MP15-20 ANTIBIOTIC SELECTION FOR PROSTATE BIOPSY PROPHYLAXIS USING RECTAL SWAB CULTURES REFLECTS LOCAL ANTIBIOGRAM

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia I1 Apr 2018MP15-20 ANTIBIOTIC SELECTION FOR PROSTATE BIOPSY PROPHYLAXIS USING RECTAL SWAB CULTURES REFLECTS LOCAL ANTIBIOGRAM Elizabeth Ann Rourke, Steven Madsen, Andrea Yunes, Joseph W Basler, and Michael A Liss Elizabeth Ann RourkeElizabeth Ann Rourke More articles by this author , Steven MadsenSteven Madsen More articles by this author , Andrea YunesAndrea Yunes More articles by this author , Joseph W BaslerJoseph W Basler More articles by this author , and Michael A LissMichael A Liss More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.533AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In the recent manuscript ″An Update of the AUA White Paper on the More Common Complications of Prostate Biopsy″, an emphasis was placed on utilization of an antibiogram to determine the community risk of resistant post biopsy infections. However, if an antibiotic augmentation strategy is utilized, there are no current recommendations regarding which antibiotic is preferred within individual communities. Herein, we evaluate the susceptibility profiles of ciprofloxacin resistant E.coli (CRE) identified from rectal swab cultures compared to our local antibiogram to determine if the antibiogram could accurately be utilized in the selection of antibiotic augmentation prior to transrectal prostate biopsy (TRPB). METHODS Pre-TRPB rectal swabs were initiated in January 2016 and data was collected through September 2017 at the South Texas Veterans Health Care System (STVHCS). Culture results and antibiotic resistance profiles were recorded and compared to the proportion of antibiotic resistance in the STVHCS 2016 antibiogram. Fisher Exact test was used for comparisons of proportions in a univariate analysis. RESULTS We identified 611 patients who underwent pre-PNB rectal culture, of which 98 were CRE isolates. Our cohort demonstrated an 80% sensitivity to ciprofloxacin as compared to the STVHCS antibiogram sensitivity of 65% (p<0.001). Gentamicin, a commonly used antibiotic augment, demonstrated similar sensitivities between the antibiogram and cohort (90% and 88% respectively). There were no statistically significant differences between the STVHCS antibiogram and the sensitivity profiles of our rectal swab cohort as demonstrated in figure 1, except for Ampicillin/Sulbactam, which was 57% in the antibiogram and 32% in our cohort (p=0.019). Of the CRE identified, 4% (4/98) were considered extended spectrum betalactamase producers (ESBL). CONCLUSIONS Overall, resistance patterns in CRE isolates from our study population are consistent with the STVHCS antibiogram therefore; a local antibiogram may be utilized in an implementation strategy for targeted antibiotics or augmentation of FQ prophylaxis for PNB. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e197 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Elizabeth Ann Rourke More articles by this author Steven Madsen More articles by this author Andrea Yunes More articles by this author Joseph W Basler More articles by this author Michael A Liss More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...