title: Radical prostatectomy in the presence of ongoing refractory ESBL Escherichia coli bacterial prostatitis.
abstract: A 44-year-old Indian national with a prostate-specific antigen of 5.4 ng/mL underwent 12-core transrectal ultrasound-guided prostate biopsies. Following this, he had three hospital admissions with severe urosepsis secondary to extended spectrum β lactamase (ESBL) producing Escherichia coli. He had recurrent sepsis immediately after discontinuation of intravenous meropenem to which the ESBL was sensitive. He proceeded to radical prostatectomy for intermediate-high risk Gleason 7 prostate cancer, while still on intravenous meropenem, 2 months after his biopsy. His prostatectomy involved a difficult dissection due to inflammatory changes and fibrosis after multiple septic episodes. He had complete resolution of infection after surgery with discontinuation of antibiotics on the third postoperative day, without any recurrence of sepsis.
authors.affiliation: Tallaght Hospital, Dublin, Ireland.
authors.forename: Louise Catherine
authors.initials: LC
authors.lastname: McLoughlin
authors.affiliation: Tallaght Hospital, Dublin, Ireland.
authors.forename: T E D
authors.initials: TE
authors.lastname: McDermott
authors.affiliation: Tallaght Hospital, Dublin, Ireland.
authors.forename: John Alan
authors.initials: JA
authors.lastname: Thornhill
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects; D008297:Male; D000077731:Meropenem; D060787:Neoplasm Grading; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D011472:Prostatitis / Q000150:complications* / Q000188:drug therapy; D012008:Recurrence; D013845:Thienamycins / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000077731:Meropenem