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- Title
Antibiotic resistance, hospitalizations, and mortality related to prostate biopsy: first report from the Norwegian Patient Registry.
- Authors
Johansen, Truls E. Bjerklund; Zahl, Per-Henrik; Baco, Eduard; Bartoletti, Riccardo; Bonkat, Gernot; Bruyere, Franck; Cai, Tommaso; Cek, Mete; Kulchavenya, Ekaterina; Köves, Bela; Mouraviev, Vladimir; Pilatz, Adrian; Tandogdu, Zafer; Tenke, Peter; Wagenlehner, Florian M. E.
- Abstract
Background: A 68-year-old man died of cerebral arterial embolism 6 days after transrectal prostate biopsy with a single p.o. dose of trimethoprim sulfamethoxazole (TMP-SMX) as prophylaxis. The case precipitated analysis of local antibiotic resistance and complication rates. Materials and methods: Data on E. coli resistance from Oslo University Hospital and national data on hospitalizations and mortality after biopsy were retrieved from local microbiology files and the Norwegian Patient Registry (NPR) 2011–2017. Results: Urine E. coli resistance against TMP-SMX increased from 35% in 2013 to more than 60% in 2015. For ciprofloxacin, the resistance increased from 15% in 2013 to about 45% in 2016. The highest annual E. coli resistance in blood cultures for TMP-SMX and ciprofloxacin was 37% and 28%, respectively. 10% of patients were hospitalized with a diagnosis of infection within the first 60 days after biopsy and there was a relative increase in mortality rate of 261% within the first 30 days. Due to the severity of the figures, the story and the NPR data were published in Norway's leading newspaper and were succeeded by a series of chronicles and commentaries. Conclusions: Several critical points of the biopsy procedure were not performed according to current standards. We believe that the patient might have died of septic embolism after biopsy. As a result of the findings and the debate, local practice was changed from transrectal to transperineal prostate biopsies.
- Subjects
DRUG resistance in bacteria; PROSTATE biopsy; MEDICAL registries; CO-trimoxazole; PUBLIC hospitals; DIGITAL rectal examination; PERINEAL care; GAS embolism
- Publication
World Journal of Urology, 2020, Vol 38, Issue 1, p17
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-019-02837-0