scholarly journals Transrectal Prostate Biopsy-Associated Prophylaxis and Infectious Complications: Report of a Query to the Emerging Infections Network of the Infectious Diseases Society of America

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
James R. Johnson ◽  
Philip M. Polgreen ◽  
Susan E. Beekmann
Keyword(s):  
Infectious Diseases ◽  
Prostate Biopsy ◽  
Infectious Complications ◽  
Emerging Infections ◽  
Prophylactic Regimen ◽  
Transrectal Prostate Biopsy ◽  
Control And Prevention ◽  
Resistant Strains ◽  
Antibiotic Dose ◽  
Question Survey

Abstract Background.  Fluoroquinolone-resistant infections after transrectal prostate biopsy (TRPB) are increasing. Methods.  Members of the Emerging Infections Network, a consortium of adult infectious diseases physicians sponsored by the Centers for Disease Control and Prevention and the Infectious Diseases Society of America, were administered an electronic 9-question survey regarding post-TRPB infections and associated prophylaxis. Results were compared with respondent characteristics. Results.  The overall response rate was 47% (552 of 1180). Of the 552 respondents, 234 (42%) reported that this problem was not applicable to their practice. The remaining 318 (58%) reported that, despite widespread recent changes in prophylactic regimens, fluoroquinolone monotherapy still was most common, but diverse alternate or supplemental oral and parenteral antibiotics (including imipenem) also were used. Reports of culture-guided prophylaxis were rare (9%). The most common duration of prophylaxis was a single prebiopsy antibiotic dose. However, 16%–23% of respondents reported prophylaxis continuing for ≥24 hours postbiopsy. Post-TRPB infections were reported as being more frequent now than 4 years ago, with sepsis and genitourinary presentations predominating, but with osteomyelitis, endocarditis, and epidural abscess also occurring. Infection isolates reportedly were usually resistant to the prophylactic regimen. Conclusions.  Emerging Infections Network members perceive post-TRPB infections as increasingly frequent, caused by resistant strains, and involving serious illness. Prophylactic approaches, although in flux, still usually entail ciprofloxacin monotherapy, which often is given for excessive durations. Multiple opportunities exist for infectious diseases specialists to partner with proceduralists in devising, studying, and implementing improved prophylaxis regimens for TRPB.

Diagnosing and Reporting of Central Line–Associated Bloodstream Infections

2012 ◽  
Vol 33 (9) ◽  
pp. 875-882 ◽  
Author(s):  
Susan E. Beekmann ◽  
Daniel J. Diekema ◽  
W. Charles Huskins ◽  
Loreen Herwaldt ◽  
John M. Boyce ◽  
...  
Keyword(s):  
Blood Culture ◽  
Infectious Diseases ◽  
Clinical Judgment ◽  
Bloodstream Infections ◽  
Central Line ◽  
Emerging Infections ◽  
Central Lines ◽  
Time To Positivity ◽  
Control And Prevention ◽  
Question Survey

Background.The diagnosis of central line-associated bloodstream infections (CLABSIs) is often controversial, and existing guidelines differ in important ways.Objective.To determine both the range of practices involved in obtaining blood culture samples and how central line-associated infections are diagnosed and to obtain members' opinions regarding the process of designating bloodstream infections as publicly reportable CLABSIs.Design.Electronic and paper 11-question survey of infectious-diseases physician members of the Infectious Diseases Society of America Emerging Infections Network (IDSA EIN).Participants.All 1,364 IDSA EIN members were invited to participate.Results.692 (51%) members responded; 52% of respondents with adult practices reported that more than half of the blood culture samples for intensive care unit (ICU) patients with central lines were drawn through existing lines. A sizable majority of respondents used time to positivity, differential time to positivity when paired blood cultures are used, and quantitative culture of catheter tips when diagnosing CLABSI or determining the source of that bacteremia. When determining whether a bacteremia met the reportable CLABSI definition, a majority used a decision method that involved clinical judgment.Conclusions.Our survey documents a strong preference for drawing 1 set of blood culture samples from a peripheral line and 1 from the central line when evaluating fever in an ICU patient, as recommended by IDSA guidelines and in contrast to current Centers for Disease Control and Prevention recommendations. Our data show substantial variability when infectious-diseases physicians were asked to determine whether bloodstream infections were primary bacteremias, and therefore subject to public reporting by National Healthcare Safety Network guidelines, or secondary bacteremias, which are not reportable.

scholarly journals Risk factors for infection development after transrectal prostate biopsy and the role of resistant bacteria in colonic flora

2017 ◽  
Vol 11 (02) ◽  
pp. 188-191 ◽  
Author(s):  
Emine Dilek Eruz ◽  
Aysun Yalci ◽  
Eriz Ozden ◽  
Halide Aslaner ◽  
Suna Ogucu-Durgun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prostate Biopsy ◽  
Bacterial Colonization ◽  
Intestinal Flora ◽  
Infectious Complications ◽  
Resistant Bacteria ◽  
Prophylactic Regimen ◽  
Colonic Flora ◽  
Transrectal Prostate Biopsy

Introduction: In this study, we aimed to identify risk factors for the development of infectious complications after prostate biopsy and to investigate the role of intestinal colonization of bacteria that are resistant to prophylactic antibiotics. Methodology: A total of 168 patients who had undergone transrectal prostate biopsy (TRPB) under ciprofloxacin and gentamycin prophylaxis were included in the study. Stool cultures and subsequent antibiotic susceptibility testing were performed in all patients before the start of antibiotic prophylaxis. Results: Of the 168 patients, 17 (10.1%) developed urinary tract infection (UTI), while 6 (3.57%) developed sepsis within seven days after biopsy. Ciprofloxacin-resistant bacterial colonization was detected in 81 (48.2%) of the patients. None of the patients with ciprofloxacin-sensitive bacteria in intestinal flora developed a UTI. The colonization of intestinal ciprofloxacin-resistant bacteria increased UTI risk significantly after TRPB (p < 0.0001). Urolithiasis history, presence of permanent urinary catheterization, hospitalization history for more than 48 hours in the last year, and recent antibiotic usage significantly increased UTI risk after TRPB. Conclusions: Development of an infection was more frequent in patients with resistant bacterial colonization. We hope to guide more comprehensive studies designed to find a standard prophylactic regimen for TRPB that can be used all over the world.

scholarly journals Impact of Rectal Swabs on Infectious Complications after Transrectal Prostate Biopsy

2016 ◽  
Vol 97 (3) ◽  
pp. 340-346 ◽  
Author(s):  
Carlos Gustavo Trujillo ◽  
Mauricio Plata ◽  
Juan Ignacio Caicedo ◽  
Juan Guillermo Cataño Cataño ◽  
Angela Marcela Mariño Alvarez ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Infectious Complications ◽  
Rectal Swabs ◽  
Transrectal Prostate Biopsy

scholarly journals Cutting to the Core of the Issue: Emerging Strategies To Reduce Prostate Biopsy-Related Infections

2016 ◽  
Vol 54 (10) ◽  
pp. 2431-2435 ◽  
Author(s):  
Robin R. Chamberland
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Prostate Biopsy ◽  
Current Trend ◽  
The United States ◽  
Infectious Complications ◽  
Published Data ◽  
The Core ◽  
Link Type ◽  
Transrectal Prostate Biopsy

Over 1 million men undergo biopsy in the United States each year to evaluate for prostate cancer (S. Loeb, H. B. Carter, S. I. Berndt, W. Ricker, and E. M. Schaeffer, J Urol 186:1830–1834, 2011,http://dx.doi.org/10.1016/j.juro.2011.06.057). In recent years, there has been a rise in infectious complications related to these procedures. This review aims to provide an overview of the guidelines that direct transrectal prostate biopsy, to describe associated infection, and to evaluate the published data driving the current trend toward prebiopsy screening for resistant organisms.

scholarly journals Addition of Ceftriaxone and Amikacin to a Ciprofloxacin plus Metronidazole Regimen for Preventing Infectious Complications of Transrectal Ultrasound-Guided Prostate Biopsy: A Randomized Controlled Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Mohammad-Hossein Izadpanahi ◽  
Kia Nouri-Mahdavi ◽  
Seyed Mahmood Majidi ◽  
Mohammad-Hatef Khorrami ◽  
Farshid Alizadeh ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Controlled Trial ◽  
Intervention Group ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Control Group ◽  
Ultrasound Guided ◽  
Prophylactic Regimen ◽  
Randomized Controlled ◽  
Group 1

Background. The objective of this study was to evaluate the efficacy of adding single doses of ceftriaxone and amikacin to a ciprofloxacin plus metronidazole regimen on the reduction of infectious complications following transrectal ultrasound-guided prostate biopsy (TRUS Bx). Materials and Methods. Four hundred and fifty patients who were candidates for TRUS Bx were divided into two groups of 225 each. The control group received ciprofloxacin 500 mg orally every 12 hours together with metronidazole 500 mg orally every 8 hours from the day prior to the procedure until the fifth postoperative day. In the second group, single doses of ceftriaxone 1 g by intravenous infusion and amikacin 5 mg/kg intramuscularly were administered 30–60 minutes before TRUS Bx in addition to the oral antimicrobials described for group 1. The incidence of infection was compared between the groups. Results. The incidence of infectious complications in the intervention group was significantly lower than that in the control group (4.6% versus 0.9%, p=0.017). Conclusion. The addition of single doses of intramuscular amikacin and intravenously infused ceftriaxone to our prophylactic regimen of ciprofloxacin plus metronidazole resulted in a statistically significant reduction of infectious complications following TRUS Bx.

scholarly journals Acute Aortic Valve Rupture from Infective Endocarditis after Transrectal Prostate Biopsy: A Call to Revise the AHA Guidelines for Prevention of Infective Endocarditis

2013 ◽  
Vol 6 ◽  
pp. CCRep.S10503 ◽  
Author(s):  
Julia Ansari ◽  
Gurkaran Singh Garcha ◽  
Henry Huang ◽  
Faisal G. Bakaeen ◽  
Salim S. Virani ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Febrile Illness ◽  
Heart Association ◽  
Infectious Complications ◽  
Medical Work ◽  
Intermittent Fever ◽  
Transrectal Prostate Biopsy

We describe the case of a 63-year-old man with a known murmur who presented with a 4-month history of intermittent fever and a progressive reduction in energy level after a transrectal prostate biopsy (TRPB). He subsequently presented with acute heart failure secondary to aortic valve cusp rupture caused by endocarditis and underwent urgent aortic valve surgery. The 2008 American College of Cardiology/American Heart Association Guideline update on infective endocarditis has narrowed the use of antibiotic prophylaxis before most accepted dental procedures and continues to recommend against prophylaxis before genitourinary or gastrointestinal procedures. In contrast, the American Urological Association recommends the use of fluoroquinolones for the prevention of transrectal ultrasound–derived infectious complications. Notably, TRPB is associated with a high frequency of bacteremia and bacteriuria. In our case, an antibiotic course before the procedure and a more meticulous medical work-up after febrile illness might have mitigated the patient's catastrophic medical presentation.

Fluoroquinolone Resistant Rectal Colonization Predicts Risk of Infectious Complications after Transrectal Prostate Biopsy

2014 ◽  
Vol 192 (6) ◽  
pp. 1673-1678 ◽  
Author(s):  
Michael A. Liss ◽  
Stephen A. Taylor ◽  
Deepak Batura ◽  
Deborah Steensels ◽  
Methee Chayakulkeeree ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Infectious Complications ◽  
Transrectal Prostate Biopsy ◽  
Rectal Colonization

scholarly journals Single Dose of Levofloxacin versus Three Dosages for Prophylaxis in Prostate Biopsy

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Edgar Linden-Castro ◽  
Marcela Pelayo-Nieto ◽  
Alejandro Alias-Melgar ◽  
Fernando Carreño-de la Rosa
Keyword(s):  
Prostate Cancer ◽  
Single Dose ◽  
Prostate Biopsy ◽  
Antimicrobial Agents ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Ultrasound Guided ◽  
Prophylactic Regimen ◽  
Local Pain ◽  
Number Of Patients

Transrectal ultrasound-guided core prostate biopsy is a key event in the diagnosis of prostate cancer, transient side events such as local pain, haematuria, haematospermia, dysuria, and rectal bleeding are reported in a large number of patients. Antimicrobial agents lower the incidence of postbiopsy infectious complications. The timing and duration of the regimen and the route of administration remain controversial. We developed a standard prophylactic regimen, in which safety and efficiency were maximized, while costs and variability were minimized. Accordingly we prospectively evaluated 425 consecutive patients, who underwent outpatient transrectal ultrasound-guided prostate biopsy after a single dose versus three doses of levofloxacin.

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