Format

Send to

Choose Destination
ANZ J Surg. 2015 Dec;85(12):931-5. doi: 10.1111/ans.12933. Epub 2014 Dec 30.

Transrectal ultrasound-guided biopsy sepsis and the rise in carbapenem antibiotic use.

Author information

1
Alfred Health, Melbourne, Victoria, Australia.
2
Cabrini Health, Melbourne, Victoria, Australia.
3
Eastern Health, Melbourne, Victoria, Australia.
4
Monash University, Melbourne, Victoria, Australia.
5
Monash Health, Melbourne, Victoria, Australia.
6
Epworth Healthcare, Melbourne, Victoria, Australia.

Abstract

BACKGROUND:

This study sought to determine the number of hospital admissions for sepsis following transrectal ultrasound-guided (TRUS) biopsy, and the rate of both prophylactic and therapeutic use of carbapenem antibiotics for TRUS biopsy, at a single institution.

METHODS:

A retrospective review of prospectively collected data from the medical records electronic database of Cabrini Health, a private metropolitan hospital, was queried for coding of admissions under any admitting urologist for sepsis and prostate-related infections from 2009 to 2012. Records were examined for whether a TRUS biopsy had been performed within 14 days prior and if a therapeutic carbapenem was required. The database also queried the use of carbapenems as prophylaxis in patients undergoing TRUS biopsy.

RESULTS:

Of the 63 admissions for TRUS biopsy sepsis, multi-drug-resistant organisms were isolated from 26 (41%). Twenty-three admissions were from the 1937 patients who underwent a TRUS biopsy at Cabrini (a sepsis rate of 1.2%) and 40 were following TRUS biopsies at other centres. Thirty-seven (58.7%) patients received therapeutic carbapenems either empirically, or after culture results. Of the 1937 Cabrini TRUS biopsy patients, 154 (8%) were given a carbapenem as prophylaxis, with a rapid increase in prophylactic use over the 4 years studied from 0.25% to 13%.

CONCLUSION:

This study did not show evidence of an increasing rate of hospital admissions for TRUS biopsy sepsis at this institution. However, there was a dramatic uptake in prophylactic administration of carbapenems. Increasing carbapenem use may contribute to development of carbapenem-resistant bacteria. Alternative methods of prostate biopsy that avoid sepsis should be considered.

KEYWORDS:

prostate biopsy; transrectal; urology

PMID:
25556709
DOI:
10.1111/ans.12933
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center