Prevalence of Fluoroquinolone-Resistant Enterobacteriaceae in the Normal Rectal Flora of Patients Undergoing Transrectal Prostate Biopsy in Phramongkutklao Hospital, Thailand

Abstract

Objectives: To study the prevalence of fluoroquinolone-resistant and extended spectrum β-lactamase-producing isolates at Phramongkutklao Hospital, Thailand, and to identify the risk factors predicting the carriage of these organisms. Methods: Menundergoing transrectal ultrasound-guided prostate biopsy were prospectively enrolled between February and October2015. Rectal swab culture was obtained before antimicrobial prophylaxis andprostate biopsy. Univariate and multivariate analyses were performed to identify the independent risk factors associated with antimicrobial-resistant flora. Results: In total, 99 patients underwent biopsy, of whom 38 (38.4%) had antimicrobial-resistant rectal flora,with 26 (26.3%) having fluoroquinolone-resistant rectal flora and12 (12.1%) having both fluoroquinolone-resistant rectal flora and extended spectrum β-lactamase.The incidence of postbiopsy infections was 6.1%. The use of antibiotics in the past 6 months was found in 23.7% of the resistant group vs.6.6% of the sensitive group(odds ratio = 4.86,p= 0.030),with the previous biopsy history being 31.6% and14.8% (odds ratio = 3.17, p= 0.036),respectively. Postbiopsy infectionsoccurred in13.2% and1% (odds ratio = 10.69,p= 0.045) of patients in the resistant and sensitive groups, respectively. Conclusions: The prevalence offluoroquinolone-resistant rectal flora increased in patients undergoing transrectal prostate biopsyat Phramongkutklao Hospital, Thailand. A history of antibiotics in the past 6 months, previous biopsy, andpostbiopsy infections were associated with antimicrobialresistance. Culture-directed prophylaxis antibiotics may reduce postbiopsy infections after transrectal prostate biopsy.

Prostate-specific antigen age-specific reference ranges and the effect of metabolic syndrome factors in a Thai population Authors

“…3 In addition, prostate biopsy for cancer diagnosis is an invasive technique with numerous consequences such as bleeding and infection. 4 Two recent studies have shown multiple factors such as age, prostatitis, ejaculation, certain lifestyles, and comorbidities influence PSA level. 5,6 The age-specific PSA reference ranges were first given by Oesterling et al in 1993.…”