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Effect of shorter antimicrobial prophylaxis+using intestinal cleaning+using single use sterile gels on infections developing after transrectal prostate biopsies

Abstract number: R2226

Arda B., Kismali E., Aydemir S., Simsir A., Sipahi O., Tamsel S., Ulusoy S., Ozyurt C., Ozinel M.A.

Background: The aim of this study was to evaluate the effects of shotrter antimicrobial prophylaxis+using intestinal cleaning+using single use sterile gels on infections developing after transrectal prostate biopsies in a tertiary-care educational hospital.

Methods: After observing an increase in infections developing after transrectal prostate biopsies at the end of 2007, biopsies were stopped and procedures before and during the biopsies were evaluated. Infections developed in the last six months were retrospectively evaluated by using records of mictobiology, radioogy and urology. Sterilisation & disinfection, antimicrobial prophylaxis regimens, intestinal decontamination procedures and routine biopsy procedures were reevaluated in cooperation with with the corresponding clinics. Afterwards we implemented three main changes: (i) Five day lasting antimicrobial prophylaxis was changed to one day lasting prophylaxis (ciprofloxacin 500 mgx2+ornidazole: 2×1 gr starting two days before the biopsy and lasting until the third day of it + amikacin 500 mg !×1 during the biopsy, to the ciprofloxacin 500 mg×2 + ornidazole given 2 h before the biopsy.) (ii) we started to implement intestinal cleaning one day before the intervention by using enema [Fleet enema adult lavman, Kozmed, Turkey, implemented twice on the day (8 h apart) before the biopsy]. (iii) we started to consume single use sterile gels during biopsy (instead of multiple use gels). Patients were diagnosed as clinical or microbiologically confirmed infection according to CDC criteria.

Results: Infection rate during the preintervention six months period was 24/294 (8.1%, 17/294 microbiologically confirmed infection, 7/294 clinically diagnosed infection)and it was 7/186 (3.7%, 5/186 microbiologically confirmed infection, 2/186 clinically diagnosed infection) in the postintervention four months period (p: 0.056 with Chi-square test).

Conclusion: When we compared the two periods, there was a prominent (more than 50% but p > 0.05) decrease in the post-biopsy infection rates. Our findings suggest that shorter antimicrobial prophylaxis regimens, sterile gel consumption and intestinal cleaning may be useful in the control of infections developing after transrectal prostate biopsies.

Session Details

Date: 16/05/2009
Time: 00:00-00:00
Session name: 19th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Helsinki, Finland, 16 - 19 May 2009
Presentation type:
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