Needle Tip Culture after Prostate Biopsy: A Tool for early Detection for Antibiotics Selection in Cases of Post-Biopsy Infection
5 January 2019
Purpose: To investigate biopsy needle tip culture after prostate biopsies for bacteria prediction and antibiotics selection.
Materials and Methods: From May 2017 to April 2019, 121 patients who underwent a prostate biopsy were enrolled. All biopsy needle tips were sent for aerobic and anaerobic culture. Patients were divided into positive and negative culture groups. Perioperative data were recorded and compared between the two groups. The culture time and susceptibility of febrile patients were analyzed. Blood cultures were conducted for all patients who experienced fever after biopsy. The time and results of the needle and blood cultures were recoded for descriptive analysis.
Results: There were 59 (48.8%) positive needle cultures. Other than fever (p = 0.023), there were no statistical significances in clinical data between the two groups. Fever occurred in eight patients, and seven febrile patients had positive needle cultures, six of whom had positive blood cultures. These six needle and blood cultures were consistent with the susceptibility test results. As compared to the waiting time for blood cultures, target antibiotics were administered at an average of 48.0 h earlier based on needle cultures. None of the patients with positive anaerobic cultures developed a fever, while all eight febrile patients had negative anaerobic cultures.
Conclusion: Fevers developed at statistically significant higher rate among those who had positive needle cultures. Needle and blood cultures were consistent with the susceptibility test results. Needle cultures can help us administer target antibiotics earlier to febrile patients without the need to wait for blood cultures.
- Anti-Bacterial Agents
- Prostatic Neoplasms
How to Cite
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68:7-30.
Loeb S, Vellekoop A, Ahmed HU, et al. Systematic review of complications of prostate biopsy. European urology. 2013;64:876-892.
Pinsky PF, Parnes HL, Andriole G. Mortality and complications after prostate biopsy in the Prostate, Lung, Colorectal and Ovarian Cancer Screening (PLCO) trial. BJU Int. 2014;113:254-259.
Loeb S, Carter HB, Berndt SI, Ricker W, Schaeffer EM. Complications after prostate biopsy: data from SEER-Medicare. J Urol. 2011;186:1830-1834.
Wei TC, Lin TP, Chang YH, Chen TJ, Lin AT, Chen KK. Transrectal ultrasound-guided prostate biopsy in Taiwan: A nationwide database study. J Chin Med Assoc. 2015;78:662-665.
Loeb S, van den Heuvel S, Zhu X, Bangma CH, Schroder FH, Roobol MJ. Infectious complications and hospital admissions after prostate biopsy in a European randomized trial. Eur Urol. 2012;61:1110-1114.
Carignan A, Roussy JF, Lapointe V, Valiquette L, Sabbagh R, Pepin J. Increasing risk of infectious complications after transrectal ultrasound-guided prostate biopsies: time to reassess antimicrobial prophylaxis? Eur Urol. 2012;62:453-459.
Cheong I-S, Lin C-T, Jou Y-C, Cheng M-C, Shen C-H, Chen P-C. One day hospitalization for trans-rectal ultrasound guided prostate biopsy: Experiences of a single institution. Urological science. 2017;28:235-239.
Ozden E, Bostanci Y, Yakupoglu KY, et al. Incidence of acute prostatitis caused by extended-spectrum beta-lactamase-producing Escherichia coli after transrectal prostate biopsy. Urology. 2009;74:119-123.
Tal R, Livne PM, Lask DM, Baniel J. Empirical management of urinary tract infections complicating transrectal ultrasound guided prostate biopsy. J Urol. 2003;169:1762-1765.
Liss MA, Chang A, Santos R, et al. Prevalence and significance of fluoroquinolone resistant Escherichia coli in patients undergoing transrectal ultrasound guided prostate needle biopsy. J Urol. 2011;185:1283-1288.
Roberts MJ, Bennett HY, Harris PN, et al. Prostate Biopsy-related Infection: A Systematic Review of Risk Factors, Prevention Strategies, and Management Approaches. Urology. 2017;104:11-21.
Liss MA, Ehdaie B, Loeb S, et al. An Update of the American Urological Association White Paper on the Prevention and Treatment of the More Common Complications Related to Prostate Biopsy. J Urol. 2017;198:329-334.
Batura D, Rao GG, Nielsen PB. Prevalence of antimicrobial resistance in intestinal flora of patients undergoing prostatic biopsy: implications for prophylaxis and treatment of infections after biopsy. BJU Int. 2010;106:1017-1020.
Peacock SJ, Eddleston M, Emptage A, King A, Crook DW. Positive intravenous line tip cultures as predictors of bacteraemia. J Hosp Infect. 1998;40:35-38.
Sankar B, Ray P, Rai J. Suction drain tip culture in orthopaedic surgery: a prospective study of 214 clean operations. Int Orthop. 2004;28:311-314.
Yamauchi Y, Isaka M, Maniwa T, Takahashi S, Kurai H, Ohde Y. Chest tube tip culture as a predictor of postoperative infection in lung cancer operations. Ann Thorac Surg. 2013;96:1796-1802.
Chandrasekar PH, Brown WJ. Clinical Issues of Blood Cultures. Archives of Internal Medicine. 1994;154:841-849.
Yamane N. Blood culture: gold standard for definitive diagnosis of bacterial and fungal infections--from the laboratory aspect. Rinsho byori. The Japanese journal of clinical pathology. 1998;46:887-892.
Opota O, Croxatto A, Prod'hom G, Greub G. Blood culture-based diagnosis of bacteraemia: state of the art. Clinical Microbiology and Infection. 2015;21:313-322.
Coburn B, Morris AM, Tomlinson G, Detsky AS. Does this adult patient with suspected bacteremia require blood cultures? Jama. 2012;308:502-511.
Lindert KA, Kabalin JN, Terris MK. Bacteremia and bacteriuria after transrectal ultrasound guided prostate biopsy. J Urol. 2000;164:76-80.
Anderson E, Leahy O, Cheng AC, Grummet J. Risk factors for infection following prostate biopsy - a case control study. BMC Infect Dis. 2015;15:580.
Raaijmakers R, Kirkels WJ, Roobol MJ, Wildhagen MF, Schrder FH. Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program. Urology. 2002;60:826-830.
Duplessis CA, Bavaro M, Simons MP, et al. Rectal cultures before transrectal ultrasound-guided prostate biopsy reduce post-prostatic biopsy infection rates. Urology. 2012;79:556-561.
Summers SJ, Patel DP, Hamilton BD, et al. An antimicrobial prophylaxis protocol using rectal swab cultures for transrectal prostate biopsy. World journal of urology. 2015;33:2001-2007.
Cheung C, Patel HD, Landis P, Carter HB, Han M. Targeted antimicrobial prophylaxis for transrectal ultrasound-guided prostate biopsy during active surveillance: Effect on hospitalization. Urol Oncol. 2018;36:158 e157-158 e112.
Jiang P, Liss MA, Szabo RJ. Targeted antimicrobial prophylaxis does not always prevent sepsis after transrectal prostate biopsy. The Journal of urology. 2018;200:361-368.
Jonathan Shoag, Tianyi Sun, Morgan Pantuck: Risk factors for post prostate biopsy infection. J Clin Oncol, 37: 2019 (suppl 7S; abstr 103) https://meetinglibrary.asco.org/record/170060/abstract
Harris LF, Jackson RT, Breslin JA, Alford RH. Anaerobic septicemia after transrectal prostatic biopsy. Archives of internal medicine. 1978;138:393-395.
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