경직장초음파 유도하 전립선 생검 후 ciprofloxacin 내성균에 의한 세균혈증의 임상 특성
Clinical Features of Bacteremia Caused by Ciprofloxacin-Resistant Bacteria after Transrectal Ultrasound-Guided Prostate Biopsy
1
조회
0
다운로드
6
인용
0
참고문헌
키워드
초록
Purpose: Fluoroquinolone is considered the prophylactic antibiotic of choice for Transrectal ultrasound (TRUS)-guided biopsy. However, failure of quinolone prophylaxis due to emerging quinolone-resistant enterobacteriae has been increasing. We reviewed bacteremia cases after TRUS-guided biopsy to identify antibiotic-resistant bacterial strains with the objective to prevent urosepsis. Materials and Methods: A total of 2,348 patients underwent TRUS-guided biopsy at our institution between January 2004 and December 2009. All patients received intravenous ciprofloxacin for prophylaxis. We retrospectively evaluated patients who developed infectious symptoms, such as fevers and chills. Results: Eleven (0.4%) of 2,348 patients developed infectious symptoms. Escherichia coli was the pathogen responsible for post-biopsy infections occurring in a; 11 (100%) patients with positive blood cultures, which confirmed ciprofloxacin-resistant E. coli, with one isolate producing extended-spectrum beta lactamase. Ten out of 11 E. coli isolates (91%) were resistant to ampicillin and 9 of 11 E. coli isolates (82%) were resistant to gentamicin. Ten out of 11 E. coli isolates (91%) were susceptible to third generation cephalosporins. All such patients were admitted to the hospital and treated with a third generation cephalosporin. One patient who habored an E. coli isolate producing extended-spectrum beta-lactamase received imipenem. Conclusions: Ciprofloxacin is effective in reducing infectious complications. However, recently, bacteremiccases are increasing due to ciprofloxacin resistant E. coli. For patients with infectious symptoms after transrectal prostate biopsy, early antibiotics change, including third generation cephalosporins, are recommended to prevent urosepsis.
Abstract
Purpose: Fluoroquinolone is considered the prophylactic antibiotic of choice for Transrectal ultrasound (TRUS)-guided biopsy. However, failure of quinolone prophylaxis due to emerging quinolone-resistant enterobacteriae has been increasing. We reviewed bacteremia cases after TRUS-guided biopsy to identify antibiotic-resistant bacterial strains with the objective to prevent urosepsis. Materials and Methods: A total of 2,348 patients underwent TRUS-guided biopsy at our institution between January 2004 and December 2009. All patients received intravenous ciprofloxacin for prophylaxis. We retrospectively evaluated patients who developed infectious symptoms, such as fevers and chills. Results: Eleven (0.4%) of 2,348 patients developed infectious symptoms. Escherichia coli was the pathogen responsible for post-biopsy infections occurring in a; 11 (100%) patients with positive blood cultures, which confirmed ciprofloxacin-resistant E. coli, with one isolate producing extended-spectrum beta lactamase. Ten out of 11 E. coli isolates (91%) were resistant to ampicillin and 9 of 11 E. coli isolates (82%) were resistant to gentamicin. Ten out of 11 E. coli isolates (91%) were susceptible to third generation cephalosporins. All such patients were admitted to the hospital and treated with a third generation cephalosporin. One patient who habored an E. coli isolate producing extended-spectrum beta-lactamase received imipenem. Conclusions: Ciprofloxacin is effective in reducing infectious complications. However, recently, bacteremiccases are increasing due to ciprofloxacin resistant E. coli. For patients with infectious symptoms after transrectal prostate biopsy, early antibiotics change, including third generation cephalosporins, are recommended to prevent urosepsis.
참고문헌 (16)
- Norberg M, "Determinants of complications after multiple transrectal core biopsies of the prostate", Eur Radiol, 6, pp.457~461 (1996)
- Kapoor DA, "Single-dose oral ciprofloxacin versus placebo for prophylaxis during transrectal prostate biopsy", Urology, 52, pp.552~558 (1998)
- Isen K, "Antibiotic prophylaxis for transrectal biopsy of the prostate: a prospective randomized study of the prophylactic use of single dose oral fluoroquinolone versus trimethoprim-sulfamethoxazole", Int Urol Nephrol, 31, pp.491~495 (1999)
- Aron M, "Antibiotic prophylaxis for transrectal needle biopsy of the prostate: a randomized controlled study", BJU Int, 85, pp.682~685 (2000)
- Davis R, "Ciprofloxacin, in the An updated review of its pharmacology, therapeutic efficacy and tolerability", Drugs, 51, pp.1019~1074 (1996)
- Feliciano J, "The incidence of fluoroquinolone resistant infections after prostate biopsy-- are fluoroquinolones still effective prophylaxis?", J Urol, 179, pp.952~955 (2008)
- Miura T, "Levofloxacin resistantEscherichia coli sepsis following an ultrasound- guided transrectal prostate biopsy: report of four cases and review of the literature", Int J Urol, 13, pp.457~459 (2008)
- Tal R, "Empirical management of urinary tract infections complicating transrectal ultrasound guided prostate biopsy", J Urol, 169, pp.1762~1765 (2003)
- Young JL, "Sepsis due to fluoroquinolone- resistant Escherichia coli after transrectal ultrasound-guided prostate needle biopsy", Urology, 74, pp.332~338 (2009)
- Koh JI, "Antibiotic prophylaxis practice in urology: a survey of 21 Korean medical institutions", Korean J UTII, 4, pp.72~79 (2009)
- Lee SJ, "Current status of antimicrobial resistance among bacterial pathogens causing urinary tract infection in Korea", Korean J UTII, 4, pp.37~46 (2009)
- Raaijmakers R, "Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program", Urology, 60, pp.826~830 (2002)
- Bootsma AM, "Antibiotic prophylaxis in urologic procedures: a systematic review", Eur Urol, 54, pp.1270~1286 (2008)
- Shandera KC, "Efficacy of one dose fluoroquinolone before prostate biopsy", Urology, 52, pp.641~643 (1998)
- Janoff DM, "Prostate needle biopsy infection after four or six dose ciprofloxacin", Can J Urol, 7, pp.1066~1069 (2000)
- 김상진, "Risk Factors for Acute Prostatitis after Transrectal Biopsy of the Prostate", Korean Journal of Urology, 51(6), pp.426~430 (2010), 대한비뇨기과학회