ro13-9904 and Prostatic-Neoplasms

Carnobacterium species are lactic acid-producing Gram-positive bacteria that have been approved by the US Food and Drug Administration and Health Canada for use as a food bio-preservative. The use of live bacteria as a food additive and its potential risk of infections in immunocompromised patients are not well understood.. An 81-year-old male with a history of metastatic prostate cancer on androgen deprivation therapy and chronic steroids presented to our hospital with a 2-week history of productive cough, dyspnea, altered mentation, and fever. Extensive computed tomography imaging revealed multifocal pneumonia without other foci of infection. He was diagnosed with pneumonia and empirically treated with ceftriaxone and vancomycin. Blood cultures from admission later returned positive for Carnobacterium inhibens. He achieved clinical recovery with step-down to oral amoxicillin/clavulanic acid for a total 7-day course of antibiotics.. This is the fourth reported case of bacteremia with Carnobacterium spp. isolated from humans. This case highlights the need to better understand the pathogenicity and disease spectrum of bacteria used in the food industry for bio-preservation, especially in immunocompromised patients.

Topics: Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Androgen Antagonists; Anti-Bacterial Agents; Bacteremia; Blood Culture; Canada; Carnobacterium; Ceftriaxone; Food Microbiology; Gram-Positive Bacterial Infections; Humans; Immunocompromised Host; Male; Pneumonia, Bacterial; Prostatic Neoplasms; Vancomycin

To prospectively evaluate the efficacy of single dose antibiotic prophylaxis in 12-core transrectal ultrasonography (TRUS) guided prostate biopsy.. A total of 400 patients who underwent prostate biopsy with TRUS guidance were included. The patients were prospectively randomized in three groups regarding antibiotic prophylaxis. The first group (139 patients) received a single gram of intramuscular ceftriaxone, while the second group (131 patients) had a 3-day course of oral ciprofloxacin. The third group (130 patients) had single oral 500 mg of ciprofloxacin. All patients had urine cultures prior to biopsy and on the second day after biopsy.. The study groups were compared in terms of the results of urine cultures and clinical parameters. Overall, only seven patients (1.8% of the cases) had positive urine cultures with no difference between these three groups. Additionally, no significant difference was observed regarding morbidity rates in all groups. Only eight patients (2%) developed major complications requiring hospitalization. There was no increase in the rate of infectious complications when the biopsy core numbers were increased up to 12.. The current study suggests that a single oral dose of antimicrobial prophylaxis is reasonable in TRUS prostate biopsy even in the case of 12-core sampling.

Topics: Aged; Anti-Infective Agents; Antibiotic Prophylaxis; Biopsy, Needle; Ceftriaxone; Ciprofloxacin; Humans; Male; Middle Aged; Prospective Studies; Prostate; Prostatic Neoplasms; Rectum; Risk Assessment; Urinary Tract Infections

Topics: Adenocarcinoma; Amoxicillin-Potassium Clavulanate Combination; Bacteria, Anaerobic; Ceftriaxone; Combined Modality Therapy; Drainage; Drug Resistance, Microbial; Fever; Firmicutes; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Lymph Node Excision; Lymphocele; Male; Middle Aged; Postoperative Complications; Prostatectomy; Prostatic Neoplasms

To assess the rates of infectious complications before and after the change of prophylactic antibiotic regimens in prostate needle biopsy.. The records of 5,577 patients who underwent prostate needle biopsy at Asan Medical Center between August 2005 and July 2012 were retrospectively reviewed. Group 1 (n=1,743) included patients treated between 2005 and 2009 with fluoroquinolone for 3 days, group 2 (n=2,723) included those treated between 2009 and 2012 with ceftriaxone once before the biopsy and fluoroquinolone before biopsy and continue therapy for 3 days, and group 3 (n=1,111) received the same treatment for more than 7 days after the biopsy. Univariable and multivariable logistic regression models addressed risk factors associated with infectious complication after prostate needle biopsy.. Infectious complication after prostate needle biopsy developed in 18 (group 1), seven (group 2), and two patients (group 3) (p=0.001). In group 1, seven patients with infectious complication had positive blood cultures and harbored fluoroquinolone-resistant Escherichia coli, four had ceftriaxone susceptible isolates, and three had extended spectrum beta-lactamase-positive E. coli. Two patients in group 1 required intensive care because of septic shock. In multivariable analysis, the patients with combination of fluoroquinolone and ceftriaxone had significantly lower infectious complication rate than the fluoroquinolon alone (p=0.003).. Antibiotic prophylaxis with ceftriaxone and fluoroquinolone before prostate needle biopsy decreased the risk of potentially serious infectious complications.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antibiotic Prophylaxis; Biopsy, Needle; Ceftriaxone; Cross Infection; Drug Evaluation; Drug Resistance, Bacterial; Drug Therapy, Combination; Escherichia coli; Escherichia coli Infections; Fluoroquinolones; Humans; Incidence; Male; Middle Aged; Prostatic Neoplasms; Republic of Korea; Retrospective Studies; Ultrasonography, Interventional; Young Adult

The objective of this study was to determine the prevalence of antibiotic resistance in fecal flora of patients undergoing transrectal ultrasound-guided needle biopsy of the prostate (TRUSB) and the factors associated with such antibiotic resistance.. A prospective study of patients undergoing TRUSB was conducted. Rectal swabs were performed and sent for cultures and antibiotic susceptibility testing before TRUSB. Clinical characteristics were determined.. 287 Gram-negative isolates from 144 patients were identified, 80.1% were Escherichia coli and 13.9% were Klebsiella pneumoniae. 27 patients who received antibiotics within 3 months exhibited higher prevalence of organisms with extended-spectrum beta-lactamases (ESBL) production (40.7 vs. 22.2%) and ceftriaxone-resistance (48.1 vs. 28.2%). 134 patients received a short-course antibiotic prophylaxis in which fluoroquinolone (FQ) contributed to 89.6% of cases. Patients who received antibiotic prophylaxis showed a higher prevalence of organisms resistant to ceftriaxone (34.3 vs. 0%), ciprofloxacin (90.3 vs. 30%) and FQ (95.5 vs. 50%) and a trend of more ESBL production (27.6 vs. 0%).. Previous antimicrobial use and prophylaxis with FQ are correlated with a higher prevalence of FQ and ceftriaxone resistance and ESBL production. A single dose of ceftriaxone without short-course FQ use is recommended as antibiotic prophylaxis in TRUSB.

Topics: Aged; Anti-Bacterial Agents; Antibiotic Prophylaxis; Biopsy, Needle; Ceftriaxone; Chi-Square Distribution; Ciprofloxacin; Drug Resistance, Bacterial; Feces; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Predictive Value of Tests; Prospective Studies; Prostatic Neoplasms; Thailand; Ultrasonography, Interventional; Urinary Tract Infections

Prostate biopsy remains the key-test in diagnosing clinically-detected prostatic carcinoma. Easy and efficient, the transrectal approach is credited with major infectious risk. The authors report a conclusive clinical experiment on 180 cases with antibioprophylaxy by injecting a single dose of third generation cephalosporin.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Infections; Biopsy, Needle; Ceftriaxone; Humans; Male; Middle Aged; Prostatic Neoplasms