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KMID : 1234520110060010061
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Korean Journal of Urogenital Tract Infection Inflammation
2011 Volume.6 No. 1 p.61 ~ p.66
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Clinical Features of Bacteremia Caused by Ciprofloxacin-Resistant Bacteria after Transrectal Ultrasound-Guided Prostate Biopsy
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Shin Bo-Sung
Hwang Eu-Chang
Jung Seung-Il
Kwon Dong-Deuk
Park Kwang-Sung
Ryu Soo-Bang
Kim Jin-Woong
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Abstract
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Purpose: Fluoroquinolone is considered the prophylactic antibiotic of choice for Transrectal ultrasound
(TRUS)-guided biopsy. However, failure of quinolone prophylaxis due to emerging quinolone-resistant enterobacteriae
has been increasing. We reviewed bacteremia cases after TRUS-guided biopsy to identify antibiotic-resistant bacterial strains with the objective to prevent urosepsis.
Materials and Methods: A total of 2,348 patients underwent TRUS-guided biopsy at our institution between
January 2004 and December 2009. All patients received intravenous ciprofloxacin for prophylaxis. We retrospectively evaluated patients who developed infectious symptoms, such as fevers and chills.
Results: Eleven (0.4%) of 2,348 patients developed infectious symptoms. Escherichia coli was the pathogen responsible for post-biopsy infections occurring in a; 11 (100%) patients with positive blood cultures, which confirmed ciprofloxacin-resistant E. coli, with one isolate producing extended-spectrum beta lactamase. Ten out of 11 E. coli isolates (91%) were resistant to ampicillin and 9 of 11 E. coli isolates (82%) were resistant to gentamicin. Ten out of 11 E. coli isolates (91%) were susceptible to third generation cephalosporins. All such patients were admitted to the hospital and treated with a third generation cephalosporin. One patient who habored an E. coli isolate producing extended-spectrum beta-lactamase received imipenem.
Conclusions: Ciprofloxacin is effective in reducing infectious complications. However, recently, bacteremiccases
are increasing due to ciprofloxacin resistant E. coli. For patients with infectious symptoms after transrectal prostate biopsy, early antibiotics change, including third generation cephalosporins, are recommended to prevent urosepsis.
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KEYWORD
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Biopsy, Infection, Prostate
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