Ho Seok Chung1, Eu Chang Hwang1, Ho Song Yu1, Seung Il Jung1, Sun Ju Lee2, Dong Hoon Lim3, Won Jin Cho3, Hyun Sop Choe4, Seung-Ju Lee4, Sung Woon Park5. 1. Department of Urology, Chonnam National University Medical School, Gwangju, Korea. 2. Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea. 3. Department of Urology, Chosun University School of Medicine, Gwangju, Korea. 4. Department of Urology, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea. 5. Department of Urology, Kwangju Christian Hospital, Gwangju, Korea.
Abstract
OBJECTIVES: To estimate the prevalence of fluoroquinolone-resistant rectal flora in patients undergoing transrectal ultrasound-guided prostate needle biopsy and to identify the high-risk groups. METHODS: From January 2015 to March 2016, rectal swabs of 557 men who underwent transrectal ultrasound-guided prostate needle biopsy were obtained from five institutions. Clinical variables, including demographics, rectal swab culture results and infectious complications, were evaluated. Univariable and multivariable analyses were used to identify the risk factors for fluoroquinolone resistance of rectal flora and infectious complications. RESULTS: The incidence of fluoroquinolone-resistant and extended-spectrum beta-lactamase production was 48.1 and 11.8%, respectively. The most common fluoroquinolone-resistant bacteria was Escherichia coli (81% of total fluoroquinolone-resistant bacteria, 39% of total rectal flora), and 16 (2.9%) patients had infectious complications. Univariable and multivariable analysis of clinical parameters affecting fluoroquinolone resistance showed no factor associated with fluoroquinolone resistance of rectal flora. The clinical parameter related to infectious complications after prostate biopsy was a history of operation within 6 months (relative risk 6.60; 95% confidence interval 1.99-21.8, P = 0.002). CONCLUSIONS: These findings suggest that a risk-based approach by history taking cannot predict antibiotic resistance of rectal flora, and physicians should consider targeted antibiotic prophylaxis or extended antibiotic prophylaxis for Korean patients undergoing transrectal ultrasound-guided prostate biopsy because of high antibiotic resistance of rectal flora.
OBJECTIVES: To estimate the prevalence of fluoroquinolone-resistant rectal flora in patients undergoing transrectal ultrasound-guided prostate needle biopsy and to identify the high-risk groups. METHODS: From January 2015 to March 2016, rectal swabs of 557 men who underwent transrectal ultrasound-guided prostate needle biopsy were obtained from five institutions. Clinical variables, including demographics, rectal swab culture results and infectious complications, were evaluated. Univariable and multivariable analyses were used to identify the risk factors for fluoroquinolone resistance of rectal flora and infectious complications. RESULTS: The incidence of fluoroquinolone-resistant and extended-spectrum beta-lactamase production was 48.1 and 11.8%, respectively. The most common fluoroquinolone-resistant bacteria was Escherichia coli (81% of total fluoroquinolone-resistant bacteria, 39% of total rectal flora), and 16 (2.9%) patients had infectious complications. Univariable and multivariable analysis of clinical parameters affecting fluoroquinolone resistance showed no factor associated with fluoroquinolone resistance of rectal flora. The clinical parameter related to infectious complications after prostate biopsy was a history of operation within 6 months (relative risk 6.60; 95% confidence interval 1.99-21.8, P = 0.002). CONCLUSIONS: These findings suggest that a risk-based approach by history taking cannot predict antibiotic resistance of rectal flora, and physicians should consider targeted antibiotic prophylaxis or extended antibiotic prophylaxis for Korean patients undergoing transrectal ultrasound-guided prostate biopsy because of high antibiotic resistance of rectal flora.
Authors: Katarzyna Piekarska; Katarzyna Zacharczuk; Tomasz Wołkowicz; Mateusz Mokrzyś; Natalia Wolaniuk; Magdalena Nowakowska; Stanisław Szempliński; Jakub Dobruch; Rafał Gierczyński Journal: Ann Clin Microbiol Antimicrob Date: 2021-12-07 Impact factor: 3.944
Authors: Byung Chan Lee; Hyoung Ook Kim; Ho Seok Chung; Suk Hee Heo; Yong Yeon Jeong; Myung Soo Kim; Eu Chang Hwang; Seung Il Jung; Dongdeuk Kwon; Kwangsung Park Journal: Prostate Int Date: 2021-02-20