Outbreak of Fluoroquinolone-ResistantEscherichia coliInfections after Transrectal Ultrasound—Guided Biopsy of the Prostate

Abstract

The outbreak of fluoroquinolone-resistant E. coli infections after TRUBP closely paralleled rising rates of fluoroquinolone resistance among outpatient E. coli isolates. The delayed detection of the outbreak and the absence of sensitive predictors of infection suggest that active surveillance for infection after TRUBP is necessary in the context of increasing fluoroquinolone resistance in the United States.

Modification of Antimicrobial Prophylaxis Based on Rectal Culture Results to Prevent Fluoroquinolone-Resistant Escherichia coli Infections after Prostate Biopsy

“…2 " 6 At the Cleveland Veterans Affairs Medical Center, an outbreak of fluoroquinolone-resistant E. coli infections after TRUBP coincided with rising rates of fluoroquinolone resistance among outpatient E. coli isolates. 6 Only 26% of patients developing infections with fluoroquinoloneresistant E. coli had received fluoroquinolones in the previous year, and only 49% were identified by a prediction rule that included prior UTI, prior hospitalization, and previous infection with fluoroquinolone-resistant gram-negative bacilli. 6 These findings suggested that modifying prophylaxis for patients with selected risk factors would have limited efficacy.…”

“…6 Only 26% of patients developing infections with fluoroquinoloneresistant E. coli had received fluoroquinolones in the previous year, and only 49% were identified by a prediction rule that included prior UTI, prior hospitalization, and previous infection with fluoroquinolone-resistant gram-negative bacilli. 6 These findings suggested that modifying prophylaxis for patients with selected risk factors would have limited efficacy. Therefore, we examined the effectiveness of screening TRUBP patients for rectal carriage of fluoroquinolone-resistant E. coli with modification of periprocedure prophylaxis as a strategy to reduce infections after TRUBP.…”

Infections caused by fluoroquinolone-resistant Escherichia coli following transrectal ultrasound-guided biopsy of the prostate

“…Concerned by what appeared to be a sudden increase in the number of cases, a case–case–control investigation was undertaken that did not identify increased exposure to antibiotics or other risk factors associated with the development of infection following TRUBP [5]. In the present analysis, we focused on the characteristics of the bacterial isolates causing infection after TRUBP.…”

Fosfomycin trometamol vs ciprofloxacin for antibiotic prophylaxis before transrectal ultrasonography-guided prostate biopsy: A meta-analysis of clinical studies

“…Currently, fluoroquinolones are the most widely used antibiotic prophylaxis for TRUS-PNB [1]. However, several studies reported an increasing incidence of fluoroquinolone-resistant (FQR) uropathogens [6,7]. These findings urge the reconsideration of fluoroquinolones as the antibiotic of choice for TRUS-PNB prophylaxis.…”