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Incidence of Urinary Tract Infection Following Transrectal Ultrasound Guided Prostate Biopsy at a Tertiary-Care Medical Center in Lebanon

Published online by Cambridge University Press:  02 January 2015

Zaher K. Otrock ,
Gerard O. Oghlakian ,
Mariana M. Salamoun ,
Maurice Haddad  and
Abdul Rahman N. Bizri
Zaher K. Otrock
Affiliation:
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Gerard O. Oghlakian
Affiliation:
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Mariana M. Salamoun
Affiliation:
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Maurice Haddad
Affiliation:
Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
Abdul Rahman N. Bizri*
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
*
Infection Control Committee/Program, Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Lebanon, e-mail: [email protected]
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Abstract

Objective:

To determine the incidence of urinary tract infections (UTIs) following transrectal ultrasound guided needle biopsy of the prostate (TRUBP) and the bacteriology of these infections.

Design:

Retrospective evaluation of the charts and records of all patients who underwent TRUBP between June 1, 2002, and August 31, 2003.

Setting:

American University of Beirut Medical Center, a tertiary-care center in Lebanon.

Patients:

Two hundred seven patients underwent TRUBP. All received prophylactic antibiotics. One hundred twenty (58%) received ciprofloxacin alone, whereas 87 (42%) received both ciprofloxacin and gentamicin. Sixty-one patients (29.5%) had an enema prior to the procedure, whereas 146 (70.5%) did not.

Results:

Thirteen patients (6.3%) were admitted with UTI. All had rigors and fever on admission. Symptoms appeared at a mean of 2.7 days and the mean hospital stay was 9.2 days. The mean duration of antibiotic treatment was 23.2 days. Ten (77%) of the patients had positive bacteriology. Urine cultures were positive in 8 (61.5%) of the patients and blood cultures in 6 (46.2%). All positive cultures grew Escherichia coli resistant to ciprofloxacin, with 5 isolates producing extended-spectrum beta-lactamases.

Conclusions:

TRUBP continues to be associated with significant infectious complications, especially UTI. Given the increasing incidence of antibiotic resistance mainly among the Enterobacteriaceae, antimicrobial prophylaxis practices should be reevaluated and the universal administration of quinolones alone or in combination with aminoglycosides should be reconsidered.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 10 , October 2004 , pp. 873 - 877
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004 

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References

1. Griffiths, K, Denis, L, Turkes, A, Morton, MS. Phytoestrogens and diseases of the prostate gland. Baillieres Clinical Endocrinology and Metabolism 1998;12:625–647.10.1016/S0950-351X(98)80008-6Google Scholar
2. Ghosn, M, Tannous, R, Gedeon, E. The cancer registry at the Hotel Dieu de France Hospital tin French. J Med Liban 1992;40:4–10.Google Scholar
3. Rodriguez, LV, Terris, MK. Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol 1998;160:2115–2120.10.1016/S0022-5347(01)62255-9Google Scholar
4. Naughton, CK, Miller, DC, Mager, DE, Ornstein, DK, Catalona, WJ. A prospective randomized trial comparing 6 versus 12 prostate biopsy cores: impact on cancer detection. J Urol 2000;164:388–392.10.1016/S0022-5347(05)67367-3Google Scholar
5. Davis, M, Sofer, M, Kim, SS, Soloway, MS. The procedure of transrectal ultrasound guided biopsy of the prostate: a survey of patient preparation and biopsy technique. J Urol 2002;167:566–570.Google Scholar
6. Sieber, PR, Rommel, FM, Agusta, VE, Breslin, JA, Huffnagle, HW, Harpster, LE. Antibiotic prophylaxis in ultrasound guided transrectal prostate biopsy. J Urol 1997;157:2199–2200.10.1016/S0022-5347(01)64716-5Google Scholar
7. Copien, DE, Andriole, GL, Yuan, JJ, Catalona, WJ. The ability of systematic transrectal ultrasound guided biopsy to detect prostate cancer in men with the clinical diagnosis of benign prostatic hyperplasia. J Urol 1991;146:75–77.Google Scholar
8. Tal, R, Livne, PM, Lask, DM, Baniel, J. Empirical management of urinary tract infections complicating transrectal ultrasound guided prostate biopsy. J Urol 2003;169:1762–1765.10.1097/01.ju.0000061280.23447.29Google Scholar
9. Carey, JM, Korman, HJ. Transrectal ultrasound guided biopsy of the prostate: do enemas decrease clinically significant complications? J Urol 2001;166:82–85.Google Scholar
10. Taylor, HM, Bingham, JB. Antibiotic prophylaxis for transrectal prostate biopsy. J Antimicrob Chemother 1997;39:115–117.10.1093/jac/39.2.115Google Scholar
11. Shandera, KC, Thibault, GP, Deshon, GE Jr. Variability in patient preparation for prostate biopsy among American urologists. Urology 1998;52:644–646.10.1016/S0090-4295(98)00313-6Google Scholar
12. Roach, MB, Figueroa, TE, McBride, D, George, WJ, Neal, DE Jr. Ciprofloxacin versus gentamicin in prophylaxis against bacteremia in transrectal prostate needle biopsy. Urology 1991;38:84–87.Google Scholar
13. Kapoor, DA, Klimberg, IW, Malek, GH, et al. Single-dose oral ciprofloxacin versus placebo for prophylaxis during transrectal prostate biopsy. Urology 1998;52:552–558.Google Scholar
14. Vallancien, G, Prapotnich, D, Veillon, B, Brisset, JM, Andre-Bougaran, J. Systematic prostatic biopsies in 100 men with no suspicion of cancer on digital rectal examination. J Urol 1991;146:1308–1312.Google Scholar
15. Brown, RW, Warner, JJ, Turner, BI, Harris, LF, Alford, RH. Bacteremia and bacteriuria after transrectal prostatic biopsy. Urology 1981;18:145–148.10.1016/0090-4295(81)90425-8Google Scholar
16. Araj, GF, Kanj, SS. Current status and changing trends of antimicrobial resistance in Lebanon. J Med Liban 2000;48:221–226.Google Scholar
17. Bizri, AR, Hamadeh, GN, Musharrafieh, UM. The current status of antibiotic prescribing in ambulatory care: the Lebanese experience. J Med Liban 2001;49:257–264.Google Scholar
18. Sturenburg, E, Mack, D. Extended-spectrum beta-lactamases: implications for the clinical microbiology laboratory, therapy, and infection control. J Infect 2003;47:273–295.Google Scholar
19. Daoud, Z, Hakime, N. Prevalence and susceptibility patterns of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a general university hospital in Beirut, Lebanon [in Spanish]. Rev Esp Quimioter 2003;16:233–238.Google Scholar
20. Hamze, M, Dabboussi, F, Izard, D. Enterobacterial susceptibility to antibiotics in northern Lebanon (1998-2001) [in French], Sante 2003;13:107–112.Google Scholar
21. Sanderson, PJ. The role of methicillin-resistant Staphylococcus aureus in orthopaedic implant surgery. J Chemother 2001;13:89–95.Google Scholar
22. Hammond, CJ, Gill, J, Peto, TE, Cadoux-Hudson, TA, Bowler, IC. Investigation of prevalence of MRSA in referrals to neurosurgery: implications for antibiotic prophylaxis. Br J Neurosurg 2002;16:550–554.Google Scholar
23. Hall, GE, Baddour, LM. Apparent failure of endocarditis prophylaxis caused by penicillin-resistant Streptococcus mitis . Am J Med Sci 2002;324:51–53.Google Scholar
24. Gilad, J, Borer, A, Maimon, N, Riesenberg, K, Klein, M, Schlaeffer, F. Failure of ciprofloxacin prophylaxis for ultrasound guided transrectal prostatic biopsy in the era of multiresistant enterobacteriaceae. J Urol 1999:161:222.10.1016/S0022-5347(01)62107-4Google Scholar