Rectal E. coli above ciprofloxacin ECOFF associate with infectious complications following prostate biopsy

2018 ◽  
Vol 37 (6) ◽  
pp. 1055-1060 ◽  
Author(s):  
Inari Kalalahti ◽  
Kaisa Huotari ◽  
Kanerva Lahdensuo ◽  
Eveliina Tarkka ◽  
Henrikki Santti ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Infectious Complications ◽  
E Coli

scholarly journals Quinolone Prophylaxis in Transrectal Ultrasound Guided Prostate Biopsy: An Eight-Year Single Center Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Bing-Juin Chiang ◽  
Yeong Shiau Pu ◽  
Shiu-Dong Chung ◽  
Shih-Ping Liu ◽  
Hong-Jeng Yu ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Pipemidic Acid ◽  
Ultrasound Guided ◽  
E Coli ◽  
Single Center Experience ◽  
Significant Difference ◽  
Group A ◽  
Group B

We retrospectively evaluated the efficacy of prophylaxis with pipemidic acid and levofloxacin in transrectal ultrasound guided prostate biopsy (TRUSP-Bx). From January 2002 to December 2004, patients receiving oral pipemidic acid 500 mg twice daily for three days with or without a preoperative intravenous cefazolin 1 gm injection comprised group A. Between January 2005 and December 2009, patients receiving oral levofloxacin 500 mg one hour before biopsy comprised group B. We calculated the annual febrile urinary tract infection (fUTI) rates. Patients’ characteristics, including age, prophylactic antibiotics, biopsy core numbers, pathologic results, PSA, and the spectrums and susceptibility of pathogens, were also evaluated. A total of 1313 (35.5%) patients belonged to group A, while 2381 (64.5%) patients belonged to group B. Seventy-three patients experienced postoperative infectious complications. There was a significant difference in the fUTI rate between groups A and B (3.7% versus 1.0%,P<0.001). The yearly fUTI rates varied from 0.6 to 3.9% between 2002 and 2009. Of the 73 patients with fUTI, those receiving levofloxacin prophylaxis were more likely to harbor fluoroquinolone-resistant pathogens (P<0.001).E. coliwas the most common pathogen in both groups. Levofloxacin remains effective and appears superior to pipemidic acid based prophylaxis.

Effectiveness of standardized peri-operative protocol with combination of gentamicin and levofloxacin as prophylactic antibiotics on preventing infections after transrectal prostate biopsy: A retrospective study of 577 patients

2021 ◽  
Author(s):  
Heng-Chieh Chiang ◽  
Jesun Lin ◽  
Meng-Yi Yan ◽  
Chun-Chi Chen ◽  
Jian-Ting Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Culture ◽  
Prostate Biopsy ◽  
Urine Culture ◽  
Controlled Trial ◽  
Infectious Complications ◽  
Positive Urine Culture ◽  
Urine Retention ◽  
E Coli ◽  
Positive Urine

Abstract PurposeThis retrospective study to determine the effectiveness standardized peri-operative protocol in combination with prophylactic gentamicin and levofloxacin in preventing infectious complications after trans-rectal prostate biopsy.Material and MethodPatients were screened for prostate cancer at our out-patient department, either due to abnormal digital examination or elevated PSA level. Patients who underwent transrectal ultrasound (TRUS) guided prostate biopsy from January 2008 to December 2012 was included in this study. After using surgical code to identify the patients, charts were reviewed, and complications were recorded. Infectious complications were defined as any patient who experienced any signs systemic inflammatory response syndrome (SIRS) within 14 days after undergoing TRUS biopsy. Complications were graded according to Clavien-Dindo classification.ResultsOut of the 577 patients there were 20 patients (3.47 %) with infectious complications. Of the 20 patients with infectious complications, only four patients (0.7%) needed hospitalization due to bacteremia. Minor complications (i.e., hematuria, acute urine retention, hematospermia, etc.) were self-resolving. There were 9 positive urine culture and 4 positive blood culture with Escherichia coli (E. coli) as the predominant species. Three patients had positive urine culture for ciprofloxacin resistant strain, which was susceptible to 2nd an 3rd generation cephalosporin or amikacin. One patient had blood culture positive for extended-spectrum beta-lactamase (ESBL) E. coli infection, which was sensitive to amikacin. The infectious complication rate and number decrease each year without increase in resistant strain.ConclusionOur current peri-operative and post-operative protocol appears to be feasible in reducing infection complications after prostate biopsy; our complication and sepsis rate were similar compared to other English literatures. A prospective randomized controlled trial would be needed to determine if a single factor or a combination of several factors are responsible for the reduction in post-biopsy infections.

scholarly journals The molecular mechanisms of fluoroquinolone resistance found in rectal swab isolates of Enterobacterales from men undergoing a transrectal prostate biopsy: the rationale for targeted prophylaxis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Katarzyna Piekarska ◽  
Katarzyna Zacharczuk ◽  
Tomasz Wołkowicz ◽  
Mateusz Mokrzyś ◽  
Natalia Wolaniuk ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Molecular Mechanisms ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Quinolone Resistance ◽  
Fluoroquinolone Resistance ◽  
Oral Antibiotic ◽  
E Coli ◽  
Transrectal Prostate Biopsy ◽  
The Common

Abstract Background Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is considered an essential urological procedure for the histological diagnosis of prostate cancer. It is, however, considered a “contaminated” procedure which may lead to infectious complications. Recent studies suggest a significant share of fluoroquinolone-resistant rectal flora in post-biopsy infections. Methods The molecular mechanisms of fluoroquinolone resistance, including PMQR (plasmid-mediated quinolone resistance) as well as mutation in the QRDRs (quinolone-resistance determining regions) of gyrA, gyrB, parC and parE, among Enterobacterales isolated from 32 of 48 men undergoing a prostate biopsy between November 2015 and April 2016 were investigated. Before the TRUS-Bx procedure, all the patients received an oral antibiotic containing fluoroquinolones. Results In total, 41 Enterobacterales isolates were obtained from rectal swabs. The MIC of ciprofloxacin and the presence of common PMQR determinants were investigated in all the isolates. Nine (21.9%) isolates carried PMQR with qnrS as the only PMQR agent detected. DNA sequencing of the QRDRs in 18 Enterobacterales (E. coli n = 17 and E. cloacae n = 1) isolates with ciprofloxacin MIC ≥ 0.25 mg/l were performed. Substitutions in the following codons were found: GyrA—83 [Ser → Leu, Phe] and 87 [Asp → Asn]; GyrB codon—605 [Met → Leu], ParC codons—80 [Ser → Ile, Arg] and 84 [Glu → Gly, Met, Val, Lys], ParE codons—458 [Ser → Ala], 461 [Glu → Ala] and 512 [Ala → Thr]. Six isolates with ciprofloxacin MIC ≥ 2 mg/l had at least one mutation in GyrA together with qnrS. Conclusions This study provides information on the common presence of PMQRs among Enterobacterales isolates with ciprofloxacin MIC ≥ 0.25 mg/l, obtained from men undergoing TRUS-Bx. This fact may partially explain why some men develop post-TRUS-Bx infections despite ciprofloxacin prophylaxis.

scholarly journals MP57-12 THE IMPACT OF INFECTIOUS COMPLICATIONS AFTER PROSTATE BIOPSY ON RADICAL PROSTATECTOMY SURGICAL OUTCOMES: A POPULATION-BASED ANALYSIS

2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Daniel Olvera-Posada ◽  
Blayne Welk ◽  
J. Andrew McClure ◽  
Jennifer Winick-Ng ◽  
Jonathan I. Izawa ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Prostate Biopsy ◽  
Surgical Outcomes ◽  
Population Based ◽  
Infectious Complications ◽  
The Impact

scholarly journals Impact of Rectal Swabs on Infectious Complications after Transrectal Prostate Biopsy

2016 ◽  
Vol 97 (3) ◽  
pp. 340-346 ◽  
Author(s):  
Carlos Gustavo Trujillo ◽  
Mauricio Plata ◽  
Juan Ignacio Caicedo ◽  
Juan Guillermo Cataño Cataño ◽  
Angela Marcela Mariño Alvarez ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Infectious Complications ◽  
Rectal Swabs ◽  
Transrectal Prostate Biopsy

Infectious complications of prostate biopsy: winning battles but not war

2020 ◽  
Vol 38 (11) ◽  
pp. 2743-2753 ◽  
Author(s):  
Okan Derin ◽  
Limírio Fonseca ◽  
Rafael Sanchez-Salas ◽  
Matthew J. Roberts
Keyword(s):  
Prostate Biopsy ◽  
Infectious Complications

scholarly journals Complications of Prostate Biopsy: A Prospective, Single-institution Study

2020 ◽  
pp. 271-279
Author(s):  
Colette M. Antoine ◽  
Belinda F. Morrison ◽  
Michael E. Brooks
Keyword(s):  
Urinary Tract ◽  
Urinary Retention ◽  
Prostate Biopsy ◽  
Public Hospital ◽  
Retention Rate ◽  
Tertiary Care ◽  
Transrectal Ultrasound ◽  
Final Analysis ◽  
Infectious Complications ◽  
Prostate Biopsies

Aims:  This study aimed to determine the prevalence rates of transrectal ultrasound-guided prostate biopsy-related complications among patients receiving treatment at the large tertiary-care urology clinic of Kingston Public Hospital (KPH), Jamaica. Study Design: Prospective cohort study. Place and Duration of Study: Kingston Public Hospital (KPH), Jamaica from July 2018 to April 2019. Methodology: Our study population included men who underwent prostate biopsy at KPH. Data on demographics and clinical characteristics were collected using purpose-designed questionnaires from consenting patients who underwent prostate biopsy during the stated period. Patients were then followed up for complications 30 days post biopsy. Details regarding hospitalization due to biopsy-related complications were obtained from the medical records. Results: Data from 185 men were included in the final analysis. Among the patients biopsied, 49% were diagnosed with prostate cancer, while 72% experienced at least one complication, mainly non-infectious complications such as hematuria (46%), lower urinary tract symptoms (24%), rectal bleeding (23%), hematospermia (9%), and urinary retention (16%). Overall, a 15% risk of developing infectious complications was observed, with 9% experiencing fever and 3% experiencing both urinary tract infection and epididymo-orchitis. Our data showed a 6% hospitalization rate within 30 days, with all available records suggesting infectious complications. One death from a prostatic abscess was noted. The present study showed that most prostate biopsy complications were minor. Moreover, although bleeding and infectious complications as well as hospitalization rates were consistent with those reported in larger series, our population experienced a slightly higher mortality and urinary retention rate. Conclusion: Overall, our results showed that prostate biopsies performed within our institution are generally safe and well tolerated. Nonetheless, further studies are needed to determine whether morbidity of the procedure remains acceptable.

#10: Fever and neutropenia. 10 years surveillance in a pediatric Mexican hospital

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S15-S15
Author(s):  
E Sánchez-Medina ◽  
A Reyes-Hernández ◽  
A Severiano-Tellez
Keyword(s):  
Septic Shock ◽  
Defense Mechanisms ◽  
Antibiotic Use ◽  
Infectious Complications ◽  
E Coli ◽  
Pediatric Cancer Patients ◽  
Leukemia Treatment ◽  
Criteria For Diagnosis ◽  
Healthcare Associated ◽  
Epidemiologic Characteristics

Abstract Background Fever and neutropenia, is a very common complication of chemotherapy in the treatment of cancer. It could happen in 10–50% of patients with solid tumors and more than 80% of patients with blood cancer. During leukemia treatment is very important first defense mechanisms integrity, such as skin, mucous membranes, Tlaxcala Children’s Hospital is a pediatric general hospital, located in the center of Mexico and is where the pediatric cancer patients are treated, with almost 30 new cases by year, treatment with chemotherapy and as an adverse event fever and neutropenia, which increases morbidity and mortality Methods We conducted an observational, descriptive, and analytic study aiming to identify fever and neutropenic events in ALL patients, their epidemiologic characteristics, antibiotic use, isolation and antibiogram, and outcome. Results We reviewed 124 files from ALL patients between 2007–2017, we found 204 cases, 70 (33.8%) at induction, 18.6% consolidation, reinduction 17.6%, maintenance 14.2%. Out of 204 cases, we documented 177 with fever and neutropenia, 15 events of septic shock and 12 with fever and neutropenia with an identifiable source; the first-line antibiotic for fever and neutropenia was ceftazidime/amikacin, and for septic shock cefepime with an aminoglycoside, we found 3.39%, 20%, and 0% deaths from each group. Patients with fever and neutropenia with or without identifiable source had a length-stay average of 9.8 days compared with 30 days in patients with septic shock, CRP average was 12.47 mg/dL in the patients who survived and 8.23 mg/dL in those who did not. We found a very low positivity in cultures, and in most cases, those cultures did not meet criteria for diagnosis, the most common bacteria identified were E. coli, P. aeruginosa. Conclusions This is the first approach to get a better knowledge about infectious complications in patients with ALL, these findings could lead to identifying opportunities to improve diagnosis and treatment which lead to reducing cost, morbidity, healthcare-associated infections.

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