Emergence of Fluoroquinolone-resistant Escherichia coli as Cause of Postprostate Biopsy Infection: Implications for Prophylaxis and Treatment

Zaytoun, Osama; Vargo, Ethan; Rajan, Rajesh; Berglund, Ryan K.; Gordon, Steven M.; Jones, J. Stephen

doi:10.1016/j.urology.2010.12.067

Cited by 154 publications

(124 citation statements)

References 27 publications

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“…However, other studies from North America [12,13] reported lower rates of sepsis (0.6%), and an Asian study [14] reported that 0.5% of prostate biopsy cases had fever, similar to the data of our study.…”

Section: Discussionsupporting

confidence: 91%

Characteristics of Patients Who Visited the Emergency Room after Prostate Biopsy: Single Center Retrospective Study

Jeong

Lee

Chung

2015

Urogenit Tract Infect

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Purpose: To educate patients and prevent biopsy-related complications, it is helpful to understand the causes for visiting the emergency room (ER).Therefore, we want to analyze the causes and factors of complications that cause patients to visit the ER after prostate biopsy. Materials and Methods:We conducted a study of in-patients who visited the ER of Pusan National University Yangsan Hospital after prostate biopsy from December 2008 to July 2015. Age, postoperative interval before visiting the ER, Charlson comorbidity index (CCI) score, symptoms in ER, prostate size, pathologic result, and number of biopsy cores were analyzed retrospectively. Results: Among all 1,694 cases of patients who had undergone prostate biopsies during a 7-year period, only 37 patients (2.2%) visited the ER. Diabetes mellitus (DM) is the most common underlying disease among patients with accompanying infection-related symptoms compared to patients with accompanying non-infection-related symptoms (p＜0.001). In univariate analysis, DM (p=0.004) and CCI score (p=0.030) were statistically significant risk factors for infection, but only DM was significant in multivariate analysis (p=0.004). Prostate size (p=0.044) was a significant risk factor for acute urinary retention (AUR) in univariate analysis, but not statistically significant in multivariate analysis. CCI score was a statistically significant risk factor for bleeding (p=0.005 [univariate], 0.035 [multivariate]). Conclusions: AUR after transrectal ultrasound-biopsy is the most common reason for visiting the ER. CCI score showed correlation with bleeding and DM showed correlation with infection. Consideration of risk factors of complications after prostate biopsy will be helpful to the patients in the treatment and prevention of complication.

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Section: Discussionsupporting

confidence: 91%

Characteristics of Patients Who Visited the Emergency Room after Prostate Biopsy: Single Center Retrospective Study

Jeong

Lee

Chung

2015

Urogenit Tract Infect

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“…Prolonged antibiotic prophylaxis extending beyond 24 h is also not in line with the EAU guidelines. The 5-day course of CIP as was given in our study might have been of benefit for some individual patients but might cause collateral damage to others and should be avoided according to the principles of antibiotic stewardship [17,30]. Therefore, a prospective, randomized study with a peri-procedural one-day dosing of FT as used in the present retrospective study, as compared to a single dose of CIP would be highly recommended.…”

Section: Discussionmentioning

confidence: 92%

“…Data were collected by reviewing all ambulatory and hospital medical charts in case of hospitalization for symptomatic UTIs. In line with EAU guidelines, we defined an episode of symptomatic UTI as follows [16][17][18]:…”

Section: Data Collection and Microbiological Considerationsmentioning

confidence: 99%

Antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: fosfomycin trometamol, an attractive alternative

Cai

Gallelli²,

Cocci

et al. 2016

World J Urol

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infections (UTIs) occurring within 1 month after TR-PB. The rate of symptomatic UTIs and the rate of ADRs were considered the main outcome measures. Results In the total study population, 72/1109 (6.5 %) patients experienced symptomatic UTIs and among these 11 (0.9 % of total) had urosepsis. Out of 72, 53 (73.6 %) symptomatic UTIs were caused by fluoroquinolone-resistant strains. Out of 632, 10 (1.6 %) patients in Group 1 and 62/477 (12.9 %) patients in Group 2 had symptomatic UTIs (p < 0.001); in particular, 2/632 (0.3 %) patients in Group 1 and 9/477 (1.8 %) patients in Group 2 had urosepsis (p < 0.001). No differences were reported in terms of adverse events (0.6 vs 0.4 %; p = 0.70). A Charlson comorbidity index ≤1 and type of antimicrobial prophylaxis (FT) were found to be associated with a lower probability of symptomatic UTIs in the multivariate model. Conclusions Antibiotic prophylaxis with FT for TR-PB had a lower rate of adverse events and a lower rate of symptomatic UTIs as compared with CIP. Fosfomycin trometamol appears as an attractive alternative prophylactic regimen in prostate biopsies.

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“…It can be placed anywhere on the perineum and avoids transgression of the rectal wall, and thus, it is a sterile biopsy with a substantially reduced risk of infection (45). The lack of postbiopsy infection or sepsis is important in contrast to the 3%-11% infection rates previously reported for transrectal US, especially in light of rising antibiotic-resistant infections after transrectal biopsies (46)(47)(48). It can be performed in men with difficult or impossible rectal access, such as patients who have undergone proctocolectomy or those with rectal stenosis from prior radiation treatment (49).…”

Section: Discussionmentioning

confidence: 99%

Transperineal In-Bore 3-T MR Imaging–guided Prostate Biopsy: A Prospective Clinical Observational Study

Penzkofer¹,

Tuncalı²,

Fedorov³

et al. 2015

Radiology

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The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.q RSNA, 2014 Purpose:To determine the detection rate, clinical relevance, Gleason grade, and location of prostate cancer (PCa) diagnosed with and the safety of an in-bore transperineal 3-T magnetic resonance (MR) imaging-guided prostate biopsy in a clinically heterogeneous patient population. Materials and Methods:This prospective retrospectively analyzed study was HIPAA compliant and institutional review board approved, and informed consent was obtained. Eighty-seven men (mean age, 66.2 years 6 6.9) underwent multiparametric endorectal prostate MR imaging at 3 T and transperineal MR imaging-guided biopsy. Three subgroups of patients with at least one lesion suspicious for cancer were included: men with no prior PCa diagnosis, men with PCa who were undergoing active surveillance, and men with treated PCa and suspected recurrence. Exclusion criteria were prior prostatectomy and/or contraindication to 3-T MR imaging. The transperineal MR imaging-guided biopsy was performed in a 70-cm wide-bore 3-T device. Overall patient biopsy outcomes, cancer detection rates, Gleason grade, and location for each subgroup were evaluated and statistically compared by using x 2 and one-way analysis of variance followed by Tukey honestly significant difference post hoc comparisons. Results:Ninety biopsy procedures were performed with no serious adverse events, with a mean of 3.7 targets sampled per gland. Cancer was detected in 51 (56.7%) men: 48.1% (25 of 52) with no prior PCa, 61.5% (eight of 13) under active surveillance, and 72.0% (18 of 25) in whom recurrence was suspected. Gleason pattern 4 or higher was diagnosed in 78.1% (25 of 32) in the no prior PCa and active surveillance groups. Gleason scores were not assigned in the suspected recurrence group. MR targets located in the anterior prostate had the highest cancer yield (40 of 64, 62.5%) compared with those for the other parts of the prostate (P , .001). Conclusion:In-bore 3-T transperineal MR imaging-guided biopsy, with a mean of 3.7 targets per gland, allowed detection of many clinically relevant cancers, many of which were located anteriorly.q RSNA, 2014

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Emergence of Fluoroquinolone-resistant Escherichia coli as Cause of Postprostate Biopsy Infection: Implications for Prophylaxis and Treatment

Cited by 154 publications

References 27 publications

Characteristics of Patients Who Visited the Emergency Room after Prostate Biopsy: Single Center Retrospective Study

Characteristics of Patients Who Visited the Emergency Room after Prostate Biopsy: Single Center Retrospective Study

Antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy: fosfomycin trometamol, an attractive alternative

Transperineal In-Bore 3-T MR Imaging–guided Prostate Biopsy: A Prospective Clinical Observational Study

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