biopsy is associated with a significant risk of complications including urinary tract infection. This study aims to compare the bacterial profile and antibiotic susceptibility pattern in urinary tract infection after prostate biopsy between patients on 2 different antimicrobial prophylactic regimens. Methods This was a comparative cross-sectional study done at the urology unit of our institution, over 13 months. Fifty-six patients who met the inclusion criteria made up the study population and were randomly assigned to two groups. Those in group 1 (28) received intravenous ciprofloxacin (Juhel) 400 mg at induction of anesthesia, while those in group 2 (28) received intravenous ceftriaxone (Rocephin) 1 g at induction of anesthesia. All patients received bisacodyl (dulcolax) rectal suppositories 20 mg nocte starting 2 nights before the procedure as well as intravenous metronidazole (Juhel) at induction of anesthesia. Urine samples were taken for urine culture and sensitivity three days after biopsy. Isolated organisms and their antibiotics sensitivities were documented. Statistical analysis was done using SPSS version 21.0 with the level of significance set at P < 0.05. Results In group 1 the prevalence of urinary tract infection was 61%. Escherichia coli was isolated in 11(64.71%) cases, Klebsiella species in 3(17.65%), staphylococcus aureus in 1(5.88%), Proteus species in 1(5.88%), and non-hemolytic streptococcus species in 1(5.88%). In this group, all isolated bacterial organisms were resistant to ciprofloxacin. In group 2 the prevalence of urinary tract infection was 43%. Klebsiella spp was isolated in 6(50%) cases, Pseudomonas aeruginosa in 3(25%), E. coli in 2(16.67%), Staphylococcus in 1(8.33%). In group 2 all isolated bacterial organisms were resistant to ceftriaxone. Conclusion Ciprofloxacin and ceftriaxone are both associated with a high rate of urinary tract infection when used as prophylaxis for prostate biopsy. The bacterial etiology of prostate biopsy-related urinary tract infection is dependent on the prophylactic antibiotics used. Based on the high rate of urinary tract infection associated with the use of either ciprofloxacin or ceftriaxone, we recommend a combination of both drugs as prophylaxis for prostate biopsy.
Background: Prostate cancer is the most common type of cancer among Nigerian men. Prostate specific antigen (PSA) is produced by the prostate gland and it is an important tumor marker in the screening and diagnosis of prostate cancer because the latter is often associated with elevated PSA levels. The aim of this study was to evaluate the profile and PSA levels of men presenting for prostate cancer screening at the National Obstetric Fistula Centre, Abakaliki, Nigeria. Methods: This was a retrospective study of 103 patients who were seen between January 2014 and December 2015 and screened for prostate cancer using PSA assay. Data was extracted from folders of patients using a proforma and analysed using the Statistical Package for Social Sciences (SPSS), version 21. Result: Out of the 103 clients studied, 67 (65%) were between the ages of 40 and 59 years. The mean age was 54.38 ± 12.5 years. Eighty-one (78.6%) of the study population had PSA levels 4 ng/ml and below, 5 (4.9%) had PSA levels of 4.1 -10 ng/ml, while 17 (16.5%) had PSA levels > 10 ng/ml. The mean PSA was 4.75 ± 8.2 ng/ml. None of the patients with family history of cancer had PSA levels of >4 ng/ml. Those who were positive for HIV also had normal PSA results. Conclusion: The findings from this study showed that the prevalence of men with raised PSA (>4 ng/ml) was high (21.4%) especially in the 60 -69 years age group. There is need to increase prostate cancer screening using PSA in our setting. The use of other parameters such as digital rectal examination, PSA density, PSA velocity and free PSA will be helpful to determine the need for histological diagnosis in these patients.
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