Selective culture of <i>Escherichia coli</i> to prevent infective complications of transrectal ultrasound‐guided prostate biopsy: Clinical efficacy and analysis of characteristics of quinolone‐resistant <i>Escherichia coli</i>

Hiyama, Yoshiki; Takahashi, Satoshi; Uehara, Teruhisa; Ichihara, Koji; Hashimoto, Jiro; Matsukawa, Masanori; Taguchi, Keisuke; Kunishima, Yasuharu; Hara, Hiroshi; Yanase, Masahiro; Itoh, Naoki; Hirose, Takaoki; Takeyama, Koh; Tachiki, Hitoshi; Masumori, Naoya

doi:10.1111/iju.13960

Cited by 9 publications

(8 citation statements)

References 17 publications

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“…Hiyama et al (2019) showed that a combination of empirical and target prophylaxis, guided by pre-biopsy rectal swabs, could be a good strategy to decrease the number of biopsy complications. 23 A similar rate of post-biopsy infections was shown in our study. Resistance to antibiotics on fecal microbiota has not been individualized as a possible risk factor for post-biopsy complications, differently than reported in the literature.…”

Section: Discussionsupporting

confidence: 90%

“…These results are comparable to the contemporary series, including those under the target and empirical prophylaxis protocols. 6,9–11,21–23 Since no resistance to ciprofloxacin/gentamicin neither to ciprofloxacin/ceftriaxone combination has been identified in our cohort, we believe that is acceptable to extrapolate our findings to compare our results with those from target prophylaxis. Hiyama et al (2019) showed that a combination of empirical and target prophylaxis, guided by pre-biopsy rectal swabs, could be a good strategy to decrease the number of biopsy complications.…”

Section: Discussionmentioning

confidence: 85%

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Major post-prostate biopsy complications under antibiotic augmentation prophylaxis protocol

Rodrigues

Muglia

Albuquerque

et al. 2021

Journal of Clinical Urology

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Objective: To identify risk factors for major post-biopsy complications under augmented prophylaxis protocol. The risk factors already described mainly comprise outdated antibiotic prophylaxis protocols. Material and methods: This retrospective cohort study included patients that underwent transrectal ultrasound-guided biopsies, from 2011 to 2016. All patients had received antibiotic prophylaxis with ciprofloxacin and gentamicin. Patients were grouped according to the presence or absence of post-biopsy complications. Demographic variables and possible risk factors based on routine clinical assessment were registered. Correlation tests, univariate and multivariate analyses were used to identify risk factors for post-biopsy complications. Results: Of the 404 patients that were included, 25 (6.2%) presented 27 post-biopsy complications, distributed as follows: acute urinary retention ( n = 14, 3.5%), infections ( n = 11, 2.7%) and hemorrhage ( n = 2, 0.5%). On univariate analysis, patients who presented complications showed higher body mass index and post-voiding residual volumes. Multivariate analysis identified ethnicity and prostate-specific antigen (PSA) density as possible risk factors for biopsy complications. The presence of bacterial resistance identified by rectal swabs did not correlate with the incidence of complications and infections. Conclusions: Non-infectious post-biopsy complications were more frequent than infectious ones in this cohort. Higher post-voiding residual volumes and PSA density, that indicates prostate enlargement, were identified as risk factors and interpreted as secondary to bladder outlet obstruction. The higher body mass index and ethnicity were also identified as risk factors and attributed to the heterogeneity of the patients included. Level of evidence: Not applicable for this multicentre audit.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 85%

Major post-prostate biopsy complications under antibiotic augmentation prophylaxis protocol

Rodrigues

Muglia

Albuquerque

et al. 2021

Journal of Clinical Urology

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“…Although several studies have examined the effectiveness of pre-biopsy rectal swab culture, 11,[16][17][18] only a few studies have explored the clinical utility of urine culture before TR-PB. 14,15 Bruyère et al reported that 3.4% (12 of 353 patients who received transrectal needle biopsy) had positive pre-biopsy urine culture (>1×10 5 CFU/mL) 48-72 h before PB, and only 1.1% of patients with negative prebiopsy urine culture developed infectious complications following PB.…”

Section: Discussionmentioning

confidence: 99%

Positive Culture Prior to Transperineal Prostate Biopsy Was Not Associated with Post-Biopsy Febrile Urinary Tract Infection Development

Tohi

Fujiwara

Harada

et al. 2021

RRU

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To investigate the association between urine culture before transperineal prostate biopsy and post-biopsy febrile urinary tract infection (fUTI). Patients and Methods: We retrospectively reviewed 307 patients who underwent urine culture before transperineal prostate biopsy between April 2017 and September 2020. Patients with indwelling urinary catheters (n=7) were excluded. Urine culture was performed 1-3 days before the biopsy, and all patients received prophylactic cefazolin regardless of culture results. A urine culture was defined as positive if cell density was more than 1×10 5 colony-forming units per mL. Baseline characteristics and the incidence of post-biopsy fUTI were compared between patients showing positive pre-biopsy culture results and those showing negative findings. Results: Out of 300, seven patients (2.3%) had positive urine culture results before the biopsy. Age (p=0.077); prostate-specific antigen at diagnosis (p=0.267); prostate volume (p=0.78); number of biopsy cores (p=0.277); percentage of patients testing positive for cancer on biopsy (p=0.71); and percentages of patients with a history of biopsy (p>0.999), diabetes mellitus (p=0.604), and immunosuppressive medication use (p>0.999) were similar between the two groups. No patient in the positive urine culture group had post-biopsy fUTI. However, 1.7% (five patients) of the negative urine culture group had the disease (p>0.999) (four patients with prostatitis and one with pyelonephritis). Among them, two patients were diagnosed by urine culture at the time of post-biopsy fUTI. Conclusion:In asymptomatic patients, positive pre-biopsy cultures were not associated with the development of post-biopsy fUTI.

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“…The preoperative use of selective media allows the isolation and analysis of these strains, consequently, more information can be collected and thus, preventing complications associated with invasive procedures such as prostate biopsy. The clinical efficacy and analysis of characteristics of quinolone‐resistant E. coli using selective culture were determined by Hiyama et al 59 . The results of the analysis of 420 patients showed 75 (17.8%) had FQ‐resistant E. coli , although none of the carriers presented any infectious complications related to resistant pathogens using targeted antimicrobial prophylaxis, they suggested that a pre‐operative selective media method might prevent infectious complications after prostate biopsy.…”

Section: Screening Cultures Using Selective Mediamentioning

confidence: 99%

Post‐prostate biopsy acute bacterial prostatitis and screening cultures using selective media: An overview

et al. 2022

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The development of several culture media and the availability to isolate and treat pathogens prior to a surgical procedure give us the ability to minimize treatmentrelated complications, and ultimately results in better outcomes for patients and avoidance of unwanted post-procedure inpatient admissions. In the last decade, an increasing incidence of multidrug-resistant Escherichia coli, especially extended-spectrum beta-lactamase-producing E. coli and fluoroquinolone-resistant pathogens, has been reported. These resistant species frequently colonize the rectal flora and gain access to the systemic circulation via the rectal plexus following a prostate biopsy. The bacteria can eventually lead to life-threatening complications, which is especially important in high-risk patients with multiple co-morbidities. Previously published studies have focused on the isolation of these pathogens with selective media before an invasive procedure and the potential benefits of incorporating the use of selective media as a mandatory pre-operative step. This preventive measure will allow us to offer a tailored prophylactic treatment that benefits patients and reduces the economic burden for the hospital.

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Selective culture of Escherichia coli to prevent infective complications of transrectal ultrasound‐guided prostate biopsy: Clinical efficacy and analysis of characteristics of quinolone‐resistant Escherichia coli

Cited by 9 publications

References 17 publications

Major post-prostate biopsy complications under antibiotic augmentation prophylaxis protocol

Major post-prostate biopsy complications under antibiotic augmentation prophylaxis protocol

Positive Culture Prior to Transperineal Prostate Biopsy Was Not Associated with Post-Biopsy Febrile Urinary Tract Infection Development

Post‐prostate biopsy acute bacterial prostatitis and screening cultures using selective media: An overview

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