Infection-related hospital admissions after transrectal biopsy of the prostate
Abstract
BACKGROUND: Urosepsis is the most common complication requiring hospital admission after transrectal biopsy of the prostate. This study aims to assess the local incidence and causative organisms of hospital admissions with urosepsis after transrectal ultrasound-guided prostate (TRUS) biopsy. As morbidity is high, treatment must be commenced empirically prior to cultures. A review of bacterial antibiotic susceptibilities was undertaken to guide optimal treatment of post-biopsy urosepsis.
METHODS: A total of 1421 patients underwent TRUS biopsy in a single city over a 2-year period. All patients received prophylactic antibiotics prior to the procedure. A retrospective review of a prospectively collated database was performed in all patients admitted to Christchurch Hospital, the only acute admitting hospital in Christchurch, with infection within 30 days after biopsy. Hospital admission records were reviewed, including urine and blood culture results.
RESULTS: Forty patients (2.8%) were admitted with infection after the biopsy, the majority occurring within the first week after procedure and four required intensive care unit (ICU) admission (10%). The most common organism isolated on urine and blood cultures was Escherichia coli. Significant E. coli resistance was seen to fluoroquinolones, amoxicillin and trimethoprim.
CONCLUSION: Rates of infection after TRUS biopsy and antibiotic resistance are increasing internationally. Treatment for urosepsis should be aggressive as 10% of…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,421 participants or records.
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