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Outcomes of Fecal Carriage of Extended-spectrum β-Lactamase After Transrectal Ultrasound-guided Biopsy of the Prostate.

Lookup NU author(s): Dr Zafer Tandogdu

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Abstract

OBJECTIVE: To determine the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (PE) fecal carriage in patients that undergo transrectal ultrasonography-guided biopsy (TRUSbx) and its relationship with post-biopsy infections. METHODS: A prospective clinical study in 4 different tertiary hospitals between 2008 and 2010 was conducted. Four hundred men with sterile urine who were to undergo a TRUSbx because of the suspicion of prostate cancer were included and followed for 14 days after biopsy. Rectal swab culture specimens were acquired immediately before the procedure. Demographic data, prophylaxis choice, quinolone or any other antibiotic consumption within the past 2 months, history of prostatitis, repeat biopsy, intensive care unit admission, hospitalization, urethral catheterization, diabetes mellitus (DM), and steroid usage were recorded. RESULTS: ESBL carriage was detected in 19% of patients and quinolone use within the last 2 months; other antibiotic use within the last 2 months and DM were found to be significantly associated (P <.05). Symptomatic urinary tract infection (UTI) on the third day after biopsy was seen in 9% of patients and was associated with fluoroquinolone (FQ) consumption before biopsy. Although ESBL-PE carriage was associated with post-biopsy UTI symptoms, it was not found to be associated with post-biopsy symptomatic UTI. Urosepsis was seen in 2 patients (0.5%) after biopsy, and both the patients were ESBL-PE carriers. CONCLUSION: The presence of ESBL-PE was associated with DM and FQ consumption before biopsy. ESBL-PE carriage was associated with a high rate of post-biopsy UTI symptoms requiring further elucidation; however, it was not associated with microbiologically proven infections. FQ consumption before TRUSbx was also associated with post-biopsy infections.

Publication metadata

Author(s): Tukenmez-Tigen E, Tandogdu Z, Ergonul O, Altinkanat G, Gunaydin B, Ozgen M, Sariguzel N, Erturk-Sengel B, Odabasi Z, Cek M, Tokuc R, Turkeri L, Mulazimoglu L, Korten V

Publication type: Article

Publication status: Published

Journal: Urology

Year: 2014

Volume: 84

Issue: 5

Pages: 1008-1015

Print publication date: 01/11/2014

Acceptance date: 18/04/2014

ISSN (print): 0090-4295

ISSN (electronic): 1527-9995

Publisher: Elsevier

URL: http://dx.doi.org/10.1016/j.urology.2014.04.060

DOI: 10.1016/j.urology.2014.04.060

PubMed id: 25239255

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