MP36-05 IS PRE-OPERATIVE URINE CULTURE NECESSARY IN ASYMPTOMATIC MEN PRIOR TO TRANSRECTAL PROSTATE NEEDLE BIOPSY?

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia II1 Apr 2016MP36-05 IS PRE-OPERATIVE URINE CULTURE NECESSARY IN ASYMPTOMATIC MEN PRIOR TO TRANSRECTAL PROSTATE NEEDLE BIOPSY? David Qi, Kathleen Lehman, Kalyan Dewan, Girish Kirimanjeswara, and Jay Raman David QiDavid Qi More articles by this author , Kathleen LehmanKathleen Lehman More articles by this author , Kalyan DewanKalyan Dewan More articles by this author , Girish KirimanjeswaraGirish Kirimanjeswara More articles by this author , and Jay RamanJay Raman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1639AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Infectious complications following transrectal prostate needle biopsy (PNB) continue to rise. These infections are thought to occur from translocation of bacteria in the rectal vault into the highly vascular prostate. The contribution (if any) of pre-biopsy bacteriuria on infectious sequelae following the procedure remains unclear. We investigate the utility of pre-operative urine culture in a cohort of patients undergoing PNB. METHODS Between March 2013 and August 2015, 150 asymptomatic male patients were prospectively enrolled in an IRB approved study investigating infections following PNB. Routine office urine cultures were obtained 14-days prior to PNB with reports of 10,000 flora or greater recorded. Per study protocol, positive cultures were not treated. Antibiotic prophylaxis regimen prior to PNB included Ciprofloxacin 500mg the day before and morning of the biopsy. Urine cultures were obtained immediately prior to PNB with plating onto Mueller- Hinton agar plates with colony forming units (CFUs) determined after incubation at 37°C for 48 hours. Infectious complications post-biopsy were recorded. RESULTS 150 men with a mean PSA of 11.4 ng/mL were included. 64% were undergoing an initial biopsy and 19% had a history of antibiotic use within the previous 6 months. Six patients (4%) had evidence of asymptomatic bacteriuria on office urine culture including 2 with > 100,000 CFU/mL E.Coli, 1 with > 100,000 CFU/mL Klebsiella, 1 with 10,000 CFU/mL E.Coli, and 2 with 10,000 CFU/mL mixed flora. Just prior to PNB, repeat urine cultures in all 150 patients noted a mean bacterial count of 55 CFU/mL with the highest urine bacterial count being 1000 CFU/mL. All 6 patients with positive office urine cultures had < 100 CFU/mL just prior to PNB. Following PNB, 4 patients (2.7%) developed an infectious complication including 2 with sepsis and 2 with culture positive UTIs. The causative organism in all cases was quinolone resistant E. Coli. None of the 6 patients with pre-operative positive urine cultures developed an infectious complication following PNB. CONCLUSIONS In this prospective study of 150 patients, < 5% had positive office cultures prior to PNB. Repeat urine culture on the morning of biopsy showed resolution in these patients and none developed post-biopsy infectious complications. Routine office urine culture in the asymptomatic male prior to PNB is likely unnecessary © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e491 Advertisement Copyright & Permissions© 2016MetricsAuthor Information David Qi More articles by this author Kathleen Lehman More articles by this author Kalyan Dewan More articles by this author Girish Kirimanjeswara More articles by this author Jay Raman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...