Infection is one of the common complications of post-prostate biopsy. Therefore, prophylaxis with fluoroquinolones and/or cephalosporins is recommended. We aimed to evaluate the prevalence of antibiotic-resistant bacteria isolated from rectal swabs in candidates for transrectal ultrasound-guided (TRUS) biopsy. The possible patient’s related risk factors attributing to resistance to antibiotics were also assessed.
Methods:
This cross-sectional study was performed on 126 male patients who were candidates for TRUS biopsy. Rectal swabs were collected and the samples were transferred to the laboratory in Amies transport medium during 2 hours and cultured on MacConkey agar with ciprofloxacin 1 mg/L and ciprofloxacin-resistant strains were identified. Kirby-Bauer disc diffusion method was used to determine the antibiotic susceptibility of the isolates.
Results:
In total, 59 bacterial isolates were obtained, which were Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa, respectively, in terms of frequency. They showed the lowest resistance to levofloxacin. Smoking was associated with positive culture results. Age was a factor with a significant effect on carrying ciprofloxacin-resistant strains.
Conclusion:
Ciprofloxacin resistance was high in almost all strains, but post-biopsy infectious complications were very low.
CarlssonSVVickersAJ. Screening for prostate cancer. Med Clin North Am2020; 104: 1051–1062.
2.
GrummetJGorinMAPopertR, et al. ‘TREXIT 2020’: Why the time to abandon transrectal prostate biopsy starts now. Prostate Cancer Prostatic Dis2020; 23(1): 62–65.
3.
ShariatSFRoehrbornCG. Using biopsy to detect prostate cancer. Rev Urol2008; 10: 262–280.
4.
ThurtleDStarlingLLeonardK, et al. Improving the safety and tolerability of local anaesthetic outpatient transperineal prostate biopsies: A pilot study of the CAMbridge PROstate Biopsy (CAMPROBE) method. J Clin Urol2018; 11(3): 192–199.
5.
ChamberlandRR. Cutting to the core of the issue: Emerging strategies to reduce prostate biopsy-related infections. J Clin Microbiol2016; 54(10): 2431–2435.
6.
LissMAPeeplesANPetersonEM. Detection of fluoroquinolone-resistant organisms from rectal swabs by use of selective media prior to a transrectal prostate biopsy. J Clin Microbiol2011; 49(3): 1116–1118.
7.
KimJBJungSIHwangEC, et al. Prevalence of antibiotic-resistant bacteria on rectal swabs and factors affecting resistance to antibiotics in patients undergoing prostate biopsy. Korean J Urol2014; 55(3): 201–206.
8.
DuplessisCABavaroMSimonsMP, et al. Rectal cultures before transrectal ultrasound-guided prostate biopsy reduce post-prostatic biopsy infection rates. Urology2012; 79(3): 556–561.
9.
TaylorAKZembowerTRNadlerRB, 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 Urol2012; 187(4): 1275–1279.
10.
NaberKGSörgelF. Antibiotic therapy – Rationale and evidence for optimal drug concentrations in prostatic and seminal fluid and in prostatic tissue. Andrologia2003; 35(5): 331–335.
11.
JohnsonJRPolgreenPMBeekmannSE. Transrectal prostate biopsy-associated prophylaxis and infectious complications: Report of a query to the Emerging Infections Network of the Infectious Diseases Society of America. Open Forum Infect Dis2015; 2(1): ofv002.
12.
FelicianoJTeperEFerrandinoM, et al. The incidence of fluoroquinolone resistant infections after prostate biopsy – Are fluoroquinolones still effective prophylaxis?J Urol2008; 179: 952–955; discussion 955.
13.
SimeWTBiazinHZelekeTA, et al. Urinary tract infection in cancer patients and antimicrobial susceptibility of isolates in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. PLoS ONE2020; 15(12): e0243474.
14.
BurdenHPRanasingheWPersadR. Antibiotics for transrectal ultrasonography-guided prostate biopsy: Are we practising evidence-based medicine. BJU Int2008; 101(10): 1202–1204.
15.
NamRKSaskinRLeeY, et al. Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy. J Urol2013; 189: S12–S17; discussion S78.
16.
WilliamsonDABarrettLKRogersBA, et al. Infectious complications following transrectal ultrasound-guided prostate biopsy: New challenges in the era of multidrug-resistantEscherichia coli. Clin Infect Dis2013; 57(2): 267–274.
17.
AbebeMTadesseSMeseretG, et al. Type of bacterial isolates and antimicrobial resistance profile from different clinical samples at a Referral Hospital, Northwest Ethiopia: Five years data analysis. BMC Research Notes2019; 12: 568.
18.
van LeendersGJLHvan der KwastTHGrignonDJ, et al. The 2019 International Society of Urological Pathology (ISUP) consensus conference on grading of prostatic carcinoma. Am J Surg Pathol2020; 44: e87–e99.
19.
CheesbroughM. District laboratory practice in tropical countries. Cambridge: Cambridge University Press, 2006.
20.
RusantiRRSri RejekiIP. Resistance of Escherichia coli from rectal swab culture in hemato-oncology wards, Dr. Soetomo Hospital, Surabaya. Folia Medica Indonesiana2015; 51: 193–195.
21.
AbughoshZMargolickJGoldenbergSL, et al. A prospective randomized trial of povidone-iodine prophylactic cleansing of the rectum before transrectal ultrasound guided prostate biopsy. J Urol2013; 189: 1326–1331.
22.
HooperDCWolfsonJS. The fluoroquinolones: Pharmacology, clinical uses, and toxicities in humans. Antimicrob Agents Chemother1985; 28(5): 716–721.
23.
NoreikaiteJJonesPFitzpatrickJ, et al. Fosfomycin vs. quinolone-based antibiotic prophylaxis for transrectal ultrasound-guided biopsy of the prostate: A systematic review and meta-analysis. Prostate Cancer Prostatic Dis2018; 21(2): 153–160.
24.
MinamidaSSatohTTabataK, et al. Prevalence of fluoroquinolone-resistant Escherichia coli before and incidence of acute bacterial prostatitis after prostate biopsy. Urology2011; 78: 1235–1239.
25.
LissMAChangASantosR, et al. Prevalence and significance of fluoroquinolone resistant Escherichia coli in patients undergoing transrectal ultrasound guided prostate needle biopsy. J Urol2011; 185(4): 1283–1288.
26.
BuckBFumoDAroraK, et al. Ciprofloxacin-resistant bacteria on pre-prostate biopsy rectal swab culture: A Northwest Ohio Study. Surg Infect2018; 19(6): 614–617.
27.
SteenselsDSlabbaertKDe WeverL, et al. 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 Infect2012; 18(6): 575–581.
28.
ChangDTChallacombeBLawrentschukN. Transperineal biopsy of the prostate – Is this the future?Nat Rev Urol2013; 10: 690–702.
