切片針頭細菌培養能早期預測經直腸超音波引導前列腺切片發燒病人的血液細菌培養
張恩承、林昌德、周詠欽、鄭明進、沈正煌、陳丕哲
嘉義基督教醫院泌尿外科
NEEDLE CULTURE CAN EARLY PREDICT BLOOD CULTURE OF FEBRILE PATIENTS IN TRANS-RECTAL ULTRASOUND GUIDE PROSTATE BIOPSY
Ian-Seng Cheong , Chang-Te Lin, Yeong-Chin Jou, Ming-Chin Cheng, Chang-Huang Shen, Pi-Che Chen
Divisions of Urology, Department of Surgery, Chiayi Christian Hospital, Chiayi, Taiwan
Purpose: Despite the prescription of antibiotic prophylaxis, the infection rate after Transrectal ultrasound guide prostate(TRUSP) biopsy was 0-6.3% and potentially progress to sepsis. Culture of prostate biopsy needle which directly contact to biopsy wound (rectum and prostate) had not been investigated. The present study described the characteristic of biopsy needle, blood and urine culture of TRUSP biopsy.
Materials and Methods : Retrospective review of consecutive patients underwent TRUSP biopsy in a single-institution from June 2017 to March 2018. Antibiotic prophylaxis with Ciprofloxacin was given for 3 days. 3-5 cm length of biopsy needle tips which the outer cutting cannula was sent for aerobic culture and the notched needle for anaerobic culture in all patients. Patients were divided into fever and non-fever groups. Investiaging the patient’s characteristic, risk factor of post TRUSP biopsy fever and the relationships among blood culture, urine culture and biopsy needle culture.
Results : Fifty patients were included in this study. There was no significant diffirent between two groups in patient’s characteristic, pre-TRUSP biopsy blood analysis and pre-TRUSP biopsy urine culture. Biopsy needle culture positive in twenty patients(40%) and the most common bacteria was E.coli(80%) which were all fluoroquinolone resistant. Fever developed in four patients after prostate biopsy and all the biopsy needle culture yielded Escherichia coli(E.coli). The biopsy needle cultures (pathogen, antibiotics susceptibility test) were compatible with blood culture and urine culture. Carbapenem and ampicillin-sulbactam were the most effective intravenous and oral antibiotic to the E.coli yielded by biopsy needle culture. The result of biopsy needle culture was reported 62.7 hours earlier than blood culture in average.
Conclusions : The result of biopsy needle culture of febril patients was reported 62.7 hours earlier than blood culture in average, and they were also all compatible with blood culture in pathogen and antibiotics susceptiblilty test. These informations can serve as an important references for antibiotics prescription.