MP16-14 RECTAL CULTURE PRIOR TO PROSTATE BIOPSY IDENTIFIES MEN AT RISK FOR INFECTION: A MULTI-INSTITUTIONAL INTERNATIONAL COLLABORATIVE STUDY (2014)

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Prostate & Genitalia1 Apr 2014MP16-14 RECTAL CULTURE PRIOR TO PROSTATE BIOPSY IDENTIFIES MEN AT RISK FOR INFECTION: A MULTI-INSTITUTIONAL INTERNATIONAL COLLABORATIVE STUDY Michael Liss, Stephen A. Taylor, Deepak Batura, Deborah Steensels, Methee Chayakulkeeree, Charlotte Soenens, G. Gopal Rao, Atreya Dash, Samuel Park, Nishant Patel, Jason Woo, Michelle McDonald, Unwanaobong Nseyo, Pooya Banapour, Stephen Unterberg, Thomas Ahlering, Hendrik Van Poppel, Joshua Fierer, and Peter Black Michael LissMichael Liss More articles by this author , Stephen A. TaylorStephen A. Taylor More articles by this author , Deepak BaturaDeepak Batura More articles by this author , Deborah SteenselsDeborah Steensels More articles by this author , Methee ChayakulkeereeMethee Chayakulkeeree More articles by this author , Charlotte SoenensCharlotte Soenens More articles by this author , G. Gopal RaoG. Gopal Rao More articles by this author , Atreya DashAtreya Dash More articles by this author , Samuel ParkSamuel Park More articles by this author , Nishant PatelNishant Patel More articles by this author , Jason WooJason Woo More articles by this author , Michelle McDonaldMichelle McDonald More articles by this author , Unwanaobong NseyoUnwanaobong Nseyo More articles by this author , Pooya BanapourPooya Banapour More articles by this author , Stephen UnterbergStephen Unterberg More articles by this author , Thomas AhleringThomas Ahlering More articles by this author , Hendrik Van PoppelHendrik Van Poppel More articles by this author , Joshua FiererJoshua Fierer More articles by this author , and Peter BlackPeter Black More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.587AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Infection after transrectal prostate biopsy has become a growing concern over the past decade largely due to ciprofloxacin resistance. Herein, we establish an international collaboration to investigate the risk of prostate biopsy infection in men with or without colonization of fluoroquinolone resistant (FQR) organisms on rectal culture. METHODS After IRB approval, six institutions provided data through a standardized, web-based data entry form on patients undergoing prostate biopsy who had rectal culture performed. The primary outcome was any post prostate biopsy infection and the secondary outcome was hospital admission due to infection. We used Chi-Squared analysis and multivariate analysis including logistic regression. RESULTS We identified 2,673 men who underwent rectal culture prior to prostate biopsy from 2007-3013. The median age was 66 years (27-89) and FQR colonization was noted in 20.5% (549/2673). Selective media was used in 43% (1151/2673) to identify FQR organisms. The majority (93%; 2474/2673) of patients received a fluoroquinolone prior to biopsy and 24% (643/2673) used more than 1 antibiotic. The majority of infectious complications were identified by chart review (63.7%; 1702/2673); whereas, the rest were identified by study directed telephone calls. The overall infection rate was 2.6% (69/2673) and admission for infection was 1.6% (44/2673). Post biopsy infection occurred in 1.6% (33/2091) of patients with negative FQR culture compared to 6.6% (36/513) with positive FQR culture (p<0.001). Hospitalization for infection occurred in 0.9% (20/2104) of FQR negative culture patients vs. 4.4% (24/525) of FQR positive culture patients (p<0.001). Age, BMI, diabetes, PSA, prostate size on ultrasound, hospitalization within the last year, and antibiotic augmentation (>2 antibiotics) were not significantly associated with infection. Using any bowel preparation (p=0.021) reduced admissions, while the presence of diabetes (p=0.014) and positive FQR on rectal culture (p<0.001) increased risk of admission. Controlling for bowel preparation and diabetes in multivariate logistic regression, FQR positive culture increased the risk of infection (OR 5.5, 95%CI 2.5-12.4; p<0.001) and hospitalization for infection (OR 8.2, 95%CI 2.9-23.1; p<0.001). CONCLUSIONS Fluoroquinolone resistant organisms on rectal culture prior to prostate biopsy identify men who are at higher risk for infection and subsequent hospitalization. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e158 Advertisement Copyright & Permissions© 2014Metrics Author Information Michael Liss More articles by this author Stephen A. Taylor More articles by this author Deepak Batura More articles by this author Deborah Steensels More articles by this author Methee Chayakulkeeree More articles by this author Charlotte Soenens More articles by this author G. Gopal Rao More articles by this author Atreya Dash More articles by this author Samuel Park More articles by this author Nishant Patel More articles by this author Jason Woo More articles by this author Michelle McDonald More articles by this author Unwanaobong Nseyo More articles by this author Pooya Banapour More articles by this author Stephen Unterberg More articles by this author Thomas Ahlering More articles by this author Hendrik Van Poppel More articles by this author Joshua Fierer More articles by this author Peter Black More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...