Culture Directed Prostate Biopsy: Culture Sensitivity Pattern and Infectious Complications: A Prospective Study
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 7
Abstract
Introduction Overall incidence of infectious complications following Transrectal Ultrasound (TRUS) guided prostate biopsy is 11%.It ranges from simple UTI to severe sepsis and mortality. It is commonly caused by gram negative coliform bacteria of fecal origin. fluoroquinolones are the most commonly preferred antibiotic used as empirical prophylaxis agent. Despite empiric prophylaxis, the incidence of complication following TRUS is 2.2%, out of which 22% are due to fluroquinolone resistant organism. So a prior rectal swab culture and targeted culture specific agent will reduce the incidence of infectious complication. Aims and objectives To ascertain the prevalence of fluoroquinolone resistant organisms in men undergoing TRUS guided prostate biopsy and to assess the efficacy of targeted antimicrobial prophylaxis based on rectal swab cultures in reducing the rate of infectious complications Results A total of 255 patients underwent rectal swab culture sensitivity before TRUS biopsy. Ciprofloxacin sensitive (CS) rectal flora was found in 215(84.3%) and Ciprofloxacin resistant (CR) in 40(15.7%) of cases. Univariate analysis demonstrated that patients with CS and CR rectal flora were similar except that a history of urinary tract infection was more common in CR patients (p = 0.004).Only 5 patients (1.9%) developed uncomplicated UTI following culture directed antibiotic therapy. These were managed by augmenting with second antibiotic with no sequel. Conclusion Culture directed targeted antimicrobial prophylaxis achieved a low rate of infectious complications in patients with CS or CR rectal flora, limited morbidity and no sequelae. These results suggest that this individualized method of prophylaxis may be widely applied to all patients undergoing TRUS guided prosta biopsy
Authors and Affiliations
Sandeep Pradhan
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