title: Prevalence of fluoroquinolone-resistant Escherichia coli before and incidence of acute bacterial prostatitis after prostate biopsy.
abstract: OBJECTIVE
  To study the prevalence of fluoroquinolone-resistant Escherichia coli before transrectal ultrasound (TRUS)-guided prostate biopsy and prospectively analyze the rates of infective complications after biopsy in patients receiving fluoroquinolone prophylaxis. E. coli is the pathogen most commonly associated with infections after TRUS-guided prostate biopsy, and the prevalence of fluoroquinolone-resistant E. coli is increasing.
  
  
  METHODS
  We analyzed the prospective data from 100 patients who underwent TRUS-guided prostate biopsy from April to December 2010. A stool culture was obtained 1 month before biopsy. Patients received 500 mg levofloxacin orally once daily for 3 days, beginning 2 hours before biopsy. All biopsies were performed as outpatient procedures.
  
  
  RESULTS
  Of the 100 patients, 13 (13%) had a stool culture positive for fluoroquinolone-resistant E. coli. In 4 (31%) of these 13 patients, acute bacterial prostatitis was detected after TRUS-guided prostate biopsy. Of the 87 patients whose stool culture was negative for fluoroquinolone-resistant E. coli, none had acute bacterial prostatitis. All 13 infected patients were treated with carbapenems immediately after diagnosis of prostatitis and made a complete recovery.
  
  
  CONCLUSIONS
  Prophylactic fluoroquinolone is still effective in preventing acute bacterial prostatitis after TRUS-guided prostate biopsy. The incidence is relatively low in patients with fluoroquinolone-sensitive E. coli. However, the prevalence of fluoroquinolone-resistant E. coli is about 13% in this population. Stool cultures for the detection of fluoroquinolone-resistant E. coli might be obtained before TRUS-guided prostate biopsy.
authors: Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. s-minami@bg7.so
authors: Satoru
authors: S
authors: Minamida
authors: Takefumi
authors: T
authors: Satoh
authors: Kenichi
authors: K
authors: Tabata
authors: Masaki
authors: M
authors: Kimura
authors: Hideyasu
authors: H
authors: Tsumura
authors: Shinji
authors: S
authors: Kurosaka
authors: Kazumasa
authors: K
authors: Matsumoto
authors: Tetsuo
authors: T
authors: Fujita
authors: Masatsugu
authors: M
authors: Iwamura
authors: Shiro
authors: S
authors: Baba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001707:Biopsy, Needle / Q000009:adverse effects*; D015780:Carbapenems / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000209:etiology; D005243:Feces / Q000382:microbiology; D024841:Fluoroquinolones / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000494:pharmacology / Q000627:therapeutic use*; D015995:Prevalence; D011467:Prostate / Q000473:pathology; D011472:Prostatitis / Q000188:drug therapy / Q000382:microbiology*; D012007:Rectum / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D024841:Fluoroquinolones; D064704:Levofloxacin; D015242:Ofloxacin