1332. The incidence of fluoroquinolone resistant E coli infections after prostate biopsy under fluoroquinolone prophylaxis: a single center experience with 2215 patients
Session: Poster Abstract Session: Clinical Trials
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • idsa-poster.pdf (148.7 kB)
  • Background: Transrectal ultrasound (TRUS) guided prostate biopsy is one of the commonest urologic procedure. Several studies have shown the benefits of fluoroquinolone prophylaxis for decreasing infective complications related to this procedure. In the present study, we evaluated the rates of infective complications and the incidence of fluoroquinolone resistant infections after prostate biopsy under flouroquinolone prophylaxis.

    Methods: From January 2003 to December 2012, we retrospectively evaluated the records of 2215 patients who underwent TRUS guided 12-core prostate biopsy. All patients received cleansing enema and ciprofloxacin before the biopsy. The infective complications included urinary tract infection and fever, and fluoroquinolone resistant infections in positive cultures were calculated.

    Results: Of 2215 patients, 306 (13.8%) had symptoms of infection (fever, dysuria, leucocytosis etc). Of those, 153 (50%) had positive urine cultures such as 129 (84.3%) grew E coli, 8 (5.2%) grew Enterococcus spp, 6 (3.9%) grew Enterobacter spp, 5 (3.2%) grew Pseudomonas spp, 3 (1.9%) MRCNS, 2 (1.3%) grew Klebsiella spp. Of the positive urine cultures yielded E coli, 99 (76.7%) were evaluated for fluoroquinolone resistance. In these group 83 (83.8%) were fluoroquinolone resistant and composed of 51 (61.4%) ESBL positive and 32 (38.6%) ESBL negative. Fluoroquinolone resistant E coli ratios were 73.4% and 95.9% before 2008 and after 2008 respectively (p=0.002).The most sensitive antibiotics for fluoroquinolone resistant E coli strains were imipenem (100%) and amikacin (81%).

    Conclusion: Our study demonstrated that there is an increase in fluoroquinolone resistant infective complications after TRUS guided prostate biopsy under fluoroquinolone prophylaxis. Empirical treatment with carbapenem (include ertapenem, imipenem, meropenem) and amikacin may be initiated until culture specific therapy can be implemented

    Özlem Kandemir, Professor1, Murat Bozlu2, Ozan Efesoy2, Onur Gültekin1 and Erdem Akbay2, (1)Clinical Microbiology and Infectious Diseases, Mersin University School of Medicine, Mersin, Turkey, (2)Urology, Mersin University School of Medicine, Mersin, Turkey

    Disclosures:

    Kandemir, None

    M. Bozlu, None

    O. Efesoy, None

    O. Gültekin, None

    E. Akbay, None

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