Work

Epidemiology and O-Serotypes of Extraintestinal Pathogenic Escherichia coli Disease in Patients Undergoing Transrectal Ultrasound Prostate Biopsy: A Prospective Multicenter Study

Year: 2020

Type: article

Abstract: Purpose: Extraintestinal pathogenic Escherichia coli (ExPEC) are a leading cause of invasive infections in adults.The study aimed to evaluate the incidence of microbiologically confirmed invasive ExPEC disease in patients undergoing transrectal ultrasound-guided prostate needle biopsy (TRUS-PNB), O-serotype distribution and antibiotic resistance profiles of associated E. coli isolates.Materials and Methods: Adult men (18 years) undergoing TRUS-PNB were enrolled.The TRUS-PNB procedure was performed according to local standard of care, including preferences of prophylactic antibiotics.Clinical and microbiological data were collected.Results: Of the 4,951 patients (mean age 66.9 years) enrolled 4,935 (99.7%) underwent TRUS-PNB (95.1% received prophylactic antibiotics); 98.9% completed the study.Overall incidence of invasive ExPEC disease was 0.67% (33/4,935 patients; 95% CI 0.46e0.94);highest incidence was in the U.S. (0.97%, 14/1,446; 95% CI 0.53e1.62).Prevalence of the 10 selected O-serotypes O1, O2, O4, O6, O8, O15, O16, O18, O25 and O75 was 52.0% (95% CI 31.3e72.2).E. coli isolates showed highest resistance rates to levofloxacin and ciprofloxacin (76%; 95% CI 54.8e90.6 for both).Among fluoroquinolone-resistant ExPEC isolates, prevalence of the 10 selected O-serotypes was 60%.Conclusions: This study provides an estimate of microbiologically confirmed invasive ExPEC disease incidence following TRUS-PNB.Information on E. coli O-serotype distribution and associated antibiotic resistance profiles from invasive ExPEC disease cases in the first 30 days following TRUS-PNB may help guiding antibiotic use and inform development of a prophylactic ExPEC vaccine.

Source: The Journal of Urology

DOI: 10.1097/ju.0000000000001425