Purpose We estimated the prevalence of fluoroquinolone resistant Escherichia coli in patients undergoing repeat transrectal ultrasound guided prostate needle biopsy and identified high risk groups. Materials and Methods From January 2009 to March 2010 rectal swabs of 136 men from 3 institutions undergoing transrectal ultrasound guided prostate needle biopsy were obtained. There were 33 men with no previous biopsy who served as the controls. Participants completed questionnaires and rectal swab culture was obtained just before performing the prostate biopsy. Selective media was used to specifically isolate fluoroquinolone resistant E. coli and sensitivities were obtained. The patients were contacted via telephone 7 days after the procedure for a followup questionnaire. Results A total of 30 patients had cultures positive for fluoroquinolone resistant bacteria for an overall rate of 22% (95% CI 15, 29). Patients with diabetes and Asian ethnicity had higher risks of resistant rectal flora colonization (OR 2.3 and 2.8, respectively). However, differences did not reach statistical significance (p = 0.09 and p = 0.08, respectively). Patients with no prior biopsy had a positive rate of 15% (5 of 33) compared to 24% (25 of 103) in those with 1 or more prior biopsies (OR 1.8, p = 0.27). Five patients (3.6%) had post-biopsy fever while only 1 of those patients had a positive rectal swab. Conclusions Using selective media to isolate fluoroquinolone resistant E. coli from the rectum before transrectal ultrasound guided prostate biopsy, we isolated organisms in 22% of patients with a wide resistance pattern. This protocol may be used to provide information regarding targeted antibiotic prophylaxis before transrectal prostate biopsies.

Pfizer of Italy.

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Objective To assess the independent association of food insecurity with processes of care and delays in filling prescriptions. Data Source 2007 California Health Interview Survey Study Design Associations of food insecurity with processes of care and delays in filling prescriptions were examined using multivariable logistic regression analyses adjusted for sociodemographic characteristics, barriers to accessing care, and health status. Data Extraction Data were analyzed from adults currently receiving treatment for type 2 diabetes and who had seen a doctor in the prior 12 months (N=3401) Principal Findings For diabetes patients currently receiving medical care, food insecurity was not associated with lower rates of performance of recommended processes of care, but was associated with delays in filling prescriptions (aOR=2.15, 95% CI 1.25, 3.71). Conclusions Food insecurity may increase delays in filling prescriptions in daily life, even though the performance of recommended processes of care in the clinic is not diminished.

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