Publication: Impact of fecal carriage of extended-spectrum beta-lactamase producing Enterobacteriaceae on the outcomes of transrectal needle biopsies of the prostate
Abstract
Amaç: Bu çalışmada, transrektal prostat biyopsisi (TRPB) öncesi, hastalarda dışkıda geniş spektrumlu beta-laktamaz üreten Enterobacteriaceae (GSBL-ÜE) taşıyıcılığı oranları, risk faktörleri ve sonuçları gösterilmesi amaçlanmıştır. Hastalar ve Yöntem: Toplam 143 TRPB yapılan hasta çalışmaya alınmıştır. Bunların 33(%23)ünde GSBL-ÜE taşıyıcılığı bulunmuştur. Ortalama hasta yaşı 62 ± 7,5 (43-81)dir. Bulgular: Tek değişkenli analizle son 2 ayda kinolon veya başka bir antibiyotik kullanımı, prostatit ve diabetes mellitus (DM) GSBL-ÜE taşıyıcılığı ile ilşkili bulunmuştur. Çok değişkenli analiz, son 2 ayda kinolon kullanımı (OR: 4,865; CI: 1,45-16,1), ve DM (OR: 4,04; CI: 1,64-10) varlığını önemli faktörler olarak göstermiştir. TRPB sonrası disüri (p<0,001), ateş (p=0,046) ve üşüme-titreme (p=0,002) gelişmesi GSBL-ÜE taşıyıcılığı ile ilişkili bulunmuştur. Asemptomatik bakteriüri ve sepsis saptanmamıştır. Semptomatik üriner sistem infeksiyon oranı %19dur. Sonuç: Bu çalışma GSBL-ÜE taşıyıcılığı için biyopsi öncesi risk faktörlerinin son 2 ayda kinolon veya diğer antibiyotik kullanımı ve DM varlığı olduğunu göstermiştir. Ciddi infektif komplikasyonların düşük oranda olması nedeniyle profilaksi rejimlerinin değiştirilmesi önerilmemektedir.
Objective: This study aimed to address the prevalence, the risk factors and the results of fecal carriage of extended-spectrum beta- lactamase producing Enterobacteriaceae (ESBL-PE) in patients who had undergone transrectal needle biopsy of the prostate (TRNBP). Patients and Methods: A total of 143 patients who had undergone TRNBP were included. Of these, 33(23%) had fecal carriage of ESBL-PE. The mean age of the patients was 62 ± 7.5 (43-81) years. Results: A univariate analysis showed that quinolone or other antibiotic use within the last 2 months, prostatitis, and diabetes mellitus (DM) were significantly associated with the presence of ESBL-PE. A multivariate analysis showed that quinolone use within the past 2 months (OR: 4.865; CI: 1.45-16.1), and DM (OR: 4.04; CI: 1.64-10) were found to be significant. Development of dysuria (p<0.001), fever (p=0.046) and chills (p=0.002) after TRNBP were shown to be related to the presence of ESBL-PE . There was no asymptomatic bacteriuria and sepsis, the rate of symptomatic urinary tract infection was 19%. Conclusion: This study showed that pre-biopsy risk factors for the presence of ESBL-PE were quinolone or other antibiotic use within the last 2 months and presence of DM. Changing prophylactic regimens should not be recommended due to the low rate of severe complications.
Objective: This study aimed to address the prevalence, the risk factors and the results of fecal carriage of extended-spectrum beta- lactamase producing Enterobacteriaceae (ESBL-PE) in patients who had undergone transrectal needle biopsy of the prostate (TRNBP). Patients and Methods: A total of 143 patients who had undergone TRNBP were included. Of these, 33(23%) had fecal carriage of ESBL-PE. The mean age of the patients was 62 ± 7.5 (43-81) years. Results: A univariate analysis showed that quinolone or other antibiotic use within the last 2 months, prostatitis, and diabetes mellitus (DM) were significantly associated with the presence of ESBL-PE. A multivariate analysis showed that quinolone use within the past 2 months (OR: 4.865; CI: 1.45-16.1), and DM (OR: 4.04; CI: 1.64-10) were found to be significant. Development of dysuria (p<0.001), fever (p=0.046) and chills (p=0.002) after TRNBP were shown to be related to the presence of ESBL-PE . There was no asymptomatic bacteriuria and sepsis, the rate of symptomatic urinary tract infection was 19%. Conclusion: This study showed that pre-biopsy risk factors for the presence of ESBL-PE were quinolone or other antibiotic use within the last 2 months and presence of DM. Changing prophylactic regimens should not be recommended due to the low rate of severe complications.