title: Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) - a multi-center retrospective study.
abstract: We retrospectively investigated the incidence of genitourinary tract infection in 5895 patients who underwent transrectal and/or transperineal prostate biopsy procedure between January and December 2011 at 46 institutions belonging to Japanese Research Group for Urinary Tract Infection (JRGU). The total rate of genitourinary tract infection after prostate biopsy was 0.76%, while that following transrectal procedure was 0.83% and following transperineal procedure was 0.57%, which were not significantly different. In contrast, febrile infection associated with a fever (≥38 °C) occurred significantly more frequently after transrectal (0.71%) than transperineal (0.16%) approach (P = 0.04). Notably, in infectious cases, Escherichia coli was most frequently isolated. Of the 9 E. coli strains isolated by urine culture, 6 (66.7%) produced extended spectrum β-lactamase (ESBL) and 7 (77.8%) showed levofloxacin resistance. Similarly, of 6 E. coli strains isolated by blood culture, 4 (66.7%) produced ESBL and 6 (100%) showed levofloxacin resistance. When the efficacy of antimicrobial prophylaxis (AMP) with levofloxacin for the patients undergoing transrectal or transperineal biopsy was compared between a single dose (500 mg) and that given for 2 or more days, no significant difference was observed for the rate of infection (transrectal: 0.82% vs. 1.04%, p = 0.94; transperineal: 0.30% vs. 0.46%, p = 0.68). Although a single dose of levofloxacin for AMP is sufficient to prevent genitourinary infection after transrectal or transperineal prostate biopsy, and recommended in this era of increased multi-drug resistant pathogens, the increase in fluoroquinolone-resistant E. coli and ESBL-producing E. coli has emerged as a profound problem for surveillance.
authors.affiliation: Department of Urology, Hyogo College of Medicine, Japan. Electronic address: ytogo@hyo-med.ac.jp.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Togo
authors.affiliation: Department of Public Health, University of Occupational and Environmental Health, Japan.
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Urology, Hyogo College of Medicine, Japan.
authors.forename: Rikiya
authors.initials: R
authors.lastname: Taoka
authors.affiliation: Department of Urology, Sapporo Medical University School of Medicine, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hiyama
authors.affiliation: Department of Urology, Sapporo Medical University School of Medicine, Japan.
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Uehara
authors.affiliation: Department of Urology, Sapporo Medical University School of Medicine, Japan.
authors.forename: Jiroh
authors.initials: J
authors.lastname: Hashimoto
authors.affiliation: Department of Urology, Sapporo Medical University School of Medicine, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kurimura
authors.affiliation: Department of Urology, Sapporo Medical University School of Medicine, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Urology, Sapporo Medical University School of Medicine, Japan.
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
authors.affiliation: Department of Urology, Faculty of Medicine, University of Tsukuba, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Miyazaki
authors.affiliation: Department of Urology, Faculty of Medicine, University of Tsukuba, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama
authors.affiliation: Division of Urology, Jikei University Katsushika Medical Center, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kira
authors.affiliation: Division of Urology, Jikei University Katsushika Medical Center, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kiyota
authors.affiliation: Department of Urology, Keio University School of Medicine, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yazawa
authors.affiliation: Department of Urology, Keio University School of Medicine, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Niwa
authors.affiliation: Department of Urology, Keio University School of Medicine, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hongo
authors.affiliation: Department of Urology, Keio University School of Medicine, Japan.
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Oya
authors.affiliation: Department of Urology, Gifu University Graduate School of Medicine, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Urology, Gifu University Graduate School of Medicine, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Yasuda
authors.affiliation: Department of Urology, Gifu University Graduate School of Medicine, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Deguchi
authors.affiliation: Department of Urology, Fujita Health University School of Medicine, Japan.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Ishikawa
authors.affiliation: Department of Urology, Fujita Health University School of Medicine, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Hoshinaga
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Japan.
authors.forename: Minori
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Shigemura
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Japan.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Japan.
authors.forename: Soichi
authors.initials: S
authors.lastname: Arakawa
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
authors.affiliation: Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Wada
authors.affiliation: Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Uehara
authors.affiliation: Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
authors.forename: Toyohiko
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kumon
authors.affiliation: Department of Urology, Institute of Biomedical & Health Sciences, Hiroshima University, Japan.
authors.forename: Kanao
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Urology, Institute of Biomedical & Health Sciences, Hiroshima University, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Matsubara
authors.affiliation: Department of Urology, University of Occupational and Environmental Health, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Urology, University of Occupational and Environmental Health, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Sho
authors.affiliation: Department of Urology, University of Occupational and Environmental Health, Japan.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Hamasuna
authors.affiliation: Department of Urology, University of Occupational and Environmental Health, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Blood Purification Center, Kagoshima University Hospital, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hayami
authors.affiliation: Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakagawa
authors.affiliation: Department of Urology, Hyogo College of Medicine, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001706:Biopsy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology*; D011467:Prostate / Q000601:surgery*; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antimicrobial prophylaxis; Genitourinary tract infection; Prostate biopsy; Prostate cancer