Rectal cleansing with povidone-iodine before transrectal ultrasound guided prostate biopsy was safe, but the 42% relative risk reduction of infectious complications was not statistically significant. Patients who have received ciprofloxacin within 3 months of transrectal ultrasound guided prostate biopsy should be considered for alternate prophylaxis or possibly a delay of biopsy beyond 3 months.

S.T. and J.M. contributed equally to this work.What's known on the subject? and What does the study add?• Transrectal ultrasound guided prostate biopsies (TRUSBx) are associated with a spectrum of complications, including most significantly infection, which affects up to 5% of patients. In the most severe cases, infection leads to sepsis, a life-threatening complication. Escherichia coli is the primary responsible pathogen. Although antibiotic prophylaxis with fluoroquinolones is routinely used, there is evidence that the infection rate after TRUSBx is increasing, and this appears to be due to an increasing prevalence of ciprofloxacin-resistant rectal flora.• This is the largest prospective clinical trial to date analysing the rectal flora of men undergoing prostate biopsies. We determined the microbial and antibiotic sensitivity profiles from 849 patients. Ciprofloxacin-resistant Gram-negative organisms were identified in the rectal flora of 19.0% of men. Furthermore, fluoroquinolone use within 6 months preceding a TRUSBx and the presence of a prosthetic heart valve were significant predictors of ciprofloxacin resistance on rectal swab. Determining the prevalence of rectal fluoroquinolone resistance has important implications in evaluation of the suitability of prophylactic regimens. Antimicrobial profiles derived from rectal swabs pre-biopsy may prove useful in guiding targeted antibiotic prophylaxis. Objectives• To establish the prevalence of ciprofloxacin-resistant bacteria in patients undergoing transrectal ultrasound guided prostate biopsies (TRUSBx) and to determine whether this predicts subsequent infectious complications.• To identify risk factors for harbouring ciprofloxacin-resistant flora. Patients and Methods• Any patient undergoing a TRUSBx from 2009 to 2011 was eligible for enrolment in this prospective study.• Pre-biopsy rectal and urine cultures and post-biopsy urine cultures were obtained and antimicrobial susceptibility was determined.• Univariate and multivariate analyses were performed to identify independent patient risk factors associated with ciprofloxacin-resistant rectal flora. Results• A total of 865 patients underwent TRUSBx, of whom 19.0% were found to have ciprofloxacin-resistant Gram-negative coliforms.• Escherichia coli was the most prevalent Gram-negative rectal isolate (80.9%) and accounted for 90.6% of ciprofloxacin resistance. • Patient characteristics that conferred an increased risk of harbouring ciprofloxacin-resistant organisms included a history of a heart valve replacement (P < 0.05) and ciprofloxacin use in the past 3 months (P < 0.05).• Infectious complications were observed in 3.6% (n = 31) of the patient population and 48% of these patients grew ciprofloxacin-resistant organisms on the pre-biopsy rectal swab (P < 0.001). Conclusions• Antimicrobial resistance to ciprofloxacin in the rectal flora was common, particularly in patients with recent ciprofloxacin use and a heart valve replacement.• Despite a significant correlation between those patients who developed infec...

Colonization of fluoroquinolone resistant organisms in the rectum identifies men at high risk for infection and subsequent hospitalization from prostate biopsy, especially in those with fluoroquinolone prophylaxis only.

Male-induced estrus was examined in montane (Microtus montanus), meadow (M. pennsylvanicus), prairie (M. ochrogaster), and pine (M. pinetorum) voles. Duration of male contact needed for receptivity, effects of parity, and vaginal cytology were assessed. Among nulliparous females, montane voles attained receptivity with less male contact than prairie voles. Meadow and pine voles showed very low receptivity rates. Among parous females, montane and meadow voles did not differ in duration of male contact needed for receptivity and required less than prairie voles. Overall, parous females had higher receptivity rates than nulliparous females. When isolated from males, prairie and pine voles had more leukocytes and fewer cornified cells in vaginal smears than montane or meadow voles. Species differences in estrus induction are discussed in relation to species differences in social organization.

This study was designed to determine testes masses, total number of spermatozoa ejaculated per copulatory episode, and the pattern of sperm numbers in successive ejaculates in prairie voles (Microtus ochrogaster), montane voles (M. montanus), pine voles (M. pinetorum), and meadow voles (M. pennsylvanicus). Prairie voles displayed mean totals of 2.7 ejaculations and 30.5 X 10(6) spermatozoa before reaching a satiety criterion; montane voles 3.4 ejaculations and 19.0 X 10(6) spermatozoa, pine voles 2.4 ejaculations and 3.3 X 10(6) spermatozoa, and meadow voles 2.5 ejaculations and 25.5 X 10(6) spermatozoa. In all species the number of spermatozoa decreased in successive ejaculates. Significant species differences were noted for the total number of spermatozoa ejaculated and number of spermatozoa ejaculated in each of the first 3 ejaculates. Species differences also were noted for testes mass, with meadow voles having the largest testes and pine voles having the smallest. These data can be compared to similar data on laboratory rats and deer mice and related to recent theory regarding sperm numbers, testes sizes, and mating systems. In general, the species with large testes appear to ejaculate more spermatozoa. The significance of species differences in testes mass and total sperm numbers remains unclear, but may relate to the occurrence of multiple mating by females during a single receptive period.