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934 Incidence Rate after Transrectal Ultrasound Guided Prostate Biopsies

Sunday, March 21, 2010
Grand Hall (Hyatt Regency Atlanta)
Min Jee Hong, RN, BSN , Asan medical center, Seoul, South Korea
Hye Ran Choi, RN, MPH , Asan medical center, Seoul, South Korea
Min Kyung Han, RN, MSN, CIC , Asan medical center, Seoul, South Korea
Sun Hee Kwak, RN, BSN , Asan medical center, Seoul, South Korea
Young Ju Lim, RN, MSN , Asan medical center, Seoul, South Korea
Hyang Mi Mun, MT, MPH , Asan medical center, Seoul, South Korea
Jae Sim Jeong, RN, CIC, PhD , Department of Clinical Nusing, University of Ulsan College of Medicine, Seoul, South Korea
Mi Na Kim, MD, PhD , Asan medical center, Seoul, South Korea
Jun Hee Woo, MD, PhD , Asan medical center, Seoul, South Korea
Background: Transrectal ultrasound guided needle biopsy of the prostate is routinely performed to diagnose the prostate cancer

Objective: This study was performed to evaluate the infection rate after transrectal ultrasound(TRUS) guided prostate biopsies.

Methods: We retrospectively reviewed 321 patients who underwent TRUS guided prostate biopsies in a general hospital.

Results: There were 4 patients(1.2%) with urinary tract infections(UTIs)(0.6%) and blood stream infections(BSIs)(0.6%). Septicaemia was also found in one case of the 2 UTI patients. The median day to take for diagnosis was 1.5 and discharge from the hospital  was 6.0 days. The etiology of infections was all of E. coli(100%), but ESBL E. coli was separated from a half of the patients with infections. Due to multiorgan failure, one(25%) patient required intensive care and treatment such as mechanical ventilation, dialysis, and so on, but the others(75%) improved easily after antibiotic treatment. Generally, patients take a precautionary antibiotic for 3 days from one day before TRUS guided prostate biopsy in the general hospital. An enema also starts once on the same day, then the next day twice. But three of the 4 patients did not reserve the test, just one dose of an antibiotic and just one time of an enema were possible for them. The complications from 25 patients were categorized as hematuria(2.2%), hematochezia(1.6%), fever(1.2%). These values were unfortunately underestimated by omitting some portion of the patients in the out-patient department during follow-up. Only ciprofloxacin  was used for a prophylatic antibiotic.

Conclusions: The infection rate was generally low due to the antibiotic treatment and enema. Ciprofloxacin is the most frequently used antibiotic to prevent urosepsis after TRUS guided prostate biopsy. The infection rate in the general hospital is relatively low in comparison with another study results. It was unusual that ESBL E. coli were separated explicitly, and ICU care was reported for the infection after the TRUS guided prostate biopsy.