Abstract:
BACKGROUND:We evaluated the effectiveness of targeted antimicrobial prophylaxis in transrectal ultrasound guided prostate biopsy (TRUSP). METHODS:A prospective, non-randomized cohort study was conducted. Rectal swab cultures plated on non-selective blood agar and on selective MacConkey agar supplemented with ciprofloxacin identified ciprofloxacin-susceptible and -resistant gram-negative bacteria (CS-GNB and CR-GNB). Patients with CS-GNB received ciprofloxacin while those with CR-GNB received directed prophylaxis. Infectious complications were defined clinically and microbiologically within 30 days after TRUSP. Data were derived at 7 and 30 days post procedure by questionnaires and electronic medical records. We hypothesized that there would be no difference in the infectious outcomes among the CS and CR groups. RESULTS:From November 1, 2012 to March 31, 2015, 510 men completed the study; 430 (84.3%) had CS-GNB and 80 (15.7%) had CR-GNB. 484 (94.9%) completed the study per protocol, while 26 (5.1%) had an intention-to-treat (ITT) analysis. Of the 484, 475 (98.1%) had no infections, nine (1.9%) had infections, six of which (1.2%) were culture-proven (CP). The nine infections were as follows: five (1.0%) uncomplicated UTIs, one (0.2%) complicated UTI, and three (0.6%) urosepsis. One case of uncomplicated UTI and two cases of urosepsis were not CP, but were diagnosed clinically. ITT outcomes were similar. The infection rates were not statistically different between the CS-and CR-GNB patients (p-value = 0.314; 95% CI 0.8-3.3). The four patients with complicated UTIs or sepsis were hospitalized for a mean of 2.6 days and discharged without sequelae. Of the nine infections, three were antimicrobial prophylaxis failures (two ciprofloxacin and one amikacin); three were likely due to failure of the collection or processing of the rectal swab or increasing bacterial resistance between the time of swab collection and biopsy, and three developed clinical infections with no isolate recovered. CONCLUSIONS:Targeted antimicrobial prophylaxis follows the principles of antimicrobial stewardship and achieved a low rate of infectious complications with limited morbidity and no sequelae. This individualized method of prophylaxis may be widely applied. Further studies are needed to explore reasons for targeted prophylaxis failure and to determine comparative efficacy of non-ciprofloxacin-containing targeted prophylaxis regimens. TRIAL REGISTRATION:ClinicalTrials.gov. NCT01659866 . Registered 9 July 2012. First patient enrolled 1 November 2012.
journal_name
BMC Infect Disjournal_title
BMC infectious diseasesauthors
Zembower TR,Maxwell KM,Nadler RB,Cashy J,Scheetz MH,Qi C,Schaeffer AJdoi
10.1186/s12879-017-2470-1subject
Has Abstractpub_date
2017-06-07 00:00:00pages
401issue
1issn
1471-2334pii
10.1186/s12879-017-2470-1journal_volume
17pub_type
临床试验,杂志文章abstract:BACKGROUND:Poor outcomes of invasive candidiasis (IC) are associated with the difficulty in establishing the microbiological diagnosis at an early stage. New scores and laboratory tests have been developed in order to make an early therapeutic intervention in an attempt to reduce the high mortality associated with inva...
journal_title:BMC infectious diseases
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2334-11-60
更新日期:2011-03-09 00:00:00
abstract::The study of hepatitis C virus (HCV) genotypes/subtypes, quasispecies and recombinants obtained by virus genome sequencing are important for epidemiological studies, to trace the source of infection, for development of new direct acting antivirals (DAAs) therapy and for understanding antiviral selection pressures. The...
journal_title:BMC infectious diseases
pub_type: 杂志文章,评审
doi:10.1186/1471-2334-14-S5-S1
更新日期:2014-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12879-016-2165-z
更新日期:2017-01-13 00:00:00
abstract:BACKGROUND:Bedaquiline was recently introduced into World Health Organization (WHO)-recommended regimens for treatment of drug resistant tuberculosis. There is limited data on the long-term safety of bedaquiline. Because bedaquiline prolongs the QT interval, there are concerns regarding cardiovascular safety. The Weste...
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pub_type: 杂志文章
doi:10.1186/s12879-019-4197-7
更新日期:2019-06-20 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-14-135
更新日期:2014-11-28 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-14-382
更新日期:2014-07-10 00:00:00
abstract:BACKGROUND:Chlamydia trachomatis is the most common sexually transmitted bacterial pathogen causing female genital tract infection throughout the world. Reinfection with the same serovar, as well as multiple infections with different serovars, occurs in humans. Using a murine model of female C. trachomatis genital trac...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-5-105
更新日期:2005-11-17 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-015-1271-7
更新日期:2015-11-14 00:00:00
abstract:BACKGROUND:The new HIV treatment guidelines in China recommend antiretroviral therapy (ART) for all people living with HIV, but significant gaps in implementation still exist. Pre-exposure prophylaxis (PrEP) can effectively reduce the risk of HIV transmission among men who have sex with men (MSM). This study assessed t...
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pub_type: 杂志文章
doi:10.1186/s12879-018-3516-8
更新日期:2018-11-28 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:2015-02-06 00:00:00
abstract:BACKGROUND:To predict the risk of infectious diseases originating in wildlife, it is important to identify habitats that allow the co-occurrence of pathogens and their hosts. Puumala hantavirus (PUUV) is a directly-transmitted RNA virus that causes hemorrhagic fever in humans, and is carried and transmitted by the bank...
journal_title:BMC infectious diseases
pub_type: 杂志文章
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更新日期:2017-07-26 00:00:00
abstract:BACKGROUND:Many people have multiple infections at the same time, but the combined contribution of those infections to disease-related mortality is unknown. Registered causes of death offer a unique opportunity to study associations between multiple infections. METHODS:We analysed over 900,000 death certificates that ...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-015-1118-2
更新日期:2015-10-06 00:00:00
abstract:BACKGROUND:Ebola haemorrhagic fever (EHF) is infamous for its high case-fatality proportion (CFP) and the ease with which it spreads among contacts of the diseased. We describe the course of the EHF outbreak in Masindi, Uganda, in the year 2000, and report on response activities. METHODS:We analysed surveillance recor...
journal_title:BMC infectious diseases
pub_type: 杂志文章
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更新日期:2011-12-28 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2015-07-30 00:00:00
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pub_type: 杂志文章
doi:10.1186/1471-2334-13-428
更新日期:2013-09-11 00:00:00
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doi:10.1186/s12879-019-3927-1
更新日期:2019-04-08 00:00:00
abstract:BACKGROUND:The preferred regimen for HIV post-exposure prophylaxis (PEP) is based mainly on safety and tolerability because it is given to immunocompetent people without HIV infection for a limited time (28 days). The frequency of adverse events (AEs) may be > 60%. Although AEs are generally not severe, they can lead t...
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pub_type: 杂志文章
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更新日期:2016-11-29 00:00:00
abstract:BACKGROUND:Patients asking for a free anonymous HIV test may have contracted other sexually transmitted infections (STIs) such as Chlamydia trachomatis, yet Chlamydia prevalence in that population is unknown. This study aimed to assess the prevalence and factors associated with Chlamydia infection in patients seeking H...
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pub_type: 杂志文章
doi:10.1186/s12879-016-1915-2
更新日期:2016-10-26 00:00:00
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更新日期:2012-06-07 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2013-06-28 00:00:00
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pub_type: 杂志文章
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更新日期:2011-04-13 00:00:00
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pub_type: 杂志文章
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更新日期:2007-04-18 00:00:00
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pub_type: 杂志文章
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更新日期:2011-09-30 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
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更新日期:2014-02-25 00:00:00
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pub_type: 杂志文章
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更新日期:2014-01-20 00:00:00
abstract:BACKGROUND:It is estimated that Lao People's Democratic Republic (Lao PDR) ranks fifth among the seven countries most affected by TB in the WHO Western Pacific Region. However, because of late implementation of mycobacterial culture, no study on resistance to anti-TB drugs had been performed yet. The objective of this ...
journal_title:BMC infectious diseases
pub_type: 杂志文章,多中心研究
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更新日期:2013-06-19 00:00:00
abstract:BACKGROUND:Human adenovirus type 3 (HAdV-3) and 7 (HAdV-7) cause significant morbidity and develop severe complications and long-term pulmonary sequelae in children. However, epidemiologic reports have suggested that nearly all highly severe or fatal adenoviral diseases in children are associated with HAdV-7 rather tha...
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pub_type: 杂志文章
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更新日期:2019-01-09 00:00:00
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pub_type: 杂志文章
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更新日期:2015-02-26 00:00:00
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pub_type: 杂志文章
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更新日期:2020-10-16 00:00:00