Acute bacterial prostatitis after transrectal prostate needle biopsy: clinical analysis.

Area of Science:

• Urology
• Infectious Diseases
• Microbiology

Background:

• Transrectal prostate biopsy is a common procedure for diagnosing prostate cancer.
• Acute bacterial prostatitis is a potential complication following prostate biopsy.
• Antibiotic prophylaxis is routinely used to prevent infections after prostate biopsy.

Purpose of the Study:

• To investigate the incidence and characteristics of acute bacterial prostatitis after transrectal prostate biopsy.
• To identify potential risk factors, including antibiotic prophylaxis, associated with post-biopsy prostatitis.
• To evaluate the susceptibility patterns of causative organisms.

Main Methods:

• Retrospective review of 457 patients undergoing transrectal prostate biopsy.
• Analysis of urine and blood cultures, treatment methods, and patient outcomes.
• Assessment of antibiotic susceptibility for isolated organisms, specifically focusing on levofloxacin resistance.

Main Results:

• Six patients (1.3%) developed acute bacterial prostatitis.
• The incidence was significantly higher after re-biopsy (4.7%) compared to first-biopsy (0.5%).
• All positive cultures yielded levofloxacin-resistant Escherichia coli, suggesting a link between levofloxacin prophylaxis and resistance.

Conclusions:

• Levofloxacin prophylaxis may be a risk factor for acute bacterial prostatitis due to the emergence of fluoroquinolone-resistant E. coli.
• Shorter durations of levofloxacin prophylaxis before biopsy might reduce the risk of resistant infections.
• Prompt treatment with cephalosporin or carbapenem is recommended for established cases of post-biopsy prostatitis.