Korean J Urogenit Tract Infect Inflamm.  2013 Apr;8(1):20-26. 10.14777/kjutii.2013.8.1.20.

Infection in Patients Undergoing Transrectal Ultrasound Guided Prostate Biopsy

• Jung SI

• KMID: 2289248
• DOI: http://doi.org/10.14777/kjutii.2013.8.1.20

Abstract

With the widespread popularity of prostate specific antigen testing, transrectal ultrasound (TRUS)-guided prostate biopsy has become a common urological procedure. The most common risks and complications associated with TRUS-guided biopsy include hematuria, hematospermia, and hematochezia. In addition, some patients develop urinary tract infections, acute bacterial prostatitis, bacteremia, and, eventually, urosepsis. Although it is commonly accepted that use of a prophylactic antimicrobial agent will lower the incidence of post biopsy infection, there is little consensus regarding the most appropriate antimicrobial regimens. Fluoroquinolone (FQ) was the best analyzed class, with higher numbers of studies and patients. According to recent data, occurrence of infectious complications after prostate biopsy has increased in recent years. Several recent studies have highlighted an increasing trend of infectious complications due to FQ resistant organisms among men undergoing TRUS guided prostate biopsy. TRUS guided prostate biopsy can result in significant morbidity, which is occurring at an increasing rate due to the increasing prevalence of FQ resistant Escherichia coli in rectal flora. Risk factors for harboring FQ resistant E. coli should be considered before prostate biopsy, and rectal swab screening cultures may provide useful evidence for selection of appropriate antimicrobials for prophylaxis and treatment of prostate biopsy-associated infections. The estimate of the incidence of sepsis following TRUS-guided prostate biopsy is low; however, the initial treatment of patients with prophylaxis failure and identification of antibiotic-resistant bacterial strains might be the most important means for prevention of urosepsis.

Keyword

Antibiotic prophylaxis; Prostate; Biopsy; Infection

MeSH Terms

Antibiotic Prophylaxis
Bacteremia
Biopsy*
Consensus
Escherichia coli
Gastrointestinal Hemorrhage
Hematuria
Hemospermia
Humans
Incidence
Male
Mass Screening
Prevalence
Prostate*
Prostate-Specific Antigen
Prostatitis
Risk Factors
Sepsis
Ultrasonography*
Urinary Tract Infections
Prostate-Specific Antigen

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