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Selective culture of Escherichia coli to prevent infective complications of transrectal ultrasound‐guided prostate biopsy: Clinical efficacy and analysis of characteristics of quinolone‐resistant Escherichia coli
Author(s) -
Hiyama Yoshiki,
Takahashi Satoshi,
Uehara Teruhisa,
Ichihara Koji,
Hashimoto Jiro,
Matsukawa Masanori,
Taguchi Keisuke,
Kunishima Yasuharu,
Hotta Hiroshi,
Yanase Masahiro,
Itoh Naoki,
Hirose Takaoki,
Takeyama Koh,
Tachiki Hitoshi,
Masumori Naoya
Publication year - 2019
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13960
Subject(s) - medicine , escherichia coli , levofloxacin , prostate biopsy , antimicrobial , antibiotics , quinolone , microbiology and biotechnology , prostate , urology , biology , cancer , biochemistry , gene
Objectives To evaluate a regimen of targeted prophylaxis using rectal swab culture in patients undergoing transrectal ultrasound‐guided prostate biopsy, and to investigate the characteristics of isolated fluoroquinolone‐resistant Escherichia coli . Methods A prospective study was carried out from June 2013 through December 2014. Rectal swabs were cultured on agar plates containing either 2 μg/mL levofloxacin or 1 μg/mL sitafloxacin before transrectal ultrasound‐guided prostate biopsy. Patients with susceptible organisms received levofloxacin or sitafloxacin, whereas those with resistant organisms received directed antimicrobial prophylaxis according to the results of the antimicrobial susceptibility test. Patients with infectious complications after prostate biopsy were identified, and characteristics of patients carrying fluoroquinolone‐resistant Escherichia coli were analyzed. Results A total of 397 men underwent transrectal ultrasound‐guided prostate biopsy. Of these patients, 74 (18.6%) had fluoroquinolone‐resistant Escherichia coli . All fluoroquinolone‐resistant Escherichia coli were susceptible to amikacin and meropenem. The risk factor for possible fluoroquinolone‐resistant Escherichia coli was age of ≥73 years. Three (0.7%) patients who received appropriate antimicrobial prophylaxis had high‐grade fever after the prostate biopsy. However, the pathogens were not fluoroquinolone‐resistant Escherichia coli . Conclusions Targeted antimicrobial prophylaxis in patients undergoing transrectal ultrasound‐guided prostate biopsy can be associated with reducing severe infectious complications caused by fluoroquinolone‐resistant Escherichia coli .