Impact of Rectal Swabs on Infectious Complications after Transrectal Prostate Biopsy.
OBJECTIVE
To determine the impact of rectal swabs (RSs) on infectious complications (IC) following prostate biopsy (PB).


METHODS
A retrospective cohort study was conducted including all patients subjected to PB between 2009 and 2013. Group B consisted of patients with a RS and group A of patients without. RS reported the presence of gram-positive or negative germs, sensitive or resistant to ciprofloxacin. Antimicrobial prophylaxis was adjusted to the result. Frequency of IC in each group was determined.


RESULTS
Group B had 548 (47.20%) patients and group A 613 (52.80%). From group B, 250 (45.62%) of the RSs showed fluoroquinolone (FQ)-resistant germs. Forty nine (16.44%) patients with sensitive germs vs. 147 (59.51%) with resistant germs had a history of previous FQ treatment (p < 0.0001). IC were observed in 33 (5.49%) patients from group A and in 7 (1.28%) patients from group B (p < 0.0001), requiring hospitalization in 4.99 vs. 1.28%, respectively. IC and hospital admissions were reduced in 76.68 and 74.34%, respectively, following the implementation of RS.


CONCLUSIONS
RS and targeted antibiotic prophylaxis prior to PB was associated with a significant reduction in IC and hospital admissions. Ceftriaxone could be an alternative in cases of known resistance. Past history of FQ treatment is associated with increased resistance.
Department of Urology, Hospital Universitario de la Fundación Santa Fe de Bogotá and Universidad de los Andes School of Medicine, Bogotá, D.C., Colombia.
Carlos Gustavo
CG
Trujillo
Mauricio
M
Plata
Juan Ignacio
JI
Caicedo
Juan Guillermo
JG
Cataño Cataño
Angela Marcela
AM
Mariño Alvarez
Diana
D
Castelblanco
Daniela
D
Robledo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000453:epidemiology*; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011467:Prostate / Q000473:pathology*; D012007:Rectum / Q000382:microbiology*; D012189:Retrospective Studies