TY - JOUR
T1 - Bacterial sepsis following prostatic biopsy
AU - Carmignani, Luca
AU - Picozzi, Stefano
AU - Spinelli, Matteo
AU - Di Pierro, Salvatore
AU - Mombelli, Gabriella
AU - Negri, Ercole
AU - Tejada, Milvana
AU - Gaia, Paola
AU - Costa, Elena
AU - Maggioni, Augusto
PY - 2012/8
Y1 - 2012/8
N2 - Purpose Despite the recent innovations, complications of prostate biopsy can occur. The aim of this study was a prospective monitoring of major septic complications occurring after transrectal prostate biopsy, to describe their causing agents, to report the clinical course of these patients, and to give guidelines based on our personal experience. Methods: This prospective study was carried out between January 2009 and September 2010. Complications were evaluated by telephone interviews. Results: Between January 2009 and September 2010, 447 (96.5%) completed the telephone interview. Urosepsis occurred in ten patients (2.2%) and in three cases evolved into septic shock. Of these ten patients, nine had a positive blood culture, of whom eight for Escherichia coli and one for Aeromonas hydrophila, Aeromonas caviae, and Aeromonas sobria. In seven cases, the E. coli isolated were resistant to fluoroquinolone and six produced an extended spectrum betalactamase. Six E. coli were classified as multidrugresistant organisms. Of the 10 patients, one died after the onset of multiorgan failure. For the other nine, the mean time spent in the hospital was 9 days (range, 6-15 days). Conclusions Escherichia coli are developing new drug resistances. Early recognition of patients who harbor MDRO E. coli in their rectum or in the urine could be an important strategy for preventing sepsis. If a patient who has recently undergone transrectal prostate biopsy shows clinical signs of sepsis in the 48 h, a multiresistant E. coli infection must be suspected. The patient must be admitted urgently to the hospital, and carbapenemantibiotic therapy should be started.
AB - Purpose Despite the recent innovations, complications of prostate biopsy can occur. The aim of this study was a prospective monitoring of major septic complications occurring after transrectal prostate biopsy, to describe their causing agents, to report the clinical course of these patients, and to give guidelines based on our personal experience. Methods: This prospective study was carried out between January 2009 and September 2010. Complications were evaluated by telephone interviews. Results: Between January 2009 and September 2010, 447 (96.5%) completed the telephone interview. Urosepsis occurred in ten patients (2.2%) and in three cases evolved into septic shock. Of these ten patients, nine had a positive blood culture, of whom eight for Escherichia coli and one for Aeromonas hydrophila, Aeromonas caviae, and Aeromonas sobria. In seven cases, the E. coli isolated were resistant to fluoroquinolone and six produced an extended spectrum betalactamase. Six E. coli were classified as multidrugresistant organisms. Of the 10 patients, one died after the onset of multiorgan failure. For the other nine, the mean time spent in the hospital was 9 days (range, 6-15 days). Conclusions Escherichia coli are developing new drug resistances. Early recognition of patients who harbor MDRO E. coli in their rectum or in the urine could be an important strategy for preventing sepsis. If a patient who has recently undergone transrectal prostate biopsy shows clinical signs of sepsis in the 48 h, a multiresistant E. coli infection must be suspected. The patient must be admitted urgently to the hospital, and carbapenemantibiotic therapy should be started.
KW - Fever
KW - Prostate biopsy
KW - Prostate cancer
KW - Sepsis
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U2 - 10.1007/s11255-012-0145-9
DO - 10.1007/s11255-012-0145-9
M3 - Article
C2 - 22371127
AN - SCOPUS:84867897294
VL - 44
SP - 1055
EP - 1063
JO - International Urology and Nephrology
JF - International Urology and Nephrology
SN - 0301-1623
IS - 4
ER -