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Urology. 2015 Dec;86(6):1200-5. doi: 10.1016/j.urology.2015.07.008. Epub 2015 Aug 20.

Rapid Identification of Rectal Multidrug-resistant Escherichia coli Before Transrectal Prostate Biopsy.

Author information

1
Department of Medicine, VA Healthcare System Minneapolis, Minneapolis, MN.
2
Departments of Medicine and Urology, VA Healthcare System San Diego, San Diego, CA.
3
Departments of Medicine and Urology, VA Healthcare System San Diego, San Diego, CA; Department of Urology, University of California, San Diego School of Medicine, La Jolla, CA.
4
Departments of Medicine and Urology, VA Healthcare System San Diego, San Diego, CA; Department of Medicine, University of California, San Diego School of Medicine, La Jolla, CA; Department of Pathology, University of California, San Diego School of Medicine, La Jolla, CA.
5
Department of Urology, University of California, San Diego School of Medicine, La Jolla, CA; Department of Microbiology, University of Washington, Seattle, WA.
6
Department of Urology, University of Texas Health Science Center San Antonio, San Antonio, TX. Electronic address: mliss008@gmail.com.

Abstract

OBJECTIVE:

To develop and evaluate a rapid multiplex-quantitative polymerase chain reaction (qPCR) to identify fecal carriers of multidrug-resistant extraintestinal pathogenic Escherichia coli (MDR-ExPEC) clonal groups.

METHODS:

Men presenting for transrectal prostate biopsy (TPB) at the San Diego Veterans Affairs Medical Center underwent rectal culture immediately before TPB. Rectal swabs were streaked onto ciprofloxacin-supplemented (4 mg/L) MacConkey agar plates, identified, and susceptibility tested. The same swab was sent to the University of Washington for qPCR test (EST200) targeting 2 major MDR-ExPEC clonal groups--ST131 and ST69--that combined were expected to represent majority of fluoroquinolone (FQ)- and trimethoprim-sulfamethoxazole-resistant E coli. We calculate test characteristics including the area under the receiver operative curve (AUC).

RESULTS:

We enrolled 104 men from 11/5/2013 to 6/10/2014. FQ-resistant E coli were cultured from 19.2% (20/104) of rectal swabs, and 26% (27/104) of all swabs were positive for EST200 by PCR. The test characteristics comparing the EST200 to the culture-based detection of FQ resistance were 75%, 86%, 94%, and 56%, respectively. The AUC was 0.84 for the EST200 to detect FQ resistance before TPB.

CONCLUSION:

Compared to the reference standard rectal culture, EST200 was able to detect majority of FQ-resistant E coli on rectal swabs before prostate biopsy.

PMID:
26299464
PMCID:
PMC4698053
DOI:
10.1016/j.urology.2015.07.008
[Indexed for MEDLINE]
Free PMC Article

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