Abstract:
OBJECTIVES:To determine the prevalence of extended-spectrum β-lactamase (ESBL) in patients undergoing transrectal prostate biopsy, to assess the incidence of postoperative sepsis, to correlate the development of sepsis with the presence of preoperative ESBL on rectal swabs, and to assess the adequacy of prophylactic antibiotic guidelines in the context of local ESBL prevalence. METHODS:Patients undergoing transrectal ultrasonography (TRUS)-guided biopsy at the Royal Melbourne Hospital between January 2012 and July 2016 had rectal swabs taken immediately prior to TRUS with specific cultures to identify the presence of ESBL. Patients were given a prophylactic antibiotic, 500 mg oral ciprofloxacin, 1 h before the TRUS procedure. Data were collected prospectively, with retrospective review of all readmitted patient files and audit data to ensure complete capture of events. RESULTS:A total of 387 TRUS-guided biopsy procedures were performed. Rectal swabs were correctly collected in 352 patients (91%). The median patient age was 65 years. In all, 25 (7%) ESBL-positive swabs were identified. Most ESBL were Escherichia coli. Half (50%) of ESBL were resistant to ciprofloxacin and all were sensitive to meropenem. A small increase in ESBL prevalence over time was not significant (R2 = 0.35). Four patients (1.1%) were readmitted with sepsis; ESBL Pseudomonas had previously grown in one patient, but sepsis was attributable to non-ESBL E. coli. In one of the readmitted patients ESBL E. coli was present, but this patient did not have ESBL preoperatively. There were no deaths or high-dependency/intensive care unit admissions. CONCLUSIONS:This study represents the largest Australian series to investigate ESBL prevalence, and reveals a rate lower than that of many other nations. Our sepsis rate is lower than many international series, perhaps because of our low ESBL rate and strict antibiotic prophylaxis. Preoperative swab results did not predict postoperative sepsis, and the process was therefore not useful for guiding antibiotic therapy. In this patient population, TRUS biopsy, with ciprofloxacin prophylaxis, remains a safe option for diagnostic prostate biopsy.
journal_name
BJU Intjournal_title
BJU internationalauthors
Sewell J,Chow K,De Sousa A,Sapre N,Norris B,Namdarian B,Sinickas V,Huang JG,Anderson Pdoi
10.1111/bju.14745subject
Has Abstractpub_date
2019-05-01 00:00:00pages
43-46eissn
1464-4096issn
1464-410Xjournal_volume
123 Suppl 5pub_type
杂志文章abstract:OBJECTIVE:To investigate the feasibility of transcript profiling in diagnostic formalin-fixed and paraffin-embedded (FFPE) biopsies for prostate cancer. MATERIALS AND METHODS:Laser-capture microdissection (LCM) was used to microdissect glandular epithelium as well as stromal tissue in archival prostate needle biopsies...
journal_title:BJU international
pub_type: 杂志文章
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journal_title:BJU international
pub_type: 杂志文章
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journal_title:BJU international
pub_type: 杂志文章,多中心研究
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abstract:OBJECTIVE:To test the replicability and robustness of findings about urological symptoms in men and women, classified using an objective statistical method, cluster analysis, by planned sensitivity analyses conducted within and across two large, epidemiological studies of lower urinary tract symptoms. METHODS:Sensitiv...
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pub_type: 杂志文章
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journal_title:BJU international
pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,多中心研究
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journal_title:BJU international
pub_type: 杂志文章
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更新日期:2000-09-01 00:00:00
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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更新日期:2005-02-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2005-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1464-410X.2006.06377.x
更新日期:2006-09-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.08208.x
更新日期:2009-05-01 00:00:00
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pub_type: 杂志文章
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journal_title:BJU international
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2002-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1046/j.1464-410x.2001.00990.x
更新日期:2001-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2008-03-01 00:00:00
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更新日期:2009-11-01 00:00:00
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更新日期:2014-11-01 00:00:00
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更新日期:2015-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2019-04-01 00:00:00
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更新日期:2018-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1046/j.1464-410x.2003.04243.x
更新日期:2003-06-01 00:00:00
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更新日期:2017-06-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2015-07-01 00:00:00