Prevalence and characteristics of fecal antimicrobial‐resistant Escherichia coli in a cohort of Japanese men undergoing prostate biopsy

Abstract

The present study showed the fecal carriage of fluoroquinolone-resistant E. coli and extended-spectrum β-lactamase-producing E. coli at 9.8% and 5.9%, respectively, with CTX-M-9 group of extended-spectrum β-lactamase-producing E. coli comprising 63.6%, in Japanese men receiving prostate biopsy. The carriage of fluoroquinolone-resistant and/or extended-spectrum β-lactamase-producing E. coli was significantly related to diabetes.

Antibiotic susceptibility of intestinal Escherichia coli in men undergoing transrectal prostate biopsies: a prospective, registered, multicentre study

“…Surprisingly, our present results indicate that the use of antibiotics during the preceding year reduced the risk of having a FQ-R E. coli strain. Although, Kamei et al [29] and Duplessis et al [26] found no difference in FQ-R between study groups with prior usage of FQ or other antibiotic therapy during the preceding 3 months and 1 year [26,29], there are several reports arguing otherwise. Taylor et al [19] presented an increased risk for FQ-R coliforms in patients with ciprofloxacin usage during the last 3 months.…”

Prevalence of fluoroquinolone‐resistant rectal flora in patients undergoing transrectal ultrasound‐guided prostate needle biopsy: A prospective multicenter study

“…16,17 In a Japanese study, FQ-R and ESBL-producing E. coli were detected in 9.8 and 5.9%, respectively, similar to studies reported in Europe and America. 5,6,8,15,18 These dissimilarities could be explained by the differences in the culture method of rectal swabs, and the regional difference in antibiotic susceptibilities within the same ethnicity. An increasing rate, of FQ resistance among Gram-negative bacteria has been reported globally, and this might be no exception.…”

“…Despite the proven efficacy and guideline recommendations of FQ as a first‐line agent for antibiotic prophylaxis, the incidence of infectious complications has increasingly risen over the past two decades . A simultaneous increase in the incidence of infectious complications from FQ‐R Escherichia coli has been reported, leading to the conclusion that post‐TRUSBx infection is caused by growing FQ‐R …”

“…Despite the proven efficacy and guideline recommendations of FQ as a firstline agent for antibiotic prophylaxis, the incidence of infectious complications has increasingly risen over the past two decades. 2 A simultaneous increase in the incidence of infectious complications from FQ-R Escherichia coli has been reported, leading to the conclusion that post-TRUSBx infection is caused by growing FQ-R. [2][3][4][5] 10.6-22.0% and 1.3-11.0%, respectively, in Western countries, and targeted antibiotic prophylaxis based on rectal swab results has been suggested as a feasible and cost-effective practice by several reports. [6][7][8] The selected approach (selective rectal swab with targeted antibiotic prophylaxis or alternative antibiotics) for patients with risk factors might be beneficial in countries with low antibiotic resistance of rectal flora.…”

Editorial Comment from Dr Sadahira et al. to Use of fosfomycin as targeted antibiotic prophylaxis before prostate biopsy: A prospective randomized study

“…Indeed, two patients developed infectious complications with FQ‐resistant bacteria, despite the fact that these bacteria could not by detected rectally. Based on the fact that all fecal FQ‐resistant or ESBL‐producing E. coli before prostate biopsy were susceptible to FOM in Japan, targeted FOM prophylaxis would have the potential to show greater benefit for the Japanese population …”