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2008 Annual Meeting Abstracts
Incidence And Antibiotic Resistance Patterns In Urosepsis Following Prostate Biopsy: A Review Of 3,000 Cases
Hooman Hajian*1, Ryan F Paterson2
1Penn State University, Hershey, PA;2University of British Columbia, Vancouver, BC, Canada
Introduction: It is common practice to require a negative urine culture and to administer a short prophylactic course of an oral fluoroquinolone prior to performing a trans-rectal ultrasound (TRUS) prostate biopsy. Despite these measures, infections ranging from prostatitis to urosepsis are among the most common complications.
Methods: We retrospectively analyzed all cases of TRUS prostate biopsies performed between 2001 and 2006 at the 3 main hospitals within our healthcare system. All subsequent hospitalizations within one month of the biopsy were reviewed.
Results: A total of 3,000 biopsies were reviewed, and 26 cases of urosepsis requiring hospitalization were identified (incidence 0.87%). Median age at time of biopsy was 64.3 years. Sepsis started within 0 to 9 days following biopsy, leading to hospitalization for 1 to 21 days. 24 cases had received antibiotic prophylaxis using Ciprofloxacin with (2) or without (22) other agents. E. Coli was the most common pathogen (85.7%). Cultures were negative in five cases, two of which had received combination prophylaxis. Ciprofloxacin resistance was present in 89.5% of cultures.
Conclusions: Considering the high rate of Ciprofloxacin resistance in the community and in our series, it may be more appropriate to use other antibiotics prophylactically. Despite our best efforts, we cannot exclude the possibility that some cases may not have been captured in our data. This may account for the observed incidence being lower than expected. Another possibility may be the success of Ciprofloxacin in preventing less virulent cases of sepsis, leaving us to observe only the most virulent cases.
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