DETECTION OF FLUOROQUINOLONE-RESISTANT BACTERIA PRIOR TO TRANSRECTAL PROSTATE BIOPSY: ANALYSIS OF STOOL SAMPLES FACILITATES TARGETED PROPHYLAXIS

作者：Budak Salih^*; Karakece Engin; Budak Gokcen Gurkok; Aydemir Huseyin; Kumsar Sukru; Kose Osman; Sencelikel Tugce; Ciftci Ihsan Hakki; Saglam Hasan Salih; Adsan Oztug

来源：Acta Medica Mediterranea, 2015, 31(2): 275-279.

• Prostate biopsy
• antibiotic prophylaxis
• fluoroquinolon- resistance
• Escherichia coli
• complications

Aims: We used faecal culture to determine the prevalence of fluoroquinolone-resistant Escherichia coli in the intestinal flora of patients undergoing prostate biopsies. We sought to use faecal culture results to choose appropriate prophylaxis prior to prostate biopsy. In addition, we identified fluoroquinolone-resistant E. coli strains in faecal cultures, and the sensitivities thereof to other drugs that could be used for prophylaxis.
Materials and methods: This study included a total of 108 patients, who were subjected to a prostate biopsy on suspicion of prostate cancer; patients ranged in age from 46-74 years. Patients with histories of prostate biopsy and/or prostate surgical operations were excluded. Faecal culture results were obtained for each patient prior to biopsy, and infections occurring after biopsy were recorded. patients were divided into two groups; those with fluoroquinolone-resistant E. coli strains, and those with fluoroquinolone-susceptible E. coli strains. The two groups were compared in reference to age, prostate specific antigen level, and antibiotic use in the prior 6 months.
Results: E. coli strains were identified in 84 of the 108 patients for whom faecal culture results were available. In 20 such patients,fluoroquinolone-resistance was evident. No infectious complication developed in any patient. Mean patient age, median prostate specific antigen level prior to biopsy (lg/L), and use of fluoroquinolones <6 months prior to biopsy were analysis as possible risk factors. However, no significant difference between patients with fluoroquinolone-resistant and fluoroquinolone-susceptible E. coli was evident.
Conclusion: We found high numbers of fluoroquinolone-resistant E. coli in faeces collected prior to prostate biopsy. Thus, fluoroquinolones should not be used for prostate biopsy prophylaxis. We found no difference in the extent of quinolone-resistance in patients graded by age, prostate specific antigen level, or antibiotic use in the prior 6 months. In risky cases, faecal culture results may be used to choose appropriate prophylaxis.

• 出版日期2015