Skip to main content
SpringerLink
Log in

Acute bacterial prostatitis after transrectal prostate needle biopsy: clinical analysis

  • Original Article
  • Published:
Journal of Infection and Chemotherapy

Abstract

We investigated the incidence and characteristics of acute bacterial prostatitis after transrectal prostate biopsy, based on urine and blood cultures, treatment method, and outcome. Four hundred and fifty-seven patients who underwent transrectal prostate biopsy in our hospital between November 2003 and October 2006 were reviewed. These patients were treated with 200 mg levofloxacin orally twice daily for 4 days, beginning 12 h before biopsy, and with 200 mg isepamicin sulfate given intravenously just before the biopsy. In patients who developed acute prostatitis urine and blood cultures were checked. All organisms isolated in urine or blood cultures were tested for antibiotic susceptibility of the 457 patients, first-biopsy was performed in 371 and re-biopsy was done in 86. Acute bacterial prostatitis developed in 6 patients (1.3%). Acute prostatitis developed after a first-biopsy in 2 patients (0.5%) and after re-biopsy in 4 patients (4.7%), showing a significant difference. All of the urine and blood cultures yielded levofloxacin-resistant Escherichia coli. Immediate intravenous cephalosporin or carbapenem was effective for all of these patients. We concluded that the use of levofloxacin could be a risk factor for acute bacterial prostatitis after transrectal prostate biopsy, due to an increase in fluoroquinolone-resistant E. coli in the rectum. The incidence of prostatitis was higher in re-biopsy patients. We consider that patients should receive levofloxacin for a shorter period before biopsy to avoid generating fluoroquinolone-resistant strains. Treatment with cephalosporin or carbapenem is recommended for patients with acute prostatitis after prostate biopsy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Crawford ED, Haynes AL Jr, Story MW, Borden TA. Prevention of urinary tract infection and sepsis following transrecal prostate biopsy. J Urol 1982;127:449–451.

    PubMed  CAS  Google Scholar 

  2. Linvert KA, Kabalin JN, Terris MK. Bacteremia and bacteriuria after transrectal ultrasound guided prostate biopsy. J Urol 2000;164:76–80.

    Article  Google Scholar 

  3. Ruebush TK, McConville JH, Calia FM. A double-blind study of trimethoprim-sulfamethoxazole prophylaxis in patients having transrectal needle biopsy of the prostate. J Urol 1979;122:492–494.

    PubMed  Google Scholar 

  4. Seiber PR, Rommel FM, Agustra VE, Breslin JA, Huffnage HW, Harpster LE: Antibiotic prophylaxis in ultrasound guided transrectal prostate biopsy. J Urol 1997;157:2199–2200.

    Article  Google Scholar 

  5. Kapoor DA, Klimberg IW, Malek GH, Wegebke JD, Cox CE, Patterson AL, et al. Single-dose oral ciprofloxacin versus placebo for prophylaxis during transrectal prostate biopsy. Urology 1998;52:552–558.

    Article  PubMed  CAS  Google Scholar 

  6. Taylor HM, Bingham JB: Antibiotic prophylaxis for transrectal prostate biopsy. J.Antimicrob Chemother 1997;39:115–117.

    Article  PubMed  CAS  Google Scholar 

  7. Hasegawa T, Shimomura T, Yamada H, Ito H, Kato N, Hasegawa N, et al. Fatal septic shock caused by transrectal needle biopsy of the prostate; a case report Kansenshogaku Zasshi 2002;76:893–897.

    Google Scholar 

  8. Hoshi A, Nitta M, Hongo S, Hanai K, Nishizawa Z, Kobayashi Y, et al. Sepsis following transrectal prostate biopsy: a report of two cases and reviewed similar cases in Japan. Acta Urol Jpn 2006;52:645–649.

    Google Scholar 

  9. Riebergen JBW, Kruger AEB, Kranse R, Schroder FH. Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program. Urology 1997;49:875–880.

    Article  Google Scholar 

  10. Djavan B, Waldert M, Zlotta A, Dobronski P, Seitz C, Remzi M, et al. Safety and morbidity of first and repeat transrectal ultrasound guided prostate needle biopsies: results of a prospective European prostate cancer detection study. J Urol 2001;166:856–860.

    Article  PubMed  CAS  Google Scholar 

  11. Griffith BC, Morey AF, Ali-Khan MM, Canby-Hagino E, Foley JP, Rozanski TA. Single dose levofloxacin prophylaxis for prostate biopsy in patients at low risk. J Urol 2002;168:1021–1023.

    Article  PubMed  CAS  Google Scholar 

  12. Shigemura K, Tanaka K, Yasuda M, Ishihara S, Muratani T, Deguchi T, et al. Efficacy of 1-day prophylaxis medication with fluoroquinolone for prostate biopsy. World J Urol 2005;23:356–360.

    Article  PubMed  CAS  Google Scholar 

  13. Drusano GL, Preston SL, Van Guilder M. A population pharmakokinetic analysis of the penetration of the prostate by levofloxacin. Antimicrob Agents Chemother 2000;44:2046–2051.

    Article  PubMed  CAS  Google Scholar 

  14. Fluit AC, Jones ME, Schmitz FJ, Acar J, Gupta R, Verhoef J. Antimicrobial resistance among urinary tract infection (UTI) isolates in Europe. Result from the SENTRY Antimicrobial Surveillance Program 1997. Antonie Van Leeuwenhoek 2000;77:147–152.

    Article  PubMed  CAS  Google Scholar 

  15. Colodner R, Keness Y, Chazan B, Raz R. Antimicrobial susceptibility of community-acquired uropathogenes in northern Israel. Int J Antimicrob Agents 2001;18:189–192.

    Article  PubMed  CAS  Google Scholar 

  16. Kahlmeter G. An international survey of the antimicrobial susceptibility of pathogens from uncomplicated urinary tract infections: the ECO. SENS Project. J Antimicrob Chemother 2003;51:69–76.

    Article  PubMed  CAS  Google Scholar 

  17. Charalabopoulos K, Karachalios G, Baltogiannis D, Charalabopoulos A, Giannakopoulos X, Sofikitis N. Penetration of antimicrobial agents into the prostate. Chemotherapy 2003;49:269–279.

    Article  PubMed  CAS  Google Scholar 

  18. Goto T, Makinose S, Ohi Y, Yamauchi D, Kayajima T, Nagayama K, et al. Diffusion of piperacillin, cefotiam, minocycline, amikacin and ofloxacin into the prostate. Int J Urol 1998;5:243–246.

    Article  PubMed  CAS  Google Scholar 

  19. Tal R, Livne PM, Lask DM, Baniel J. Empirical management of urinary tract infections complicating transrectal ultrasound guided prostate biopsy. J Urol 2003;169:1762–1765.

    Article  PubMed  Google Scholar 

  20. Eom JS, Hwang BY, Sohn JW, Kim WJ, Kim MJ, Park SC, et al. Clinical and molecular epidemiology of quinolone-resistant Escherichia coli isolated from urinary tract infection. Microb Drug Resist 2002;8:227–234.

    Article  PubMed  CAS  Google Scholar 

  21. Horcajada JP, Vila J, Moreno-Martinez A, Ruiz J, Martinez JA, Sanchez M, et al. Molecular epidemiology and evolution of resistance to quinolones in Escherichia coli after prolonged administration of ciprofloxacin in patients with prostatitis. J Antimicrob Chemother 2002;49:55–59.

    Article  PubMed  CAS  Google Scholar 

  22. Aparicio JR, Such J, Pascual S, Arroyo A, Plazas J, Girona E, et al. Development of quinolone-resistant strains of Escherichia coli in stools of patients with cirrhosis undergoing norfloxacin prophylaxis: clinical consequences. J Hepatol 1999;31:277–283.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Ishikawa Prefectural Central Hospital, 2-1 Kuratsukihigashi, Kanazawa, Ishikawa, 920-8530, Japan

    Kazuyoshi Shigehara, Tohru Miyagi, Takao Nakashima & Masayoshi Shimamura

Authors
  1. Kazuyoshi Shigehara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tohru Miyagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takao Nakashima
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masayoshi Shimamura
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kazuyoshi Shigehara.

About this article

Cite this article

Shigehara, K., Miyagi, T., Nakashima, T. et al. Acute bacterial prostatitis after transrectal prostate needle biopsy: clinical analysis. J Infect Chemother 14, 40–43 (2008). https://doi.org/10.1007/s10156-007-0570-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10156-007-0570-3

Key words

Search

Navigation