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Predictors of fluoroquinolone-resistant bacteria in the rectal vault of men undergoing prostate biopsy.

Publication ,  Journal Article
Tan, WP; Papagiannopoulos, D; Latchamsetty, KC; Wilson, N; O'Block, N; Raff, L; Mena Lora, A; Coogan, CL; Abern, MR
Published in: Prostate Cancer Prostatic Dis
May 2019

IMPORTANCE: Fluoroquinolone (FQ)-resistant rectal vault flora is associated with infectious complications in men undergoing transrectal ultrasound-guided prostate needle biopsy (TRUS-PNB). OBJECTIVE: To determine the patient factors that predict FQ-resistant rectal cultures in men who are undergoing transrectal ultrasound-guided prostate needle biopsy. METHODS: An IRB approved retrospective review of 6183 consecutive men who had undergone a rectal swab culture in preparation for TRUS-PNB between January 2013 and December 2014 was performed. Multivariable logistic regression was used to determine the clinical and demographic factors associated with FQ-resistant Enterobacteriaceae in the rectal vault. RESULTS: Of the 6179 rectal swabs analyzed, 4842 (78%) were FQ-sensitive, and 1337 (22%) were FQ-resistant. On univariable analysis, increasing age, prior TRUS-PNB, higher number of biopsy cores obtained, diabetes mellitus, antimicrobial use within the past 6 months and non-Caucasian race were predictors of FQ-resistance (all p < 0.05). Men with FQ-resistant cultures were more likely to have benign pathology on TRUS-PNB (p = 0.004). On multivariable analysis, increasing patient age (OR = 1.01/year [1.00-1.02]), use of antimicrobials in the last 6 months (OR = 2.85[2.18-3.72]), African American (OR = 1.99 [1.66-2.37]), Asian (OR = 3.39 [2.63-4.37]), and Hispanic (OR = 2.10 [1.72-2.55]) races were independently associated with FQ-resistant rectal cultures. The overall infectious rate was 1.1% (56/5214) and the sepsis rate was 0.46% (24/5214). The infection rate in the FQ-resistant group was 3.9% (43/1107) compared to FQ-sensitive group 0.3% (13/4107), p < 0.001. CONCLUSION: In this cohort, increasing age, recent antimicrobial-use, and non-Caucasian race were independent predictors of FQ-resistance in the rectal vault. As FQ-resistance is associated with infectious complications from transrectal ultrasound-guided prostate needle biopsy, understanding risk factors may assist infection control efforts.

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Published In

Prostate Cancer Prostatic Dis

DOI

EISSN

1476-5608

Publication Date

May 2019

Volume

22

Issue

2

Start / End Page

268 / 275

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Risk Factors
  • Rectum
  • Prostatic Neoplasms
  • Prostate
  • Postoperative Complications
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Humans
 

Citation

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Tan, W. P., Papagiannopoulos, D., Latchamsetty, K. C., Wilson, N., O’Block, N., Raff, L., … Abern, M. R. (2019). Predictors of fluoroquinolone-resistant bacteria in the rectal vault of men undergoing prostate biopsy. Prostate Cancer Prostatic Dis, 22(2), 268–275. https://doi.org/10.1038/s41391-018-0092-3
Tan, Wei Phin, Dimitri Papagiannopoulos, Kalyan C. Latchamsetty, Nathaniel Wilson, Nicholas O’Block, Lester Raff, Alfredo Mena Lora, Christopher L. Coogan, and Michael R. Abern. “Predictors of fluoroquinolone-resistant bacteria in the rectal vault of men undergoing prostate biopsy.Prostate Cancer Prostatic Dis 22, no. 2 (May 2019): 268–75. https://doi.org/10.1038/s41391-018-0092-3.
Tan WP, Papagiannopoulos D, Latchamsetty KC, Wilson N, O’Block N, Raff L, et al. Predictors of fluoroquinolone-resistant bacteria in the rectal vault of men undergoing prostate biopsy. Prostate Cancer Prostatic Dis. 2019 May;22(2):268–75.
Tan, Wei Phin, et al. “Predictors of fluoroquinolone-resistant bacteria in the rectal vault of men undergoing prostate biopsy.Prostate Cancer Prostatic Dis, vol. 22, no. 2, May 2019, pp. 268–75. Pubmed, doi:10.1038/s41391-018-0092-3.
Tan WP, Papagiannopoulos D, Latchamsetty KC, Wilson N, O’Block N, Raff L, Mena Lora A, Coogan CL, Abern MR. Predictors of fluoroquinolone-resistant bacteria in the rectal vault of men undergoing prostate biopsy. Prostate Cancer Prostatic Dis. 2019 May;22(2):268–275.

Published In

Prostate Cancer Prostatic Dis

DOI

EISSN

1476-5608

Publication Date

May 2019

Volume

22

Issue

2

Start / End Page

268 / 275

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Risk Factors
  • Rectum
  • Prostatic Neoplasms
  • Prostate
  • Postoperative Complications
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Humans