PURPOSE: To evaluate the risk factors and efficacy of a povidone-iodine enema on infectious complications after transrectal ultrasound-guided prostate biopsy. METHODS: A total of 814 males who underwent transrectal ultrasound-guided prostate biopsy from January 2011 to December 2013 were evaluated retrospectively. Clinical variables, including demographics, prior antibiotic, or quinolone exposure, rectal swab culture results, povidone-iodine rectal cleansing, antibiotic prophylaxis, and infectious complications, were evaluated. RESULTS: Overall, 16 of 814 (2.0%) patients developed infectious complications after prostate biopsy. Of the patients with infectious complications, five had fever, two had urinary tract infections, and nine had bacteremia or sepsis. Infectious complication rates were not significantly different between povidone-iodine rectal cleansing (n = 613) and no cleansing (n = 201) groups (1.5 vs. 3.5%, p = 0.083). However, povidone-iodine rectal cleansing reduced severe infectious complications such as bacteremia and sepsis (0.3 vs. 3.5%, p = 0.001). A rectal swab culture was performed in 552 patients, and extended-spectrum β-lactamase (ESBL)-producing and quinolone-resistant Escherichia coli were detected in 4.5 and 7.8% of cultures, respectively. Quinolone and antibiotic exposure within 6 months prior to prostate biopsy were associated with quinolone resistance and ESBL positivity of rectal flora and infectious complications. CONCLUSIONS: In the era of quinolone resistance, a povidone-iodine enema may reduce the infectious complication rate by reducing bacterial load. Quinolone exposure prior to prostate biopsy was a risk factor for antibiotic resistance to rectal flora and infectious complications.
PURPOSE: To evaluate the risk factors and efficacy of a povidone-iodine enema on infectious complications after transrectal ultrasound-guided prostate biopsy. METHODS: A total of 814 males who underwent transrectal ultrasound-guided prostate biopsy from January 2011 to December 2013 were evaluated retrospectively. Clinical variables, including demographics, prior antibiotic, or quinolone exposure, rectal swab culture results, povidone-iodine rectal cleansing, antibiotic prophylaxis, and infectious complications, were evaluated. RESULTS: Overall, 16 of 814 (2.0%) patients developed infectious complications after prostate biopsy. Of the patients with infectious complications, five had fever, two had urinary tract infections, and nine had bacteremia or sepsis. Infectious complication rates were not significantly different between povidone-iodine rectal cleansing (n = 613) and no cleansing (n = 201) groups (1.5 vs. 3.5%, p = 0.083). However, povidone-iodine rectal cleansing reduced severe infectious complications such as bacteremia and sepsis (0.3 vs. 3.5%, p = 0.001). A rectal swab culture was performed in 552 patients, and extended-spectrum β-lactamase (ESBL)-producing and quinolone-resistant Escherichia coli were detected in 4.5 and 7.8% of cultures, respectively. Quinolone and antibiotic exposure within 6 months prior to prostate biopsy were associated with quinolone resistance and ESBL positivity of rectal flora and infectious complications. CONCLUSIONS: In the era of quinolone resistance, a povidone-iodine enema may reduce the infectious complication rate by reducing bacterial load. Quinolone exposure prior to prostate biopsy was a risk factor for antibiotic resistance to rectal flora and infectious complications.
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: J Stuart Wolf; Carol J Bennett; Roger R Dmochowski; Brent K Hollenbeck; Margaret S Pearle; Anthony J Schaeffer Journal: J Urol Date: 2008-02-20 Impact factor: 7.450
Authors: Dong Soo Park; Jin Ho Hwang; Don Kyung Choi; In Hyuck Gong; Young Kwon Hong; Sujin Park; Jong Jin Oh Journal: Surg Infect (Larchmt) Date: 2014-05-19 Impact factor: 2.150
Authors: Aisha K Taylor; Teresa R Zembower; Robert B Nadler; Marc H Scheetz; John P Cashy; Diana Bowen; Adam B Murphy; Elodi Dielubanza; Anthony J Schaeffer Journal: J Urol Date: 2012-02-16 Impact factor: 7.450
Authors: Michael A Liss; Alexandra Chang; Rosanne Santos; Amy Nakama-Peeples; Ellena M Peterson; Kathryn Osann; John Billimek; Richard J Szabo; Atreya Dash Journal: J Urol Date: 2011-02-22 Impact factor: 7.450
Authors: Ji Won Ryu; Seung Il Jung; Ji Hoon Ahn; Eu Chang Hwang; Ho Song Yu; Taek Won Kang; Dong Deuk Kwon; Kwangsung Park; Jin Woong Kim Journal: Int Urol Nephrol Date: 2016-08-05 Impact factor: 2.370