G Gopal Rao1, Deepak Batura. 1. Department of Microbiology, North West London Hospitals NHS Trust, Watford Road, London, HA1 3UJ, UK.
Abstract
PURPOSE: To report the incidence of emergency admissions attributable to infective complications of transrectal ultrasound-guided prostate biopsy (TGB) and evaluate appropriateness of antimicrobial prophylaxis. METHODS: Retrospective cross-sectional study of patients undergoing TGB at the North West London Hospitals in 2009-2011. Demographic information of patients who had emergency admission within 30 days of TGB, length of hospital stay and microbiology results were obtained from the hospital's information system, medical records and laboratory information system. All patients received ciprofloxacin and amikacin prophylaxis. RESULTS: 1,419 TGB were performed in 1,276 patients. Forty-eight (3.3 %) patients had emergency admissions. Thirty-three (2.3 %) admissions were due to complications from TGB, while 15 (1 %) were for unrelated reasons. 30/33 (90 %, overall 2.1 %) of admissions from TGB complications were due to confirmed infections or systemic inflammatory response syndrome (SIRS). The rest were admitted with urinary retention. Admission rates due to TGB complications and infection/SIRS remained consistent over the 3 years (2009: TGB complications-2 %, TGB infection/SIRS-1.8 %; 2010: TGB complications-2.4 %, TGB infections/SIRS-2.2 %; 2011: TGB complications-2.6 %, TGB infection/SIRS-2.4 %; P > 0.05). All 11 cases with bacteraemia were caused by ciprofloxacin-resistant but amikacin-susceptible E. coli. CONCLUSIONS: We observed a consistent rate of emergency admissions for complications following TGB; 90 % of these were due to infections. Ciprofloxacin-resistant but amikacin-sensitive E. coli was isolated in all bacteriologically confirmed infections. These results suggest that infective complications of TGB cannot be altogether eliminated despite appropriate antimicrobial prophylaxis. Therefore, additional strategies for reduction in biopsy-related admissions due to infections have to be considered.
PURPOSE: To report the incidence of emergency admissions attributable to infective complications of transrectal ultrasound-guided prostate biopsy (TGB) and evaluate appropriateness of antimicrobial prophylaxis. METHODS: Retrospective cross-sectional study of patients undergoing TGB at the North West London Hospitals in 2009-2011. Demographic information of patients who had emergency admission within 30 days of TGB, length of hospital stay and microbiology results were obtained from the hospital's information system, medical records and laboratory information system. All patients received ciprofloxacin and amikacin prophylaxis. RESULTS: 1,419 TGB were performed in 1,276 patients. Forty-eight (3.3 %) patients had emergency admissions. Thirty-three (2.3 %) admissions were due to complications from TGB, while 15 (1 %) were for unrelated reasons. 30/33 (90 %, overall 2.1 %) of admissions from TGB complications were due to confirmed infections or systemic inflammatory response syndrome (SIRS). The rest were admitted with urinary retention. Admission rates due to TGB complications and infection/SIRS remained consistent over the 3 years (2009: TGB complications-2 %, TGBinfection/SIRS-1.8 %; 2010: TGB complications-2.4 %, TGB infections/SIRS-2.2 %; 2011: TGB complications-2.6 %, TGB infection/SIRS-2.4 %; P > 0.05). All 11 cases with bacteraemia were caused by ciprofloxacin-resistant but amikacin-susceptible E. coli. CONCLUSIONS: We observed a consistent rate of emergency admissions for complications following TGB; 90 % of these were due to infections. Ciprofloxacin-resistant but amikacin-sensitive E. coli was isolated in all bacteriologically confirmed infections. These results suggest that infective complications of TGB cannot be altogether eliminated despite appropriate antimicrobial prophylaxis. Therefore, additional strategies for reduction in biopsy-related admissions due to infections have to be considered.
Authors: D Steensels; K Slabbaert; L De Wever; P Vermeersch; H Van Poppel; J Verhaegen Journal: Clin Microbiol Infect Date: 2011-09-29 Impact factor: 8.067
Authors: Daniel Portalez; Pierre Mozer; François Cornud; Raphaëlle Renard-Penna; Vincent Misrai; Matthieu Thoulouzan; Bernard Malavaud Journal: Eur Urol Date: 2012-06-27 Impact factor: 20.096
Authors: Brian T Helfand; Stacy Loeb; Qiaoyan Hu; Phillip R Cooper; Kimberly A Roehl; Barry B McGuire; Nikola A Baumann; William J Catalona Journal: J Urol Date: 2013-02-27 Impact factor: 7.450
Authors: David M Livermore; Dorothy James; Mark Reacher; Catriona Graham; Thomas Nichols; Peter Stephens; Alan P Johnson; Robert C George Journal: Emerg Infect Dis Date: 2002-05 Impact factor: 6.883
Authors: Hosam M Zowawi; Patrick N A Harris; Matthew J Roberts; Paul A Tambyah; Mark A Schembri; M Diletta Pezzani; Deborah A Williamson; David L Paterson Journal: Nat Rev Urol Date: 2015-09-01 Impact factor: 14.432
Authors: Demis N Lipe; Phillip B Mann; Rodrick Babakhanlou; Maria T Cruz Carreras; A Guido Hita; Monica K Wattana Journal: Emerg Med Int Date: 2021-07-27 Impact factor: 1.112