Patterns of infection following transrectal ultrasound-guided biopsy of the prostate in a regional New South Wales Centre.

OBJECTIVE

To determine the rates, severity and patterns of resistance in patients presenting with post-transrectal ultrasound infection in a regional centre in New South Wales, Australia.

DESIGN

A single-centre retrospective review from August 2013 until August 2017.

SETTING

Murrumbidgee Local Health District, New South Wales.

PARTICIPANTS

All patients who underwent transrectal ultrasonography biopsy of the prostate in the public health system.

MAIN OUTCOME MEASURES

Rate of infection and sepsis following biopsy of the prostate requiring readmission to hospital within 30 days from the procedure.

RESULTS

A total of 317 men underwent transrectal ultrasound-guided biopsy of the prostate over the study period. Nineteen (6%) patients presented with clinical signs of post-transrectal ultrasound infection, of which 18 (5.7%) required readmission for intravenous antibiotics. Median time to readmission was 2 days (0-7), and the average length of hospital stay was 5 days (1-15). Three (0.3%) patients required admission to intensive care for inotropic support. Thirteen patients (68%) had positive blood cultures, and all were positive for Escherichia coli. Four of these patients (21%) had extended spectrum beta-lactamase producing isolates resistant to their preoperative antibiotics.

CONCLUSION

Prostate cancer is common in the elderly community with worse outcomes in regional settings. Infective complications from transrectal ultrasound biopsy were 6% in this regional setting with high rates of multi-resistant organisms. Awareness of this is important for rural health practitioners who are likely to be exposed to this patient population.