Bacterial sepsis following prostatic biopsy

Abstract

Escherichia coli are developing new drug resistances. Early recognition of patients who harbor MDRO E. coli in their rectum or in the urine could be an important strategy for preventing sepsis. If a patient who has recently undergone transrectal prostate biopsy shows clinical signs of sepsis in the 48 h, a multiresistant E. coli infection must be suspected. The patient must be admitted urgently to the hospital, and carbapenem antibiotic therapy should be started.

Morbidity After Transperineal Prostate Biopsy in 3000 Patients Undergoing 12 vs 18 vs More Than 24 Needle Cores

“…Transperineal biopsy compared with the transrectal approach reduces the risk of sepsis that is continuously increasing because of antibiotic-resistant flora, such as Escherichia coli infection. 19,20 To our knowledge, this series is the first to evaluate transperineal prostate biopsy complications in such a high number of patients. We documented overall side effects after prostate biopsy in 40.2% (1206 of 3000) of the patients, which were directly correlated with number of needle cores: 31.5% for 12 cores, 41.8% for 18 cores, and 57.4% for >24 cores (P ¼ .001).…”

Impact of Rectal Swabs on Infectious Complications after Transrectal Prostate Biopsy

“…Asymptomatic bacteriuria, UTI, and epididymitis are the most frequent IC, but more severe cases such as meningitis, vertebral osteomyelitis, sepsis, and septic shock have also been reported [10]. However, their frequency varies considerably.…”

A single dose of meropenem is superior to ciprofloxacin in preventing infections after transrectal ultrasound-guided prostate biopsies in the era of quinolone resistance

“…In the past years, the most investigators suggested a scheme of over 24 h [15]; recently, the 1-day regime is recommended, from EAU and AUA guidelines, for biopsy prophylaxis. Despite the above recommendations, UTIs after a prostate biopsy are dangerous complication and can lead to sepsis or even to septic shock and death [16]. E. coli remains the most common bacterium isolated in urine and blood cultures [17].…”