Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Reports suggest that fluoroquinolone (FQ)-resistant and ESBL-producing rectal flora are associated with infectious complications in men undergoing transrectal ultrasound-guided prostate needle biopsy (TRUS-B).
Objectives: We investigated the relationship between carriage of FQ-resistant and ESBL-producing and complex of the rectal flora, and the 30 day incidence rate of post-TRUS-B infectious complications.
Methods: From 1 January 2018 to 30 April 2019, rectal swabs of 361 patients were cultured pre-TRUS-B for FQ-resistant and ESBL-producing flora. Patients were followed up for 30 days for infectious complications post-biopsy. Multivariable logistic regression analyses were used to identify risk factors.
Results: Overall, 86.4% ( = 312/361) and 62.6% ( = 226/361) of patients carried FQ-resistant and ESBL-producing and complex, respectively. Approximately 60% ( = 289/483) of the FQ-resistant and 66.0% ( = 202/306) of the ESBL-positive isolates exhibited resistance to the pre-biopsy prophylactic antibiotic regimen of levofloxacin and gentamicin. Amikacin and meropenem were the most effective antibiotics against the MDR rectal and complex (78.7% and 84.3%, respectively). The 30 day incidence rate for post-biopsy infections was 3.1% ( = 11/361), with an overall high probability (96.9%) of staying free of infections within the 30 day period post-TRUS-B. Antibiotic use in the previous 3 months was a risk factor for rectal carriage of FQ-resistant and ESBL-positive isolates. Rectal colonization by ESBL-positive and complex comprised an independent risk factor for post-biopsy infectious complications.
Conclusions: The findings suggest that a change in prophylactic antibiotics to a more targeted regimen may be warranted in our institution.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9636584 | PMC |
| http://dx.doi.org/10.1093/jacamr/dlac113 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Significance of Targeted Antimicrobial Prophylaxis Using Rectal-culture Selective Screening Media Prior to Transrectal Prostate Biopsy: A Multicenter, Randomized Controlled Trial.
Urology
February 2025
Department of Urology, Shimane University Faculty of Medicine, Shimane, Japan; The Japanese Research Group for Urinary Tract Infection (JRGU), Nishinomiya, Japan.
Objective: To examine whether antimicrobial prophylaxis based on screening rectal cultures using selective media prevented acute bacterial prostatitis following transrectal prostate biopsy (TRPB).
Methods: In this multicenter, randomized controlled trial, we enrolled 403 patients undergoing TRPB with low risks of infectious complications. Patients were randomized into a cultured group (CG) or no cultured group (NCG).
Third nationwide surveillance of bacterial pathogens in patients with acute uncomplicated cystitis conducted by the Japanese surveillance committee during 2020 and 2021: Antimicrobial susceptibility of Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus.
J Infect Chemother
April 2024
Munakata Suikokai General Hospital, Fukuoka, Japan.
Article Synopsis
- A nationwide surveillance in Japan studied the antimicrobial susceptibility of bacteria in acute uncomplicated cystitis, focusing on E. coli, K. pneumoniae, and S. saprophyticus, between April 2020 and September 2021.
- The study isolated 823 bacterial strains from urine samples of 848 patients, with a majority being E. coli (92.9%), and determined susceptibility to 18 antibacterial agents.
- Results showed a concerning increase in fluoroquinolone-resistant E. coli and extended-spectrum β-lactamase (ESBL)-producing E. coli, especially in postmenopausal women, highlighting the need for clinicians to adapt their antibiotic choices due to rising resistance rates.
Occurrence and significance of fluoroquinolone-resistant and ESBL-producing and complex of the rectal flora in Ghanaian patients undergoing prostate biopsy.
JAC Antimicrob Resist
December 2022
Department of Surgery University of Ghana Medical School, PO Box 4236, Accra, Ghana.
Background: Reports suggest that fluoroquinolone (FQ)-resistant and ESBL-producing rectal flora are associated with infectious complications in men undergoing transrectal ultrasound-guided prostate needle biopsy (TRUS-B).
Objectives: We investigated the relationship between carriage of FQ-resistant and ESBL-producing and complex of the rectal flora, and the 30 day incidence rate of post-TRUS-B infectious complications.
Methods: From 1 January 2018 to 30 April 2019, rectal swabs of 361 patients were cultured pre-TRUS-B for FQ-resistant and ESBL-producing flora.
High prevalence of fluoroquinolone-resistant UTI among US emergency department patients diagnosed with urinary tract infection, 2018-2020.
Acad Emerg Med
September 2022
The David Geffen School of Medicine at UCLA, Chairman Emeritus, Dept. of Emergency Medicine, Faculty, Division of Infectious Diseases, Olive View-UCLA Medical Center, Sylmar, California, USA.
Background: Uropathogen resistance, fluoroquinolone-resistance (FQR), and extended spectrum beta-lactamase (ESBL), has been observed to be emerging worldwide with prevalences above recommended thresholds for routine empirical treatment. The primary aim of our study was to determine the prevalence of FQR from a geographically diverse sample of United States emergency departments (EDs).
Methods: We conducted a multi-center, observational cohort study using a network of 15 geographically diverse US EDs.
Trial Comparing a Combined Regimen of Amikacin and Ciprofloxacin to Ciprofloxacin Alone as Transrectal Prostate Biopsy Prophylaxis in the Era of High Fluoroquinolone-Resistant Rectal Flora.
J Korean Med Sci
April 2018
Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
Background: To investigate whether addition of amikacin to fluoroquinolone (FQ) antimicrobial prophylaxis reduces infections after transrectal ultrasound-guided prostate biopsy (TRUSPB).
Methods: A total of 503 patients undergoing rectal swab were divided into three groups. Patients with FQ-sensitive rectal flora (group 1, n = 248) were administered ciprofloxacin before TRUSPB, and patients with FQ-resistant rectal flora were either administered ciprofloxacin (group 2, n = 97) or amikacin and ciprofloxacin (group 3, n = 158) before TRUSPB.