Rectal Swabs for Detecting Multidrug Resistant Bacteria Prior to Transrectal Prostate Fusion Biopsy: A Prospective Evaluation of Risk Factor Screening and Microbiologic Findings

Würnschimmel, Christoph; Martin, L.; Leyh-Bannurah, Sami-Ramzi; Oh‐Hohenhorst, Su Jung; Kachanov, Mykyta; Maurer, Tobias; Knipper, Sophie; Graefen, Markus; Budäus, Lars

doi:10.1016/j.urology.2019.10.008

Cited by 5 publications

(4 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The last study in literature which investigated FQ-R prevalence in rectal swab was conducted by Würnschimmel et al in Germany in 2019. According to this study, FQ-R E.coli was found in 12 (6%) patients out of 200 patients [16] . In our study we did not have rectal swab, so we do not have an FQ-R prevalence rate in the intestinal flora.…”

Section: Discussionmentioning

confidence: 49%

Evaluation of patients with urinary tract infection after transrectal ultrasound guided prostate biopsy

Kutluhan¹

2019

Haydarpasa Numune Med J

View full text Add to dashboard Cite

Introduction: This study aims to evaluate the patients who developed urinary tract infection after transrectal ultrasoundguided prostate biopsy and to determine antibiotic resistance profiles in urinary cultures after prostate biopsy. Methods: Between 2015 and 2019, 892 patients who underwent transrectal ultrasound-guided prostate biopsy because of suspected rectal examination and/or increased PSA level were retrospectively reviewed. Urine cultures of all patients before biopsy were sterile. All patients received oral ciprofloxacin prophylaxis, starting three days before prostate biopsy. Standard 12 quadrant prostate biopsies were performed to all patients. Forty-five patients who were admitted to the hospital again due to fever, dysuria or sepsis were included in this study. In these cases, microorganisms and resistance status were investigated. Results: Forty patients had complaints of dysuria, 17 patients had fever with tremors, and one patient had sepsis. No prostate abscess was detected on ultrasound. The rate of urinary tract infection after ciprofloxacin prophylaxis was 5.04% and 1.90% of the patients had fever after prostate biopsy. Reproduction was detected in 77,7% of urine cultures performed after the biopsy. The most commonly isolated microorganisms were Escherichia coli (71.4%), Klebsiella pneumoniae (20%), and Staphylococcus spp (8.5%), respectively. Blood culture was obtained from 37.7% of the patients, and the reproduction rate was 64.7%. E. coli was the most frequently isolated agent in blood culture. In urine culture, methicillin resistance in staphylococci was 66.6%, Extended Spectrum Beta-Lactamase (ESBL) rate in E. coli was 56%, ciprofloxacin resistance was 91,4%, trimethoprim-sulfamethoxazole resistance was 54.2% and gentamicin resistance was 25.7%. Discussion and Conclusion: Nearly all patients who developed urinary tract infection after prostate biopsy had ciprofloxacinresistant microorganisms in urine cultures. Targeted antibiotic use can be considered to reduce post-biopsy infection. Also, alternative agents as prophylaxis can be used.

show abstract

Section: Discussionmentioning

confidence: 49%

Evaluation of patients with urinary tract infection after transrectal ultrasound guided prostate biopsy

Kutluhan¹

2019

Haydarpasa Numune Med J

View full text Add to dashboard Cite

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

“…Dem gegenüber stehen Screening-basierte PAP(„targeted prophylaxis“)-Strategien als vielversprechender Ansatz, um eine testgerechte periprozedurale PAP durchzuführen und Reserveantibiotika einzusparen. Hier werden präinterventionell Rektalabstriche entnommen und auf Resistenzen gegenüber ausgewählten PAP-Substanzen gescreent [ 8 , 12 , 25 , 27 – 29 , 31 ]. Dieses Screening relevanter PAP-Substanzen ist im klinischen Alltag nicht etabliert, da kommerzielle Selektivmedien fehlen.…”

Section: Diskussion Und Limitationenunclassified

Antibiotikaprophylaxe bei transrektaler Prostatabiopsie

Rothe

Querbach

Busch

et al. 2021

Urologe

View full text Add to dashboard Cite

Zusammenfassung Hintergrund Die transrektale Prostatastanzbiopsie (TRPB) gehört zu den häufigsten interventionell-urologischen Eingriffen in Deutschland. Es wird leitliniengerecht eine kurzeitige periprozedurale Antibiotikaprophylaxe (PAP) empfohlen. Die Indikationsrücknahme von Fluorchinolonen als PAP-Substanz durch das Bundesinstitut für Arzneimittel und Medizinprodukte macht die Verwendung alternativer Substanzen notwendig. Ziele Im Rahmen der Studie wurde die klinische Praxis der PAP bei TRPB mit Fokus auf infektiöse Komplikationen im Vergleich zwischen Fluorchinolon- und Cotrimoxazol-PAP evaluiert. Methodik Es handelt sich um eine retrospektive monozentrische Auswertung klinischer Routinedaten von Patienten mit TRPB zwischen 03.01.2019 und 28.01.2021. Ergebnisse Es wurden 508 erwachsene männliche Patienten eingeschlossen, das mediane Alter betrug 68 Jahre. 55,9 % erhielten eine Cotrimoxazol-PAP, 40,0 % eine Fluorchinolon-PAP. Insgesamt traten in 5,5 % postinterventionelle Komplikationen auf, davon 50,0 % infektiöse Komplikationen. Der Vergleich von Cotrimoxazol- und Fluorchinolon-PAP ergab keinen Unterschied der Komplikationsraten. Bei aufgrund von Komplikationen durchgeführten mikrobiologischen Urinuntersuchungen zeigten sich Erregernachweise mit Resistenz gegenüber der zuvor eingesetzten PAP im Sinne einer Selektion. Schlussfolgerung Eine Cotrimoxazol-PAP für TRPB ist verglichen mit dem bisherigen Standard einer Fluorchinolon-PAP nicht mit vermehrt infektiösen Komplikationen assoziiert. Die präinterventionelle Analyse von Keimspektrum und Resistenz ermöglicht den Einsatz einer gezielten Prophylaxe und kann somit Komplikationen reduzieren.

show abstract

Rectal Swabs for Detecting Multidrug Resistant Bacteria Prior to Transrectal Prostate Fusion Biopsy: A Prospective Evaluation of Risk Factor Screening and Microbiologic Findings

Cited by 5 publications

References 25 publications

Evaluation of patients with urinary tract infection after transrectal ultrasound guided prostate biopsy

Evaluation of patients with urinary tract infection after transrectal ultrasound guided prostate biopsy

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

Antibiotikaprophylaxe bei transrektaler Prostatabiopsie

Contact Info

Product

Resources

About