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Transrectal ultrasound‐guided biopsy sepsis and the rise in carbapenem antibiotic use
Author(s) -
Leahy Olivia R.,
O'Reilly Mary,
Dyer David R.,
Phillips David,
Grummet Jeremy P.
Publication year - 2015
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12933
Subject(s) - medicine , sepsis , antibiotics , carbapenem , biopsy , radiology , intensive care medicine , microbiology and biotechnology , biology
Abstract Background This study sought to determine the number of hospital admissions for sepsis following transrectal ultrasound‐guided ( TRUS ) biopsy, and the rate of both prophylactic and therapeutic use of carbapenem antibiotics for TRUS biopsy, at a single institution. Methods A retrospective review of prospectively collected data from the medical records electronic database of C abrini H ealth, a private metropolitan hospital, was queried for coding of admissions under any admitting urologist for sepsis and prostate‐related infections from 2009 to 2012. Records were examined for whether a TRUS biopsy had been performed within 14 days prior and if a therapeutic carbapenem was required. The database also queried the use of carbapenems as prophylaxis in patients undergoing TRUS biopsy. Results Of the 63 admissions for TRUS biopsy sepsis, multi‐drug‐resistant organisms were isolated from 26 (41%). Twenty‐three admissions were from the 1937 patients who underwent a TRUS biopsy at C abrini (a sepsis rate of 1.2%) and 40 were following TRUS biopsies at other centres. Thirty‐seven (58.7%) patients received therapeutic carbapenems either empirically, or after culture results. Of the 1937 C abrini TRUS biopsy patients, 154 (8%) were given a carbapenem as prophylaxis, with a rapid increase in prophylactic use over the 4 years studied from 0.25% to 13%. Conclusion This study did not show evidence of an increasing rate of hospital admissions for TRUS biopsy sepsis at this institution. However, there was a dramatic uptake in prophylactic administration of carbapenems. Increasing carbapenem use may contribute to development of carbapenem‐resistant bacteria. Alternative methods of prostate biopsy that avoid sepsis should be considered.