Bacterial sepsis after prostate biopsy--a new perspective

Area of Science:

• Urology
• Infectious Diseases
• Medical Microbiology

Background:

• Transrectal ultrasound (TRUS)-guided prostate biopsy is a common urological procedure.
• Urosepsis is a potential complication following TRUS-guided prostate biopsy.
• Understanding the incidence and causative agents of urosepsis is critical for patient management.

Purpose of the Study:

• To determine the incidence of sepsis following TRUS-guided prostate biopsy.
• To identify common pathogens and their antibiotic resistance patterns in post-biopsy urosepsis.

Main Methods:

• Retrospective review of 24 male patients who presented with urosepsis after TRUS-guided prostate biopsy.
• Analysis of causative bacteria, time to presentation, and hospitalization duration.
• Evaluation of antibiotic prophylaxis and treatment regimens.

Main Results:

• Sepsis occurred in a small proportion of patients, with a median presentation of 1 day post-biopsy and a median hospitalization of 4 days.
• Escherichia coli was the most common pathogen (67%), exhibiting variable resistance.
• Two patients receiving extensive prophylaxis still developed urosepsis, highlighting the need for tailored treatment.

Conclusions:

• Prophylactic ciprofloxacin remains a viable option for preventing urosepsis post-TRUS biopsy due to its relatively low incidence.
• Suspected ciprofloxacin resistance necessitates individualized treatment plans based on local resistance profiles, patient history, and culture results.