[Multiresistant Escherichia coli meningitis after transrectal prostate biopsy]

Area of Science:

• Urology
• Infectious Diseases
• Microbiology

Background:

• Transrectal prostate biopsy is the gold standard for prostate cancer diagnosis.
• Prophylactic fluoroquinolone use is common but associated with rising antimicrobial resistance.
• Escherichia coli is a common pathogen in urinary tract infections and can cause severe systemic illness.

Observation:

• A patient undergoing transrectal prostate biopsy received prophylactic fluoroquinolones.
• The patient developed meningitis caused by a multidrug-resistant strain of Escherichia coli.
• The infection proved fatal despite medical intervention.

Findings:

• Multiresistant Escherichia coli strains pose a significant risk following transrectal prostate biopsy.
• Fluoroquinolone prophylaxis may not be effective against resistant strains and could contribute to their emergence.
• Invasive infections like meningitis can result from transrectal prostate biopsy.

Implications:

• Increased vigilance is required when prescribing fluoroquinolones for prophylaxis before prostate biopsies.
• Alternative prophylactic strategies or enhanced surveillance for resistant organisms may be necessary.
• This case underscores the critical need to monitor and combat antimicrobial resistance in urological procedures.