Rising Incidence of Acute Prostatitis Following Prostate Biopsy: Fluoroquinolone Resistance and Exposure Is a Significant Risk Factor

Mosharafa, Ashraf A.; Torky, Mohamed H.; Said, Wael M. El; Meshref, Alaa

doi:10.1016/j.urology.2011.04.064

Cited by 90 publications

(52 citation statements)

References 15 publications

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“…In our study, E. coli was the pathogen isolated most frequently from patients with infectious complications of prostate biopsy, which was consistent with previous findings [15,20,26,27]. Soto et al investigated the association of in vitro biofilm formation by strains of E. coli with their ability to cause cystitis, pyelonephritis, or prostatitis, and found that the strains causing prostatitis produced biofilms in vitro more frequently than did those causing cystitis and pyelonephritis, and that this was associated with a higher frequency of expression of the virulence factor hemolysin [28].…”

Section: Discussionsupporting

confidence: 93%

“…As a result, the incidence of prostate biopsy-associated UTI has decreased from 4.7%-5.4% to 0.90%. Recent studies in the literature have reported varying incidence rates of post-biopsy UTI or sepsis, ranging from 0.5% to 9.3% [8,14,[18][19][20][21]. Some methods have been investigated for reducing infectious complications of prostate biopsy.…”

Section: Discussionmentioning

confidence: 99%

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Febrile Infection in Post-Prostate Biopsy: Results of a Ten-Year Single-Institution Study in South Taiwan

Tsai

Chen²,

Jou

et al. 2014

Surgical Infections

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Background: Post-biopsy infection is one of the major concerns of urologists and patients for prostate biopsy. Many efforts have been made to reduce the infection rate. We conducted a study at a single institution with the goal of describing the bacteriology and incidence trends of febrile infections following trans-rectal ultrasound (TRUS)-guided biopsy of the prostate. (Period 4), 1,406 patients underwent prostate biopsy at our hospital. All biopsies were conducted under TRUS guidance without preparation by enemas. Several steps were taken to reduce infectious complications following biopsy, including a shift to levofloxacin prophylaxis starting from Period 3 of our study and thorough instructions in post-biopsy self-care starting from the beginning of Period 4. The incidence and bacteriology of urinary tract infection (UTI) following the prostate biopsies were reviewed from chart records. Results: Twenty-eight of 514 (5.4%), 13 of 276 (4.7%) nine of 274 (3.2%), and three of 342 (0.9%) patients had postbiopsy febrile infections during the four periods of the study, respectively. Fifteen of 28 (53.5%), four of 13 (30.8%), five of nine (55.6%), and zero of three patients, respectively, had positive cultures of blood, urine, or both during the four study periods. Escherichia coli was the pathogen isolated most commonly and ampicillinand fluoroquinolone-resistant strains of this organism were identified at a high frequency. The times to onset of fever after biopsy in the four study periods were 1.5 -1.3 d, 3.7 -2.7 d, 2.2 -1.6 d, and 2.5 -0.9 d, respectively. Conclusions: Ampicillin-and fluoroquinolone-resistant strains of E. coli were the uropathogenic bacteria identified most commonly after prostate biopsy at our hospital. The incidence of UTI following prostate biopsy can be reduced by explaining instructions for medication and self-care thoroughly to patients undergoing such biopsy.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Febrile Infection in Post-Prostate Biopsy: Results of a Ten-Year Single-Institution Study in South Taiwan

Tsai

Chen²,

Jou

et al. 2014

Surgical Infections

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“…and Staphylococcus aureus are observed most frequently. [9] The increasing prevalence of gram-positive pathogens may represent a change in the epidemiology of the disease due to treatment. In some cases, prostatitis is caused by atypical pathogens.…”

Section: Discussionmentioning

confidence: 99%

Prostate Biopsy Related Acute Bacterial Prostatitis: Current Microbiological Spectrum, Sensitivity to Antibiotics And Clinical Findings In Turkey

Türk

Ün

Şener

et al. 2018

EJMO

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“…In most studies, E. coli represented almost 90% and more of recovered isolates and more than 80% were resistant to fluoroquinolones [3,10,14,21,22,23,24]. …”

Section: Discussionmentioning

confidence: 99%

The Value of Rectal Cultures in Treatment of Sepsis Following Post-Transrectal Ultrasound-Guided Prostate Biopsy

et al. 2015

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Background: Cases with sepsis after transrectal ultrasound-guided prostate biopsy (TRUSPB) were documented, with special focus on cultures and susceptibility of isolates. We also evaluated the contribution of concomitant rectal cultures to the treatment of selective cases. Materials and Methods: Patients with sepsis after TRUSPB were followed prospectively. Manifestations and risk factors for antimicrobial resistance were documented. Results of urine and blood cultures and antimicrobial susceptibility were recorded for all participating patients. In 40 patients, rectal swab cultures were obtained concomitantly. Results: Ninety-five patients were consecutively studied. Sepsis symptoms started showing up within 48 h after biopsy in 93% of patients. At least one of the cultures was positive in 72 patients. E. coli grew in 70 cases; isolates were highly resistant: 67% displayed multidrug-resistance. Rectal cultures grew E. coli in 38 cases. In patients with positive E. coli in rectum and in at least one additional culture (blood and/or urine), the antibiogram was identical in all cases but one. Eight cases had negative cultures. Conclusion: The prevalence of antimicrobial resistance among E. coli isolates from patients with TRUSPB sepsis was alarming. Susceptibilities of rectal E. coli isolates used for deescalation of initial empiric treatment in culture-negative TRUSPB sepsis can contribute to the reduction of broad-spectrum antibiotics exposure.

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Rising Incidence of Acute Prostatitis Following Prostate Biopsy: Fluoroquinolone Resistance and Exposure Is a Significant Risk Factor

Cited by 90 publications

References 15 publications

Febrile Infection in Post-Prostate Biopsy: Results of a Ten-Year Single-Institution Study in South Taiwan

Febrile Infection in Post-Prostate Biopsy: Results of a Ten-Year Single-Institution Study in South Taiwan

Prostate Biopsy Related Acute Bacterial Prostatitis: Current Microbiological Spectrum, Sensitivity to Antibiotics And Clinical Findings In Turkey

The Value of Rectal Cultures in Treatment of Sepsis Following Post-Transrectal Ultrasound-Guided Prostate Biopsy

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