MP35-12 IS ANTIBIOTIC PROPHYLAXIS INDICATED FOR TRANSPERINEAL PROSTATE BIOPSY? LOCAL ANTIBIOGRAM FINDINGS TO INFORM ANTIBIOTIC SELECTION

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You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP35)1 Sep 2021MP35-12 IS ANTIBIOTIC PROPHYLAXIS INDICATED FOR TRANSPERINEAL PROSTATE BIOPSY? LOCAL ANTIBIOGRAM FINDINGS TO INFORM ANTIBIOTIC SELECTION Ashley Davis, Mariela Martinez Rivera, Michael Silver, David Daniel, David Silver, Ervin Teper, Alejandro Zuretti, and Ariel Schulman Ashley DavisAshley Davis More articles by this author , Mariela Martinez RiveraMariela Martinez Rivera More articles by this author , Michael SilverMichael Silver More articles by this author , David DanielDavid Daniel More articles by this author , David SilverDavid Silver More articles by this author , Ervin TeperErvin Teper More articles by this author , Alejandro ZurettiAlejandro Zuretti More articles by this author , and Ariel SchulmanAriel Schulman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002044.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transperineal (TP) prostate biopsy avoids rectal flora with less infectious risk than transrectal biopsy. The role of antibiotic prophylaxis remains undefined. We examined genitourinary and rectal colonization in men undergoing TP prostate biopsy to guide future antibiotic selection. METHODS: We evaluated patients undergoing TP biopsy at a single center from 2019 to 2020. Preoperative negative urinalysis was required, and procedural IV cefazolin and gentamicin prophylaxis was used. Catheterized urine, prostate tissue and rectal swab cultures were taken at the time of procedure. We examined culture positivity, resistant patterns and procedural complications. RESULTS: 146 TP biopsies were included. Median age was 65 (61-72), mean prostate volume was 60 (11-226) and mean PSA was 7.8 (0.84-60). 13 (8.9%) patients harbored positive genitourinary cultures including 7 (4.79%) positive urine, 4 (2.74%) positive prostate tissue, and 2 (1.37%) with bacteria in both. Escherichia coli was the most common bacteria on urine culture and staphylococcus epidermidis was the most common on prostate culture (Table 1). There were 8 unique bacteria isolated with variable resistance patterns (Table 2). Fluoroquinolone resistance was identified in 9/64 (14%) rectal swab isolates reflecting the overall community-level resistance. Despite culture findings, there was no post biopsy sepsis or infectious complications. One patient developed CAUTI-sepsis at day 10 secondary to prolonged catheterization. CONCLUSIONS: In this review of TP prostate biopsies using single-dose IV cefazolin and gentamicin prophylaxis, 8.9% (n=13) of men harbored occult positive urine and/or prostate tissue cultures at the time of biopsy despite negative urinalysis, although there were no immediate infectious complications. Thus, there seems to remain a risk of infectious complications and prophylaxis should be considered based on local resistance patterns. Source of Funding: Maimonides Research and Development Foundation © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e631-e632 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ashley Davis More articles by this author Mariela Martinez Rivera More articles by this author Michael Silver More articles by this author David Daniel More articles by this author David Silver More articles by this author Ervin Teper More articles by this author Alejandro Zuretti More articles by this author Ariel Schulman More articles by this author Expand All Advertisement Loading ...