Increasing Rate of Fluoroquinolone Resistant Escherichia Coli and Incidence of Infectious Complications Following TRUS Guided Prostate Biopsy in Calgary, Alberta, Canada - A Retrospective Analysis
CUA Online Library. Rudzinski J. 06/25/13; 31333; MP-08.03
CLICK HERE TO LOGIN
REGULAR CONTENT
REGULAR CONTENT
Login now to access Regular content available to all registered users.
Abstract
Rate & Comment (0)
Introduction: Increasing risk of infectious complications associated with colonic Escherichia coli (E.coli) following trans-rectal ultrasound guided prostate biopsy (TRUS-PB) has been observed. Fluoroquinolone (FQ) antibiotics are used as the first line prophylaxis prior to TRUS-PB. We sought to evaluate whether increasing E.coli resistance correlates with increased incidence in infectious complications following TRUS-PB at our institution.
Methods: We conducted an electronic health record review of 927 patients who underwent TRUS-PB between January and July 2012 in Calgary. The variables collected prospectively included patient age, pre-biopsy PSA, and date of biopsy. We documented presentation to the emergency department (ED) within 30 days of TRUS-PB for infectious complications, such as: urinary tract infections (UTI), prostatitis, and sepsis/bacteremia. For patients seen in the ED, we analyzed blood and urine cultures results, as well as antibiotic susceptibility and resistance rates.
Results: 41 patients (4.4%) were assessed in the ED due to post TRUS-PB infectious complications within 30 days post-biopsy. The most common infectious complication was sepsis in 22 patients (2.3%), followed by UTI in 9 (0.9%), and prostatitis in 4 (0.4%). Of the 22 septic patients, blood culture results showed FQ resistance in 15 (68%). 15 patients were septic due to E. coli; 13 ciprofloxacin resistant and 2 ciprofloxacin susceptible strains. One patient had sepsis due to FQ susceptible Klebsiella oxytoca. Remaining three were septic with FQ resistant Bacterioides fragils, Klebsiella pneumonia, and Comamonas species. 3 patients were diagnosed with sepsis, but had negative blood cultures. All of the UTIs were due to ciprofloxacin resistant E.coli.
Conclusion: Our results suggest increased incidence of infectious complications due to FQ resistant organisms following TRUS-PB, which could be attributed to increasing community resistance to ciprofloxacin.
Methods: We conducted an electronic health record review of 927 patients who underwent TRUS-PB between January and July 2012 in Calgary. The variables collected prospectively included patient age, pre-biopsy PSA, and date of biopsy. We documented presentation to the emergency department (ED) within 30 days of TRUS-PB for infectious complications, such as: urinary tract infections (UTI), prostatitis, and sepsis/bacteremia. For patients seen in the ED, we analyzed blood and urine cultures results, as well as antibiotic susceptibility and resistance rates.
Results: 41 patients (4.4%) were assessed in the ED due to post TRUS-PB infectious complications within 30 days post-biopsy. The most common infectious complication was sepsis in 22 patients (2.3%), followed by UTI in 9 (0.9%), and prostatitis in 4 (0.4%). Of the 22 septic patients, blood culture results showed FQ resistance in 15 (68%). 15 patients were septic due to E. coli; 13 ciprofloxacin resistant and 2 ciprofloxacin susceptible strains. One patient had sepsis due to FQ susceptible Klebsiella oxytoca. Remaining three were septic with FQ resistant Bacterioides fragils, Klebsiella pneumonia, and Comamonas species. 3 patients were diagnosed with sepsis, but had negative blood cultures. All of the UTIs were due to ciprofloxacin resistant E.coli.
Conclusion: Our results suggest increased incidence of infectious complications due to FQ resistant organisms following TRUS-PB, which could be attributed to increasing community resistance to ciprofloxacin.
Introduction: Increasing risk of infectious complications associated with colonic Escherichia coli (E.coli) following trans-rectal ultrasound guided prostate biopsy (TRUS-PB) has been observed. Fluoroquinolone (FQ) antibiotics are used as the first line prophylaxis prior to TRUS-PB. We sought to evaluate whether increasing E.coli resistance correlates with increased incidence in infectious complications following TRUS-PB at our institution.
Methods: We conducted an electronic health record review of 927 patients who underwent TRUS-PB between January and July 2012 in Calgary. The variables collected prospectively included patient age, pre-biopsy PSA, and date of biopsy. We documented presentation to the emergency department (ED) within 30 days of TRUS-PB for infectious complications, such as: urinary tract infections (UTI), prostatitis, and sepsis/bacteremia. For patients seen in the ED, we analyzed blood and urine cultures results, as well as antibiotic susceptibility and resistance rates.
Results: 41 patients (4.4%) were assessed in the ED due to post TRUS-PB infectious complications within 30 days post-biopsy. The most common infectious complication was sepsis in 22 patients (2.3%), followed by UTI in 9 (0.9%), and prostatitis in 4 (0.4%). Of the 22 septic patients, blood culture results showed FQ resistance in 15 (68%). 15 patients were septic due to E. coli; 13 ciprofloxacin resistant and 2 ciprofloxacin susceptible strains. One patient had sepsis due to FQ susceptible Klebsiella oxytoca. Remaining three were septic with FQ resistant Bacterioides fragils, Klebsiella pneumonia, and Comamonas species. 3 patients were diagnosed with sepsis, but had negative blood cultures. All of the UTIs were due to ciprofloxacin resistant E.coli.
Conclusion: Our results suggest increased incidence of infectious complications due to FQ resistant organisms following TRUS-PB, which could be attributed to increasing community resistance to ciprofloxacin.
Methods: We conducted an electronic health record review of 927 patients who underwent TRUS-PB between January and July 2012 in Calgary. The variables collected prospectively included patient age, pre-biopsy PSA, and date of biopsy. We documented presentation to the emergency department (ED) within 30 days of TRUS-PB for infectious complications, such as: urinary tract infections (UTI), prostatitis, and sepsis/bacteremia. For patients seen in the ED, we analyzed blood and urine cultures results, as well as antibiotic susceptibility and resistance rates.
Results: 41 patients (4.4%) were assessed in the ED due to post TRUS-PB infectious complications within 30 days post-biopsy. The most common infectious complication was sepsis in 22 patients (2.3%), followed by UTI in 9 (0.9%), and prostatitis in 4 (0.4%). Of the 22 septic patients, blood culture results showed FQ resistance in 15 (68%). 15 patients were septic due to E. coli; 13 ciprofloxacin resistant and 2 ciprofloxacin susceptible strains. One patient had sepsis due to FQ susceptible Klebsiella oxytoca. Remaining three were septic with FQ resistant Bacterioides fragils, Klebsiella pneumonia, and Comamonas species. 3 patients were diagnosed with sepsis, but had negative blood cultures. All of the UTIs were due to ciprofloxacin resistant E.coli.
Conclusion: Our results suggest increased incidence of infectious complications due to FQ resistant organisms following TRUS-PB, which could be attributed to increasing community resistance to ciprofloxacin.
Code of conduct/disclaimer available in General Terms & Conditions
{{ help_message }}
{{filter}}