Peri-procedural povidone-iodine rectal preparation reduces microorganism counts and infectious complications following ultrasound-guided needle biopsy of the prostate.

Abstract

PURPOSE:

The purpose of the study was to evaluate whether a peri-procedural povidone-iodine rectal preparation (PIRP) prior to transrectal ultrasound-guided prostate needle biopsy (TRUS PNB) can reduce microorganism colony counts and infectious complications.

METHODS:

Our institutional TRUS PNB database was reviewed to identify infectious post-biopsy complications (defined as fever >38.5 °C with positive culture). The last 570 biopsy patients were divided into those administered only preoperative oral and/or parenteral antibiotics (n = 456; chronologically cohorts A-D) versus men receiving peri-procedural PIRP in conjunction with standard preoperative antibiotics (n = 114; cohort E). Rectal cultures were obtained in the PIRP cohort to quantify changes in microorganism colony counts.

RESULTS:

Mean baseline PSA for patients was 11.6 ng/ml, 63 % were undergoing an initial biopsy, and 17 % had documented use of antibiotic therapy within the previous 6 months. A reduction in infectious complications was observed when comparing the conventional antibiotic (cohorts A-D) versus PIRP (cohort E) group (1.8 vs. 0 %), with the largest magnitude of decline occurring in the concurrent contemporary cohorts (cohort D-5.3 % vs. cohort E-0 %, p = 0.03). Rectal cultures obtained in 92 men before and after PIRP administration noted a 97 % reduction in microorganism colonies (2.1 × 10(5) vs. 6.3 × 10(3) CFU/ml, p < 0.001). No adverse reactions to the PIRP were reported by patients 7 days post-biopsy.

CONCLUSIONS:

Peri-procedural PIRP decreased microorganism colony counts and effectively reduced infectious complications following TRUS PNB. This safe, cheap, and simple strategy may be a reasonable alternative to systemic or targeted antibiotic therapy to reduce post-biopsy infections.

• Authors: Justin R Gyorfi, Christopher Otteni, Kevin Brown, Amar Patel, Kathleen Lehman, Brett E Phillips, Kalyan Dewan, Girish Kirimanjeswara, Jay D Raman
• Journal: World journal of urology (World J Urol) Vol. 32 Issue 4 Pg. 905-9 (Aug 2014) ISSN: 1433-8726 [Electronic] Germany
• PMID: 24682238 (Publication Type: Journal Article)

Chemical References

• Anti-Infective Agents, Local
• Povidone-Iodine

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Infective Agents, Local (therapeutic use)
• Bacteria (isolation & purification)
• Bacterial Infections (epidemiology, prevention & control)
• Biopsy, Needle (methods)
• Humans
• Image-Guided Biopsy
• Incidence
• Male
• Middle Aged
• Perioperative Care (methods)
• Povidone-Iodine (therapeutic use)
• Prostate (diagnostic imaging, microbiology, pathology)
• Retrospective Studies
• Ultrasonography