Rectal Colonization with Fluoroquinolone-Resistant E. coli Poses a Major Risk for Infection After Transrectal Prostate Biopsy

Transrectal ultrasound–guided prostate needle biopsy (TPB) is the gold standard for diagnosing prostate cancer. However, the rate of infection — even after recommended prophylaxis with a fluoroquinolone — is 3% to 5% and rising. The increase is thought to be due to the emergence of fluoroquinolone-resistant Escherichia coli, particularly the more virulent sequence type (ST) 131.

To further study this hypothesis, investigators performed a retrospective review involving men who underwent TPB at the San Diego Veterans Affairs Medical Center between January 2010 and February 2014 (N=1638). All received a single 750-mg oral dose of ciprofloxacin 1 hour before the procedure; rectal swabs for culture were collected at the time of biopsy for 914 pat…