ArticleUrology practice2018
Prospective Monitoring and Adapting Strategies for Prevention of Infection Following Transrectal Prostate Procedures.
Article in Urology practice, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors at 1 institution in 1 country.
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Abstract
introductionA number of strategies have been attempted to minimize infection risk following transrectal prostate procedures (TRPXs). We report our prospective efforts at augmenting our prophylaxis strategy over time.
methodsSince 2010, we prospectively monitor post-TRPX infections and changed our prophylaxis regimen twice in an effort to respond to increases in infectious complications. In 2011 we added a single-dose of intramuscular (IM) aminoglycoside to our prophylaxis regimen of fluoroquinolones (FQ) or trimethoprim-sulfamethoxazole. In 2015 we began performing formalin needle-tip disinfection before each biopsy and screening high-risk patients for antibiotic resistance using rectal swab cultures (targeted prophylaxis). We report our rates of infections and antibiotic resistance patterns over this period.
resultsFrom 2010-2016, we performed 2398 TRPXs; overall, there were 41 cases (1.7%) of infection-related hospitalization, however the rate differed significantly over the study period. The infection-related hospitalization rate declined from 3.8 to 1.1% in the first 3 years following the addition of IM aminoglycoside (2011-2013) - a decrease of 69%. In 2014 our infection rate increased to 2.6% prompting initiation of protocol #3 wherein the addition of target prophylaxis and formalin needle-tip disinfection identified a 29.8% FQ-resistance rate and resulted in another decline in our infection rate to 1.2% - a decrease of 53%.
conclusionsWhile the initial addition of IM aminoglycoside appeared to be effective in decreasing post-procedure infections, further augmentation of our prophylaxis regimen through rectal swab screening of high-risk patients and formalin needle-tip disinfection led to an additional decline in rates of infection-related hospitalizations.
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