MP53-17 CULTURE-DIRECTED ANTIMICROBIAL PROPHYLAXIS IN TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BIOPSIES: CONTEMPORARY 7-YEAR EXPERIENCE

Abstract

You have accessJournal of UrologyCME1 May 2022MP53-17 CULTURE-DIRECTED ANTIMICROBIAL PROPHYLAXIS IN TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BIOPSIES: CONTEMPORARY 7-YEAR EXPERIENCE Steven A Sidelsky, Pooja Talaty, Pranvera Sulejmani, Mira Suseno, Sandra Naegele, Kristian Novakovic, Brian T. Helfand, and Alexander P. Glaser Steven A SidelskySteven A Sidelsky More articles by this author , Pooja TalatyPooja Talaty More articles by this author , Pranvera SulejmaniPranvera Sulejmani More articles by this author , Mira SusenoMira Suseno More articles by this author , Sandra NaegeleSandra Naegele More articles by this author , Kristian NovakovicKristian Novakovic More articles by this author , Brian T. HelfandBrian T. Helfand More articles by this author , and Alexander P. GlaserAlexander P. Glaser More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002628.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Infectious complications can occur in 1-5% of patients undergoing transrectal ultrasound-guided prostate needle biopsy (TRUS-PNB). Resistance to fluoroquinolones (FQ) has led to use of a pre-biopsy rectal swab to examine for FQ-resistant flora. As our practice and many others transition to transperineal (TP) biopsies, we sought to study the rate of infectious complications in a contemporary TRUS-PNB series with pre-biopsy rectal swabs. METHODS: Patients undergoing TRUS-PNB from 1/1/2014-12/31/2020 were identified using the Enterprise Data Warehouse. Clinical variables, rectal swab results, prophylactic antibiotic given, blood and urine cultures, admissions, and mortality within 90 days was extracted. Chart review was performed for all patients with a blood culture ordered within 90 days of TRUS-PNB. RESULTS: Of the 4,441 patients who underwent TRUS-PNB, 15-19% had FQ-resistant flora, and this rate did not significantly change per year (Figure 1; p=0.53). Thirty-nine (0.9%) patients had a blood culture ordered within 90 days. Chart review of these patients confirmed 20 (0.45%) were admitted with post-biopsy infection (Table 1). Others had blood cultures ordered for issues unrelated to prostate biopsy including post-prostatectomy complications (n=6), pneumonia (n=4), DVT/PE (n=2), ureteral stone (n=1), acute cholecystitis (n=1), and other unrelated issues (n=3). There were no identified deaths within 90 days. The rate of post-biopsy infection was higher for men with FQ-resistant flora (1.17%) compared to men without FQ-resistant flora (0.3%; p=0.0035). CONCLUSIONS: Rates of admission for infection after culture-directed antimicrobial prophylaxis are low (∼0.5%). Men with FQ-resistance are at higher risk for infection despite targeted prophylaxis. This data serves as a contemporary series for comparison as many practices transition to TP biopsy. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e902 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Steven A Sidelsky More articles by this author Pooja Talaty More articles by this author Pranvera Sulejmani More articles by this author Mira Suseno More articles by this author Sandra Naegele More articles by this author Kristian Novakovic More articles by this author Brian T. Helfand More articles by this author Alexander P. Glaser More articles by this author Expand All Advertisement PDF DownloadLoading ...