A1 Refereed original research article in a scientific journal

Antibiotic susceptibility of intestinal Escherichia coli in men undergoing transrectal prostate biopsies: A prospective, registered, multicentre study




AuthorsJuha Knaapila, Heini Kallio, Antti J Hakanen, Kari Syvänen, Otto Ettala, Esa Kähkönen, Tarja Lamminen, Marjo Seppänen, Ivan Jambor, Antti Rannikko, Jarno Riikonen, Eveliina Munukka, Erkki Eerola, Marianne Gunell, Peter J. Boström

PublisherBlackwell Publishing Ltd

Publication year2018

JournalBJU International

Journal name in sourceBJU International

Volume122

Issue2

First page 203

Last page210

Number of pages8

ISSN1464-4096

eISSN1464-410X

DOIhttps://doi.org/10.1111/bju.14198


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.



Last updated on 2024-26-11 at 10:43