title: Prevalence of antibiotic resistance in fecal flora of patients undergoing transrectal ultrasound-guided prostate biopsy in Thailand.
abstract: OBJECTIVE
  The objective of this study was to determine the prevalence of antibiotic resistance in fecal flora of patients undergoing transrectal ultrasound-guided needle biopsy of the prostate (TRUSB) and the factors associated with such antibiotic resistance.
  
  
  METHODS
  A prospective study of patients undergoing TRUSB was conducted. Rectal swabs were performed and sent for cultures and antibiotic susceptibility testing before TRUSB. Clinical characteristics were determined.
  
  
  RESULTS
  287 Gram-negative isolates from 144 patients were identified, 80.1% were Escherichia coli and 13.9% were Klebsiella pneumoniae. 27 patients who received antibiotics within 3 months exhibited higher prevalence of organisms with extended-spectrum beta-lactamases (ESBL) production (40.7 vs. 22.2%) and ceftriaxone-resistance (48.1 vs. 28.2%). 134 patients received a short-course antibiotic prophylaxis in which fluoroquinolone (FQ) contributed to 89.6% of cases. Patients who received antibiotic prophylaxis showed a higher prevalence of organisms resistant to ceftriaxone (34.3 vs. 0%), ciprofloxacin (90.3 vs. 30%) and FQ (95.5 vs. 50%) and a trend of more ESBL production (27.6 vs. 0%).
  
  
  CONCLUSIONS
  Previous antimicrobial use and prophylaxis with FQ are correlated with a higher prevalence of FQ and ceftriaxone resistance and ESBL production. A single dose of ceftriaxone without short-course FQ use is recommended as antibiotic prophylaxis in TRUSB.
authors.affiliation: Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Suwatthiya
authors.initials: S
authors.lastname: Siriboon
authors.forename: Surapee
authors.initials: S
authors.lastname: Tiengrim
authors.forename: Tawatchai
authors.initials: T
authors.lastname: Taweemongkongsup
authors.forename: Visanu
authors.initials: V
authors.lastname: Thamlikitkul
authors.forename: Methee
authors.initials: M
authors.lastname: Chayakulkeeree
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D001707:Biopsy, Needle / Q000009:adverse effects; D002443:Ceftriaxone / Q000008:administration & dosage; D016009:Chi-Square Distribution; D002939:Ciprofloxacin / Q000008:administration & dosage; D024881:Drug Resistance, Bacterial; D005243:Feces / Q000382:microbiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D013785:Thailand; D018084:Ultrasonography, Interventional; D014552:Urinary Tract Infections / Q000382:microbiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D002443:Ceftriaxone