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Pokes, Pathogens, and Primum Non Nocere: Prudent Prophylaxis Protocols for Prostate Biopsy

Published online by Cambridge University Press:  02 January 2015

Sarah M. Drawz*
Affiliation:
University of Minnesota, Minneapolis, Minnesota
James R. Johnson
Affiliation:
University of Minnesota, Minneapolis, Minnesota Veterans Affairs Medical Center, Minneapolis, Minnesota
*
Department of Lab Medicine and Pathology, MMC 609, 420 Delaware Street SE, Minneapolis, MN 55455 ([email protected])

Extract

Infectious complications following transrectal ultrasound-guided biopsy of the prostate (TRUBP)—including urinary tract infections, prostatitis, epididymo-orchitis, and bacteremia—have increased dramatically in recent years. Traditionally, fluoroquinolones have been the mainstay for perioperative prophylaxis. Likely as a result of a combination of this selective pressure and temporal shifts in the clonal composition of the rectal microbiota, most post-TRUBP infections today are caused by fluoroquinolone-resistant Escherichia coli, especially those from sequence type 131 (ST131), an emerging multidrug-resistant strain that is highly prevalent among pre-TRUBP rectal isolates. Clinicians need improved approaches for preventing these complications. Fortunately, helpful guidance is beginning to appear.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1.Nam, RK, Saskin, R, Lee, Y, et al.Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy. J Urol 2010;183(3):963968.Google Scholar
2.Loeb, S, Carter, HB, Berndt, SI, Ricker, W, Schaeffer, EM. Complications after prostate biopsy: data from SEER-Medicare. J Urol 2011;186(5):18301834.Google Scholar
3.Williamson, DA, Barrett, LK, Rogers, BA, Freeman, JT, Hadway, P, Paterson, DL. Infectious complications following transrectal ultrasound-guided prostate biopsy: new challenges in the era of multidrug-resistant Escherichia coli. Clin Infect Dis 2013;57:267274.Google Scholar
4.Zaytoun, OM, Vargo, EH, Rajan, R, Berglund, R, Gordon, S, Jones, JS. Emergence of fluoroquinolone-resistant Escherichia coli as cause of postprostate biopsy infection: implications for prophylaxis and treatment. Urology 2011;77(5):10351041.Google Scholar
5.Liss, MA, Peterson, EM, Johnston, B, Osann, K, Johnson, JR. Prevalence of ST131 among fluoroquinolone-resistant Escherichia coli obtained from rectal swabs before transrectal prostate biopsy. Urology 2013;81(3):548555.Google Scholar
6.Williamson, DA, Roberts, SA, Paterson, DL, et al.Escherichia coli bloodstream infection after transrectal ultrasound-guided prostate biopsy: implications of fluoroquinolone-resistant sequence type 131 as a major causative pathogen. Clin Infect Dis 2012; 54(10):14061412.Google Scholar
7.Suwantarat, N, Dumford, DM III, Ponce-Terashima, R, et al.Modification of antimicrobial prophylaxis based on rectal culture results to prevent fluoroquinolone-resistant Escherichia coli infections after prostate biopsy. Infect Control Hosp Epidemiol 2013;34:973976 (in this issue).Google Scholar
8.Duplessis, CA, Bavaro, M, Simons, MP, et al.Rectal cultures before transrectal ultrasound-guided prostate biopsy reduce post-pro-static biopsy infection rates. Urology 2012;79(3):556561.CrossRefGoogle ScholarPubMed
9.Taylor, AK, Zembower, TR, Nadler, RB, et al.Targeted antimicrobial prophylaxis using rectal swab cultures in men undergoing transrectal ultrasound guided prostate biopsy is associated with reduced incidence of postoperative infectious complications and cost of care. J Urol 2012;187(4):12751279.CrossRefGoogle ScholarPubMed
10.Mosharafa, AA, Torky, MH, El Said, WM, Meshref, A. Rising incidence of acute prostatitis following prostate biopsy: fluoroquinolone resistance and exposure is a significant risk factor. Urology 2011;78(3):511514.Google Scholar
11.Steensels, D, Slabbaert, K, De Wever, L, Vermeersch, P, Van Poppel, H, Verhaegen, J. Fluoroquinolone-resistant E. coli in intestinal flora of patients undergoing transrectal ultrasound-guided prostate biopsy: should we reassess our practices for antibiotic prophylaxis? Clin Microbiol infect 2011;18(6):575581.Google Scholar
12.Young, JL, Liss, MA, Szabo, RJ. Sepsis due to fluoroquinolone-resistant Escherichia coli after transrectal ultrasound-guided prostate needle biopsy. Urology 2009;74(2):332338.Google Scholar
13.Wolf, JS Jr, Bennett, CJ, Dmochowski, RR, Hollenbeck, BK, Pearle, MS, Schaeffer, AJ. Best Practice Policy Statement on Urologie Surgery Antimicrobial Prophylaxis. Linthicum, MD: American Uro-logical Association, 2008. http://www.auanet.org/common/pdf/education/clinical-guidance/An timicrobial-Prophylaxis.pdf. Accessed May 19, 2013.Google Scholar
14.Zani, EL, Clark, OA, Rodrigues Netto, N Jr. Antibiotic prophylaxis for transrectal prostate biopsy. Cochrane Database Syst Rev 2011(5):CD006576.Google Scholar
15.Zaytoun, OM, Anil, T, Moussa, AS, Jianbo, L, Fareed, K, Jones, JS. Morbidity of prostate biopsy after simplified versus complex preparation protocols: assessment of risk factors. Urology 2011; 77(4):910914.Google Scholar
16.Moyer, VA. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2012;157(2):120134.Google Scholar
17.Carter, HB, Albertsen, PC, Barry, MJ, et al.Early Detection of Prostate Cancer: AUA Guideline. Linthicum, MD: American Urological Association, 2013. https://www.auanet.org/common/pdf/education/clinical-guidance/Prostate-Cancer-Detection.pdf. Accessed May 19, 2013.Google Scholar