Outcomes of Fecal Carriage of Extended-spectrum β-Lactamase After Transrectal Ultrasound–guided Biopsy of the Prostate

Tigen, Elif Tükenmez; Tandoğdu, Zafer; Ergönül, Önder; Altinkanat, Gulsen; Günaydın, Bilal; Özgen, Mahir Bülent; Sarıgüzel, Nevin; Şengel, Buket Ertürk; Odabaşı, Zekaver; Çek, Mete; Tokuç, Reşit; Türkeri, Levent; Mülazımoğlu, Lütfiye; Korten, Volkan

doi:10.1016/j.urology.2014.04.060

Cited by 31 publications

(23 citation statements)

References 21 publications

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“…Fluoroquinolone resistant organisms have been identified in 10-30% of patients undergoing rectal swab culture before PB 47,[49][50][51][52] , although rates of clinical infectious complications are lower at approximately 1-17.5% 7,45,46,48,[53][54][55][56][57] . Most infections are self-limiting and can be managed in the outpatient setting 7,45 .…”

Section: Infectious Complications and Hospitalization Rates After Promentioning

confidence: 99%

Complications After Systematic, Random, and Image-guided Prostate Biopsy

et al. 2017

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Evidence Synthesis: The most frequent complication after PB is minor and self-limiting bleeding (hematuria and hematospermia), irrespective of the biopsy approach. Occurrence of rectal bleeding was comparable among traditional TRUS-guided and image-guided PB. Almost 25% of patients experience lower urinary tract symptoms, but only a few have urinary retention, with higher rates after transperineal approach. Temporary erectile dysfunction is not negligible, with a return to baseline after 1-6 months. The incidence of infective complications is being increasing, with higher rates among men with medical comorbidities and older age. Transperineal and in-bore MRI targeted biopsy may reduce the risk of severe infectious complications. Mortality after PB is uncommon, irrespective of biopsy technique. Conclusions:Complications after PB are frequent but often self-limiting. The incidence of hospitalization due to severe infections is continuously increasing. Still, a careful appraisal of 3 patient's general health status, risk factors and likelihood of antimicrobial resistance should be done before scheduling a PB. Patient Summary:In this paper we reviewed the variety and incidence of complications after prostate biopsy. Even if frequent, seldom represent a problem for the patient. The most troublesome complications are infections. In order to minimize this risk, a careful evaluation of patient's medical condition must be done before biopsy.4

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Section: Infectious Complications and Hospitalization Rates After Promentioning

confidence: 99%

Complications After Systematic, Random, and Image-guided Prostate Biopsy

et al. 2017

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“…Each urologist must weigh the need for a prostate biopsy in relation to the risk, assess the individual risks factors including the risk of harbouring a resistant bacteria (e.g. ESBL) and consider the need for a rectal swab before the instrumentation [331].…”

Section: N41 Diagnostic Procedures 3n411 Transrectal Prostate Bmentioning

confidence: 99%

Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis

Amaral

Pereira

Rodrigues

et al. 2019

Porto Biomedical Journal

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Background: Urinary tract infection (UTI) is a common complication of spinal cord injury (SCI). Urodynamic testing is widely used for characterization of vesico-sphincteric dysfunction and for therapeutic orientation. As an invasive procedure, the risk of UTI is increased so, in some medical centers, antibiotic prophylaxis is instituted. Fosfomycin is one of the antibiotics used. Objective: The aim of this study was to evaluate the incidence of UTI after urodynamics in patients with SCI, under fosfomycin prophylaxis. Methods: Retrospective analysis was performed on patients with SCI, admitted to a rehabilitation center between January 2016 and June 2017, who underwent urodynamics studies under fosfomycin prophylaxis. Demographic data, risk factors for UTI—bacteriuria before urodynamics, high residual volume (>100 mL), bladder emptying method, vesico-sphincteric dyssynergia, and detrusor hyperactivity were analyzed. The incidence of UTI after urodynamics was evaluated. Results: The study included 84 patients, predominantly men 55 (65.5%). The mean age of the patients was 55.6 (18.9). Eleven (22.5%) had vesico-sphincteric dyssynergia, 32 (65.3%) detrusor hyperactivity and 22 (44.9%) had a high residual volume. Thirty-seven (44.1%) had asymptomatic bacteriuria before the urodynamics. Urinary complaints suggestive of UTI after urodynamics were observed in 2(2.4%) of patients, without significant bacteriuria and identification of bacterial agent. Conclusions: The incidence of UTI after invasive procedures is reported between 3% and 20% in the literature, so antibiotic prophylaxis has been instituted, although controversial. In the study, in none of the patients the diagnosis of UTI was confirmed. Fosfomycin prophylaxis may have been important in reducing the incidence of UTI.

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“…reported that the rate of sepsis after a prostate biopsy was 0.07% . However, an increase in infectious diseases caused by ESBL‐producing bacteria has recently been reported . Notably, a febrile UTI after the examination can be serious and life threatening, thus an urgent response is necessary.…”

Section: Sepsis and Mortalitymentioning

confidence: 99%

“…61 However, an increase in infectious diseases caused by ESBL-producing bacteria has recently been reported. 54,80,81 Notably, a febrile UTI after the examination can be serious and life threatening, thus an urgent response is necessary. Williamson et al found that 17 (36%) of 47 cases with E. coli bacteremia development after a transrectal biopsy received inappropriate empiric therapy, of which 12 (25%) were regarded as serious and requiring admission to the intensive care unit.…”

Section: Prevention Without Antibioticsmentioning

confidence: 99%

Prevention of infectious complications after prostate biopsy procedure

Togo

Yamamoto

2017

Int J of Urology

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Although febrile complications are rarely encountered after a prostate biopsy procedure, in recent years the number of cases of fatal infection after that have increased along with increases in resistant bacteria. The available biopsy approaches are transrectal and transperineal, with the transrectal approach primarily used. As the invasion path of the puncture needle differs between these approaches, pretreatment and the method of administration of preventive antimicrobial drugs should be separately considered for infection prevention. Recently, the Japanese guidelines for perioperative infection prevention in the field of urology were revised after receiving approval from the Japanese Urological Association. With use of the transrectal approach, attempts have been made to selectively administer prophylactic antibiotics by confirming the presence or absence of resistant bacteria in rectal swab culture results before carrying out a prostate biopsy procedure because of potential problems associated with resistant bacteria in rectal flora. For preventive antibiotics, a single dose of oral quinolone is recommended for patients with low risk, whereas daily administrations of piperacillin/ tazobactam are recommended for those considered to be high risk. In contrast, for the transperineal procedure, a single dose of oral quinolone is recommended as a preventive antibiotic. With both approaches, it is important to empirically administer broad-spectrum antimicrobials when occurrence of a febrile infection after a prostate biopsy procedure is confirmed.

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Outcomes of Fecal Carriage of Extended-spectrum β-Lactamase After Transrectal Ultrasound–guided Biopsy of the Prostate

Cited by 31 publications

References 21 publications

Complications After Systematic, Random, and Image-guided Prostate Biopsy

Complications After Systematic, Random, and Image-guided Prostate Biopsy

Urinary tract infection in patients with spinal cord injury after urodynamics under fosfomycin prophylaxis: a retrospective analysis

Prevention of infectious complications after prostate biopsy procedure

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