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Fluoroquinolone-res...
Fluoroquinolone-resistant Escherichia coli among the rectal flora is the predominant risk factor for severe infection after transrectal ultrasound-guided prostate biopsy : a prospective observational study
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- Holmbom, Martin, 1984- (author)
- Linköpings universitet,Medicinska fakulteten,Avdelningen för kirurgi, ortopedi och onkologi,Region Östergötland, Urologiska kliniken i Östergötland
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- Forsberg, Jon (author)
- Linköpings universitet,Institutionen för biomedicinska och kliniska vetenskaper,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland
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- Fredrikson, Mats, 1957- (author)
- Linköpings universitet,Avdelningen för inflammation och infektion,Forum Östergötland
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- Nilsson, Maud, 1953- (author)
- Linköpings universitet,Medicinska fakulteten,Avdelningen för inflammation och infektion
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- Nilsson, Lennart, 1949- (author)
- Linköpings universitet,Medicinska fakulteten,Avdelningen för inflammation och infektion
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- Hanberger, Håkan, 1954- (author)
- Linköpings universitet,Medicinska fakulteten,Avdelningen för inflammation och infektion,Region Östergötland, Infektionskliniken i Östergötland
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- Hällgren, Anita, 1963- (author)
- Linköpings universitet,Medicinska fakulteten,Avdelningen för inflammation och infektion,Region Östergötland, Infektionskliniken i Östergötland
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(creator_code:org_t)
- Medical Journals Sweden, 2023
- 2023
- English.
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In: Scandinavian journal of urology. - : Medical Journals Sweden. - 2168-1805 .- 2168-1813. ; 58, s. 32-37
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.2...
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Abstract
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- BACKGROUND: Infection of the prostate gland following biopsy, usually with Escherichia coli, is a common complication, despite the use of antimicrobial prophylaxis. A fluoroquinolone (FQ) is commonly prescribed as prophylaxis. Worryingly, the rate of fluoroquinolone-resistant (FQ-R) E. coli species has been shown to be increasing. OBJECTIVE: This study aimed to identify risk factors associated with infection after transrectal ultrasound-guided prostate biopsy (TRUS-Bx). METHODS: This was a prospective study on patients undergoing TRUS-Bx in southeast Sweden. Prebiopsy rectal and urine cultures were obtained, and antimicrobial susceptibility and risk-group stratification were determined. Multivariate analyses were performed to identify independent risk factors for post-biopsy urinary tract infection (UTI) and FQ-R E. coli in the rectal flora. RESULTS: In all, 283 patients were included, of whom 18 (6.4%) developed post-TRUS-Bx UTIs. Of these, 10 (3.5%) had an UTI without systemic inflammatory response syndrome (SIRS) and 8 (2.8%) had a UTI with SIRS. Being in the medium- or high-risk groups of infectious complications was not an independent risk factor for UTI with SIRS after TRUS-Bx, but low-level FQ-resistance (minimum inhibitory concentration (MIC): 0.125-0.25 mg/L) or FQ-resistance (MIC > 0.5 mg/L) among E. coli in the faecal flora was. Risk for SIRS increased in parallel with increasing degrees of FQ-resistance. Significant risk factor for harbouring FQ-R E.coli was travelling outside Europe within the previous 12 months. CONCLUSION: The predominant risk factor for UTI with SIRS after TRUS-Bx was FQ-R E. coli among the faecal flora. The difficulty in identifying this type of risk factor demonstrates a need for studies on the development of a general approach either with rectal swab culture for targeted prophylaxis, or prior rectal preparation with a bactericidal agent such as povidone-iodine before TRUS-Bx to reduce the risk of FQ-R E. coli-related infection.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Keyword
- Anti-Bacterial Agents; Antibiotic Prophylaxis; Biopsy; Drug Resistance
- Bacterial; Escherichia coli; Escherichia coli Infections; Fluoroquinolones; Humans; Image-Guided Biopsy; Male; Prospective Studies; Prostate; Rectum; Risk Factors; Systemic Inflammatory Response Syndrome; Ultrasonography
- Interventional; Urinary Tract Infections; antiinfective agent; quinolone derivative; antibiotic prophylaxis; antibiotic resistance; biopsy; Escherichia coli; Escherichia coli infection; human; image guided biopsy; interventional ultrasonography; male; pathology; prospective study; prostate; rectum; risk factor; systemic inflammatory response syndrome; urinary tract infection
Publication and Content Type
- ref (subject category)
- art (subject category)
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Holmbom, Martin, ...
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Forsberg, Jon
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Fredrikson, Mats ...
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Nilsson, Maud, 1 ...
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Nilsson, Lennart ...
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Hanberger, Håkan ...
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Hällgren, Anita, ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Infectious Medic ...
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Scandinavian jou ...
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Linköping University