Antibiotic susceptibility of intestinal Escherichia coli in men undergoing transrectal prostate biopsies: a prospective, registered, multicentre study
Objectives To determine, in a prospective, multicentre setting, the prevalence of fluoroquinolone‐resistant (FQ‐R) and extended‐spectrum β‐lactamase (ESBL)‐producing Escherichia coli (E. coli) strains in men undergoing transrectal ultrasonography‐guided prostate biopsy (TRUS‐Bx) in Finland; and to s...
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| Veröffentlicht in: | BJU international 2018-08, Vol.122 (2), p.203-210 |
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| creator | Knaapila, Juha Kallio, Heini Hakanen, Antti J Syvänen, Kari Ettala, Otto Kähkönen, Esa Lamminen, Tarja Seppänen, Marjo Jambor, Ivan Rannikko, Antti Riikonen, Jarno Munukka, Eveliina Eerola, Erkki Gunell, Marianne Boström, Peter J. |
| description | Objectives
To determine, in a prospective, multicentre setting, the prevalence of fluoroquinolone‐resistant (FQ‐R) and extended‐spectrum β‐lactamase (ESBL)‐producing Escherichia coli (E. coli) strains in men undergoing transrectal ultrasonography‐guided prostate biopsy (TRUS‐Bx) in Finland; and to survey the associated risk factors for having the previously mentioned strains.
Patients and Methods
This is a substudy of the trial investigating the role of magnetic resonance imaging (MRI) in prostate cancer diagnosis (Improved Prostate Cancer Diagnosis – Combination of Magnetic Resonance Imaging Targeted Biopsies and Biomarkers Multi‐institutional Study [multi‐IMPROD], NCT02241122). In all, 359 patients from four study centres were recruited to this prospective study. After having signed the informed consent form, these men with suspicion of prostate cancer completed a detailed questionnaire on their medical, smoking, and travelling history, as well as their recent use of antibiotics. After the bi‐parametric MRI scan, TRUS‐Bx was taken and a rectal swab sample was collected and cultured for determining the antimicrobial susceptibility profile of E. coli strains. The potential risk factors for having FQ‐R or third‐generation cephalosporin‐resistant (3GC‐R) E. coli strains were analysed using univariate and multivariate logistic regression analysis.
Results
The percentage of FQ‐R and 3GC‐R E. coli strains amongst the study population was 13% and 8%, respectively. Amongst patients having E. coli strains, the rate of FQ‐R and 3GC‐R strains was 14% and 8%, respectively. Of the 3GC‐R E. coli strains, 62% proved to be ESBL‐producers and 88% were also FQ‐R. In multivariate analysis, international travel during the preceding year significantly increased the risk of having a FQ‐R E. coli strain (odds ratio [OR] 3.592, P = 0.001) and, unexpectedly, use of antibiotics during the previous year significantly decreased this risk (OR 0.442, P = 0.035). No significant risk factors for having 3GC‐R E. coli were identified.
Conclusion
The occurrence of intestinal FQ‐R and/or 3GC‐R (potentially ESBL‐producing) E. coli strains in men undergoing TRUS‐Bx in Finland is notable. The finding is consistent with the global increase in antimicrobial resistance. International travel appears to be an indisputable risk factor for having intestinal FQ‐R E. coli strains. The contemporary antimicrobial resistance situation should be taken into account in the care of post‐TRUS‐Bx infections. |
| doi_str_mv | 10.1111/bju.14198 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2013516884</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2084359958</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3888-c31b501908df3b0b1b2d29f4f0735f10aed7d2b8614cd39a37711119b613d7f53</originalsourceid><addsrcrecordid>eNp1kU1v1DAQhi1ERUvhwB9AlriA1G3tOE5sbqUqFFSJC5W4RXY82XqVOMEfrfaP8HuZ7bYckPDBHzOPXs-8Q8gbzk45rjO7Kae85lo9I0e8bupVzdnP5093pptD8jKlDWMYaOQLclhpKYRk7RH5fR6yt37OvqeppB6W3XP0eUvngfqQIWUfzEgvU38L0fe33tB-Hj3m6ASBluAgrmcf1jRHE1KEPiO-xDllk4Gi9pI8pI_UPAQXzPs7OKER1j5liOBO6FRGLABCjkBTLm77ihwMZkzw-vE8JjefL39cXK2uv3_5enF-veqFUgp3biXjmik3CMsst5Wr9FAPrBVy4MyAa11lVcPr3gltRNvuDNO24cK1gxTH5P1eF0v7VbDXbvJowjiaAHNJXcW4kLxRqkb03T_oZi4RrdlRmJdaS4XUhz3VY69oxtAt0U8mbjvOut3fHQ6rexgWsm8fFYudwP0ln6aDwNkeuPcjbP-v1H36drOX_AMvVKE1</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2084359958</pqid></control><display><type>article</type><title>Antibiotic susceptibility of intestinal Escherichia coli in men undergoing transrectal prostate biopsies: a prospective, registered, multicentre study</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Knaapila, Juha ; Kallio, Heini ; Hakanen, Antti J ; Syvänen, Kari ; Ettala, Otto ; Kähkönen, Esa ; Lamminen, Tarja ; Seppänen, Marjo ; Jambor, Ivan ; Rannikko, Antti ; Riikonen, Jarno ; Munukka, Eveliina ; Eerola, Erkki ; Gunell, Marianne ; Boström, Peter J.</creator><creatorcontrib>Knaapila, Juha ; Kallio, Heini ; Hakanen, Antti J ; Syvänen, Kari ; Ettala, Otto ; Kähkönen, Esa ; Lamminen, Tarja ; Seppänen, Marjo ; Jambor, Ivan ; Rannikko, Antti ; Riikonen, Jarno ; Munukka, Eveliina ; Eerola, Erkki ; Gunell, Marianne ; Boström, Peter J.</creatorcontrib><description>Objectives
To determine, in a prospective, multicentre setting, the prevalence of fluoroquinolone‐resistant (FQ‐R) and extended‐spectrum β‐lactamase (ESBL)‐producing Escherichia coli (E. coli) strains in men undergoing transrectal ultrasonography‐guided prostate biopsy (TRUS‐Bx) in Finland; and to survey the associated risk factors for having the previously mentioned strains.
Patients and Methods
This is a substudy of the trial investigating the role of magnetic resonance imaging (MRI) in prostate cancer diagnosis (Improved Prostate Cancer Diagnosis – Combination of Magnetic Resonance Imaging Targeted Biopsies and Biomarkers Multi‐institutional Study [multi‐IMPROD], NCT02241122). In all, 359 patients from four study centres were recruited to this prospective study. After having signed the informed consent form, these men with suspicion of prostate cancer completed a detailed questionnaire on their medical, smoking, and travelling history, as well as their recent use of antibiotics. After the bi‐parametric MRI scan, TRUS‐Bx was taken and a rectal swab sample was collected and cultured for determining the antimicrobial susceptibility profile of E. coli strains. The potential risk factors for having FQ‐R or third‐generation cephalosporin‐resistant (3GC‐R) E. coli strains were analysed using univariate and multivariate logistic regression analysis.
Results
The percentage of FQ‐R and 3GC‐R E. coli strains amongst the study population was 13% and 8%, respectively. Amongst patients having E. coli strains, the rate of FQ‐R and 3GC‐R strains was 14% and 8%, respectively. Of the 3GC‐R E. coli strains, 62% proved to be ESBL‐producers and 88% were also FQ‐R. In multivariate analysis, international travel during the preceding year significantly increased the risk of having a FQ‐R E. coli strain (odds ratio [OR] 3.592, P = 0.001) and, unexpectedly, use of antibiotics during the previous year significantly decreased this risk (OR 0.442, P = 0.035). No significant risk factors for having 3GC‐R E. coli were identified.
Conclusion
The occurrence of intestinal FQ‐R and/or 3GC‐R (potentially ESBL‐producing) E. coli strains in men undergoing TRUS‐Bx in Finland is notable. The finding is consistent with the global increase in antimicrobial resistance. International travel appears to be an indisputable risk factor for having intestinal FQ‐R E. coli strains. The contemporary antimicrobial resistance situation should be taken into account in the care of post‐TRUS‐Bx infections.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/bju.14198</identifier><identifier>PMID: 29533507</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents - pharmacology ; Antibiotic Prophylaxis ; Antibiotics ; Antimicrobial agents ; Antimicrobial resistance ; Biopsy ; Diagnosis ; Drug resistance ; Drug Resistance, Bacterial ; E coli ; ESBL ; Escherichia coli ; Escherichia coli - drug effects ; fluoroquinolone resistance ; Fluoroquinolones - pharmacology ; Humans ; Image-Guided Biopsy ; Intestine ; Magnetic Resonance Imaging ; Male ; Medical diagnosis ; Microbial Sensitivity Tests ; Middle Aged ; Multivariate analysis ; NMR ; Nuclear magnetic resonance ; Population studies ; Prospective Studies ; Prostate - pathology ; prostate biopsies ; prostate biopsy ; prostate biopsy complications ; Prostate cancer ; Prostatic Neoplasms - pathology ; Rectum ; Rectum - microbiology ; Risk Factors ; Smoking ; Travel ; Ultrasonography, Interventional ; Ultrasound</subject><ispartof>BJU international, 2018-08, Vol.122 (2), p.203-210</ispartof><rights>2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd</rights><rights>2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.</rights><rights>BJUI © 2018 BJU International</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3888-c31b501908df3b0b1b2d29f4f0735f10aed7d2b8614cd39a37711119b613d7f53</citedby><cites>FETCH-LOGICAL-c3888-c31b501908df3b0b1b2d29f4f0735f10aed7d2b8614cd39a37711119b613d7f53</cites><orcidid>0000-0003-0997-9668</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbju.14198$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbju.14198$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29533507$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Knaapila, Juha</creatorcontrib><creatorcontrib>Kallio, Heini</creatorcontrib><creatorcontrib>Hakanen, Antti J</creatorcontrib><creatorcontrib>Syvänen, Kari</creatorcontrib><creatorcontrib>Ettala, Otto</creatorcontrib><creatorcontrib>Kähkönen, Esa</creatorcontrib><creatorcontrib>Lamminen, Tarja</creatorcontrib><creatorcontrib>Seppänen, Marjo</creatorcontrib><creatorcontrib>Jambor, Ivan</creatorcontrib><creatorcontrib>Rannikko, Antti</creatorcontrib><creatorcontrib>Riikonen, Jarno</creatorcontrib><creatorcontrib>Munukka, Eveliina</creatorcontrib><creatorcontrib>Eerola, Erkki</creatorcontrib><creatorcontrib>Gunell, Marianne</creatorcontrib><creatorcontrib>Boström, Peter J.</creatorcontrib><title>Antibiotic susceptibility of intestinal Escherichia coli in men undergoing transrectal prostate biopsies: a prospective, registered, multicentre study</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Objectives
To determine, in a prospective, multicentre setting, the prevalence of fluoroquinolone‐resistant (FQ‐R) and extended‐spectrum β‐lactamase (ESBL)‐producing Escherichia coli (E. coli) strains in men undergoing transrectal ultrasonography‐guided prostate biopsy (TRUS‐Bx) in Finland; and to survey the associated risk factors for having the previously mentioned strains.
Patients and Methods
This is a substudy of the trial investigating the role of magnetic resonance imaging (MRI) in prostate cancer diagnosis (Improved Prostate Cancer Diagnosis – Combination of Magnetic Resonance Imaging Targeted Biopsies and Biomarkers Multi‐institutional Study [multi‐IMPROD], NCT02241122). In all, 359 patients from four study centres were recruited to this prospective study. After having signed the informed consent form, these men with suspicion of prostate cancer completed a detailed questionnaire on their medical, smoking, and travelling history, as well as their recent use of antibiotics. After the bi‐parametric MRI scan, TRUS‐Bx was taken and a rectal swab sample was collected and cultured for determining the antimicrobial susceptibility profile of E. coli strains. The potential risk factors for having FQ‐R or third‐generation cephalosporin‐resistant (3GC‐R) E. coli strains were analysed using univariate and multivariate logistic regression analysis.
Results
The percentage of FQ‐R and 3GC‐R E. coli strains amongst the study population was 13% and 8%, respectively. Amongst patients having E. coli strains, the rate of FQ‐R and 3GC‐R strains was 14% and 8%, respectively. Of the 3GC‐R E. coli strains, 62% proved to be ESBL‐producers and 88% were also FQ‐R. In multivariate analysis, international travel during the preceding year significantly increased the risk of having a FQ‐R E. coli strain (odds ratio [OR] 3.592, P = 0.001) and, unexpectedly, use of antibiotics during the previous year significantly decreased this risk (OR 0.442, P = 0.035). No significant risk factors for having 3GC‐R E. coli were identified.
Conclusion
The occurrence of intestinal FQ‐R and/or 3GC‐R (potentially ESBL‐producing) E. coli strains in men undergoing TRUS‐Bx in Finland is notable. The finding is consistent with the global increase in antimicrobial resistance. International travel appears to be an indisputable risk factor for having intestinal FQ‐R E. coli strains. The contemporary antimicrobial resistance situation should be taken into account in the care of post‐TRUS‐Bx infections.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Antibiotic Prophylaxis</subject><subject>Antibiotics</subject><subject>Antimicrobial agents</subject><subject>Antimicrobial resistance</subject><subject>Biopsy</subject><subject>Diagnosis</subject><subject>Drug resistance</subject><subject>Drug Resistance, Bacterial</subject><subject>E coli</subject><subject>ESBL</subject><subject>Escherichia coli</subject><subject>Escherichia coli - drug effects</subject><subject>fluoroquinolone resistance</subject><subject>Fluoroquinolones - pharmacology</subject><subject>Humans</subject><subject>Image-Guided Biopsy</subject><subject>Intestine</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Microbial Sensitivity Tests</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Population studies</subject><subject>Prospective Studies</subject><subject>Prostate - pathology</subject><subject>prostate biopsies</subject><subject>prostate biopsy</subject><subject>prostate biopsy complications</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Rectum</subject><subject>Rectum - microbiology</subject><subject>Risk Factors</subject><subject>Smoking</subject><subject>Travel</subject><subject>Ultrasonography, Interventional</subject><subject>Ultrasound</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1v1DAQhi1ERUvhwB9AlriA1G3tOE5sbqUqFFSJC5W4RXY82XqVOMEfrfaP8HuZ7bYckPDBHzOPXs-8Q8gbzk45rjO7Kae85lo9I0e8bupVzdnP5093pptD8jKlDWMYaOQLclhpKYRk7RH5fR6yt37OvqeppB6W3XP0eUvngfqQIWUfzEgvU38L0fe33tB-Hj3m6ASBluAgrmcf1jRHE1KEPiO-xDllk4Gi9pI8pI_UPAQXzPs7OKER1j5liOBO6FRGLABCjkBTLm77ihwMZkzw-vE8JjefL39cXK2uv3_5enF-veqFUgp3biXjmik3CMsst5Wr9FAPrBVy4MyAa11lVcPr3gltRNvuDNO24cK1gxTH5P1eF0v7VbDXbvJowjiaAHNJXcW4kLxRqkb03T_oZi4RrdlRmJdaS4XUhz3VY69oxtAt0U8mbjvOut3fHQ6rexgWsm8fFYudwP0ln6aDwNkeuPcjbP-v1H36drOX_AMvVKE1</recordid><startdate>201808</startdate><enddate>201808</enddate><creator>Knaapila, Juha</creator><creator>Kallio, Heini</creator><creator>Hakanen, Antti J</creator><creator>Syvänen, Kari</creator><creator>Ettala, Otto</creator><creator>Kähkönen, Esa</creator><creator>Lamminen, Tarja</creator><creator>Seppänen, Marjo</creator><creator>Jambor, Ivan</creator><creator>Rannikko, Antti</creator><creator>Riikonen, Jarno</creator><creator>Munukka, Eveliina</creator><creator>Eerola, Erkki</creator><creator>Gunell, Marianne</creator><creator>Boström, Peter J.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0997-9668</orcidid></search><sort><creationdate>201808</creationdate><title>Antibiotic susceptibility of intestinal Escherichia coli in men undergoing transrectal prostate biopsies: a prospective, registered, multicentre study</title><author>Knaapila, Juha ; Kallio, Heini ; Hakanen, Antti J ; Syvänen, Kari ; Ettala, Otto ; Kähkönen, Esa ; Lamminen, Tarja ; Seppänen, Marjo ; Jambor, Ivan ; Rannikko, Antti ; Riikonen, Jarno ; Munukka, Eveliina ; Eerola, Erkki ; Gunell, Marianne ; Boström, Peter J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3888-c31b501908df3b0b1b2d29f4f0735f10aed7d2b8614cd39a37711119b613d7f53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Antibiotic Prophylaxis</topic><topic>Antibiotics</topic><topic>Antimicrobial agents</topic><topic>Antimicrobial resistance</topic><topic>Biopsy</topic><topic>Diagnosis</topic><topic>Drug resistance</topic><topic>Drug Resistance, Bacterial</topic><topic>E coli</topic><topic>ESBL</topic><topic>Escherichia coli</topic><topic>Escherichia coli - drug effects</topic><topic>fluoroquinolone resistance</topic><topic>Fluoroquinolones - pharmacology</topic><topic>Humans</topic><topic>Image-Guided Biopsy</topic><topic>Intestine</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Microbial Sensitivity Tests</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Population studies</topic><topic>Prospective Studies</topic><topic>Prostate - pathology</topic><topic>prostate biopsies</topic><topic>prostate biopsy</topic><topic>prostate biopsy complications</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Rectum</topic><topic>Rectum - microbiology</topic><topic>Risk Factors</topic><topic>Smoking</topic><topic>Travel</topic><topic>Ultrasonography, Interventional</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Knaapila, Juha</creatorcontrib><creatorcontrib>Kallio, Heini</creatorcontrib><creatorcontrib>Hakanen, Antti J</creatorcontrib><creatorcontrib>Syvänen, Kari</creatorcontrib><creatorcontrib>Ettala, Otto</creatorcontrib><creatorcontrib>Kähkönen, Esa</creatorcontrib><creatorcontrib>Lamminen, Tarja</creatorcontrib><creatorcontrib>Seppänen, Marjo</creatorcontrib><creatorcontrib>Jambor, Ivan</creatorcontrib><creatorcontrib>Rannikko, Antti</creatorcontrib><creatorcontrib>Riikonen, Jarno</creatorcontrib><creatorcontrib>Munukka, Eveliina</creatorcontrib><creatorcontrib>Eerola, Erkki</creatorcontrib><creatorcontrib>Gunell, Marianne</creatorcontrib><creatorcontrib>Boström, Peter J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Knaapila, Juha</au><au>Kallio, Heini</au><au>Hakanen, Antti J</au><au>Syvänen, Kari</au><au>Ettala, Otto</au><au>Kähkönen, Esa</au><au>Lamminen, Tarja</au><au>Seppänen, Marjo</au><au>Jambor, Ivan</au><au>Rannikko, Antti</au><au>Riikonen, Jarno</au><au>Munukka, Eveliina</au><au>Eerola, Erkki</au><au>Gunell, Marianne</au><au>Boström, Peter J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antibiotic susceptibility of intestinal Escherichia coli in men undergoing transrectal prostate biopsies: a prospective, registered, multicentre study</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2018-08</date><risdate>2018</risdate><volume>122</volume><issue>2</issue><spage>203</spage><epage>210</epage><pages>203-210</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>Objectives
To determine, in a prospective, multicentre setting, the prevalence of fluoroquinolone‐resistant (FQ‐R) and extended‐spectrum β‐lactamase (ESBL)‐producing Escherichia coli (E. coli) strains in men undergoing transrectal ultrasonography‐guided prostate biopsy (TRUS‐Bx) in Finland; and to survey the associated risk factors for having the previously mentioned strains.
Patients and Methods
This is a substudy of the trial investigating the role of magnetic resonance imaging (MRI) in prostate cancer diagnosis (Improved Prostate Cancer Diagnosis – Combination of Magnetic Resonance Imaging Targeted Biopsies and Biomarkers Multi‐institutional Study [multi‐IMPROD], NCT02241122). In all, 359 patients from four study centres were recruited to this prospective study. After having signed the informed consent form, these men with suspicion of prostate cancer completed a detailed questionnaire on their medical, smoking, and travelling history, as well as their recent use of antibiotics. After the bi‐parametric MRI scan, TRUS‐Bx was taken and a rectal swab sample was collected and cultured for determining the antimicrobial susceptibility profile of E. coli strains. The potential risk factors for having FQ‐R or third‐generation cephalosporin‐resistant (3GC‐R) E. coli strains were analysed using univariate and multivariate logistic regression analysis.
Results
The percentage of FQ‐R and 3GC‐R E. coli strains amongst the study population was 13% and 8%, respectively. Amongst patients having E. coli strains, the rate of FQ‐R and 3GC‐R strains was 14% and 8%, respectively. Of the 3GC‐R E. coli strains, 62% proved to be ESBL‐producers and 88% were also FQ‐R. In multivariate analysis, international travel during the preceding year significantly increased the risk of having a FQ‐R E. coli strain (odds ratio [OR] 3.592, P = 0.001) and, unexpectedly, use of antibiotics during the previous year significantly decreased this risk (OR 0.442, P = 0.035). No significant risk factors for having 3GC‐R E. coli were identified.
Conclusion
The occurrence of intestinal FQ‐R and/or 3GC‐R (potentially ESBL‐producing) E. coli strains in men undergoing TRUS‐Bx in Finland is notable. The finding is consistent with the global increase in antimicrobial resistance. International travel appears to be an indisputable risk factor for having intestinal FQ‐R E. coli strains. The contemporary antimicrobial resistance situation should be taken into account in the care of post‐TRUS‐Bx infections.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29533507</pmid><doi>10.1111/bju.14198</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0997-9668</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | BJU international, 2018-08, Vol.122 (2), p.203-210 |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Adult Aged Aged, 80 and over Anti-Bacterial Agents - pharmacology Antibiotic Prophylaxis Antibiotics Antimicrobial agents Antimicrobial resistance Biopsy Diagnosis Drug resistance Drug Resistance, Bacterial E coli ESBL Escherichia coli Escherichia coli - drug effects fluoroquinolone resistance Fluoroquinolones - pharmacology Humans Image-Guided Biopsy Intestine Magnetic Resonance Imaging Male Medical diagnosis Microbial Sensitivity Tests Middle Aged Multivariate analysis NMR Nuclear magnetic resonance Population studies Prospective Studies Prostate - pathology prostate biopsies prostate biopsy prostate biopsy complications Prostate cancer Prostatic Neoplasms - pathology Rectum Rectum - microbiology Risk Factors Smoking Travel Ultrasonography, Interventional Ultrasound |
| title | Antibiotic susceptibility of intestinal Escherichia coli in men undergoing transrectal prostate biopsies: a prospective, registered, multicentre study |
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