Keywords
biopsy
bacteriemia
antibiotic prophylaxis
antimicrobial drug resistance
How to Cite
Abstract
Objective: To identify fluoroquinolone resistance in rectal swabs before transrectal prostate biopsy.
Materials and Methods: We reviewed clinical charts of patients who uderwent transrectal prostate biopsy between May 2011 and August 2013. We obtained a rectal swab one week before the procedure. Intake of fluoroquinolones 6 months before the biopsy was evaluated. Antibiotic prophylaxis was adjusted according the swab as follows: if it was resistant to fluoroquinolones the patient received ceftriaxone 1 g in one take, otherwise the patient received ciprofloxacine 500 mg 1 hour before the procedure and two times a day per 5 days. The follow-up was carried on during the first week before the procedure using a phone interview and during the first month with a scheduled appointment. We used the statistical software STATA 11.0.
Results: A total of 761 patients underwent transrectal prostate biopsy, 554 patients had rectal swab, 254 showed resistant rectal swab, in whom 153 received Ciprofloxacin 6 months after the procedure, 7 % of all the patients presented bacteremia. None of the patients with Ceftriaxon as antibiotic prophylaxis presented bacteremia nor sepsis.
Conclusions: Performing rectal swabs before biopsy is an useful stategy to identify the presence of fluoroquinolone resistant organisms, which allows to use a target antibiotic profilaxis and decrease the risk of bacteremia and infectious complications after biopsy.
Hodge KK, McNeal JE, Stamey TA. Ultrasound
guided transrectal core biopsies
of the palpably abnormal prostate. J Urol.
;142:66.
Tal R, Livne PM, Lask DM et al. Empirical
management of urinary tract
infections complicating transrectal ultrasound
guided prostate biopsy. J Urol.
;169:1762.
Patel U, Kirby R. Infections after prostate
biopsy and antibiotic resistance. BJU Int.
;101:1201.
Sejnau IJE, Daza Almendrales F, Plata
Salazar M et al. Perfil microbiológico
y resistencia antibiótica en las
bacteriemias postbiopsia transrectal de
próstata en el Hospital Universitario Fundación
Santa Fe. Urol Colomb [internet].
;17(2):27-34. Disponible en: http://
www.urologiacolombiana.com/revistas/
agosto-2008/006.pdf
Velasco Valencia DK, Fornasini M. Bacteriemia
en pacientes sometidos a biopsia
de próstata: perfil bacteriológico y
patrones de susceptibilidad antibiótica.
Estudio realizado en el Hospital Carlos
Andrade Marín. Quito: USFQ; 2009.
Liss MA, Chang A, Santos M et al.
Prevalence and significance of fluoroquinolone
resistant Escherichia coli in patients
undergoing transrectal ultrasound
guided prostate needle biopsy. J Urol.
;185(4):1283-8.
Dindo D, Demartines N, Clavien PA.
Classification of surgical complications:
A new proposal with evaluation in a cohort
of 6336 patients and results of a survey.
Ann Surg. 2004;240:205-13.
Terris MK. Prostate biopsy strategies:
past, present, and future. Urol Clin North
Am. 2002;29:205-12.
Mian BM. Prostate biopsy strategies:
current state of the art. J Natl Compr
Canc Netw. 2004;2:213-22.
Ramírez M. Estrategias para la biopsia
de próstata: revisión de la literatura.
Servicio de Urología. Hospital Universitario
la Fe. Valencia. Actas Urol Esp.
;31(10):1089-99.
Silva B, Hidalgo JP, Aroca P et al. ¿Es
necesario el enema rectal en la biopsia de
próstata? Revista Chilena de Urología.
;72(3):250-3.
Jeon SS, Woo SH, Hyun JH et al.. Bisacodyl
rectal preparation can decrease
infectious complications of transrectal
ultrasound-guided prostate biopsy. Urology.
;62:461-6.
Feliciano J, Teper E, Ferrandino M et al.
The incidence of fluoroquinolone resistant
infections after prostate biopsy- are
fluoroquinolones still effective prophylaxis?
J Urol. 2008;179:952-5.
Wolf JS, Bennett CJ, Dmochowski RR et
al. Best practice policy statement on urologic
surgery antimicrobial prophylaxis.
J Urol. 2008;179:1379.
Aron M, Rajeev TP, Gupta NP. Antibiotic
prophylaxis for transrectal needle biopsy
of the prostate: A randomized controlled
study. BJU Int. 2000;85:682.
Plata M, Trujillo CG. Tendencias en la
preparación y realización de la ecografía
transrectal de próstata y biopsia en Colombia.
Censo Urologico nacional. Urol
Colomb. 2010;XIX(3):77-84.
Taylor H, Bingham JB. Antibiotic prophylaxis
for transrectal prostate biopsy. J
Antimicrob Chemother. 1997;39(2):115-
Schaeffer A. The impact of collateral
damage on urological care. J
Urol. 2012;187:1527-8. doi:10.1016/
juro.2012.02.009.
Batura D. Prevalence of antimicrobial
resistance in intestinal flora of patients
undergoing prostatic biopsy: implications
for prophylaxis and treatment
of infections after biopsy. BJU Int.
;106:1017.
This journal is registered under a Creative Commons Attribution 4.0 International Public License. Thus, this work may be reproduced, distributed, and publicly shared in digital format, as long as the names of the authors and Pontificia Universidad Javeriana are acknowledged. Others are allowed to quote, adapt, transform, auto-archive, republish, and create based on this material, for any purpose (even commercial ones), provided the authorship is duly acknowledged, a link to the original work is provided, and it is specified if changes have been made. Pontificia Universidad Javeriana does not hold the rights of published works and the authors are solely responsible for the contents of their works; they keep the moral, intellectual, privacy, and publicity rights.
Approving the intervention of the work (review, copy-editing, translation, layout) and the following outreach, are granted through an use license and not through an assignment of rights. This means the journal and Pontificia Universidad Javeriana cannot be held responsible for any ethical malpractice by the authors. As a consequence of the protection granted by the use license, the journal is not required to publish recantations or modify information already published, unless the errata stems from the editorial management process. Publishing contents in this journal does not generate royalties for contributors.