Impact of Rectal Swabs on Infectious Complications after Transrectal Prostate Biopsy

Urol Int. 2016;97(3):340-346. doi: 10.1159/000448595. Epub 2016 Oct 1.


Objectives: To determine the impact of rectal swabs (RSs) on infectious complications (IC) following prostate biopsy (PB).

Methods: A retrospective cohort study was conducted including all patients subjected to PB between 2009 and 2013. Group B consisted of patients with a RS and group A of patients without. RS reported the presence of gram-positive or negative germs, sensitive or resistant to ciprofloxacin. Antimicrobial prophylaxis was adjusted to the result. Frequency of IC in each group was determined.

Results: Group B had 548 (47.20%) patients and group A 613 (52.80%). From group B, 250 (45.62%) of the RSs showed fluoroquinolone (FQ)-resistant germs. Forty nine (16.44%) patients with sensitive germs vs. 147 (59.51%) with resistant germs had a history of previous FQ treatment (p < 0.0001). IC were observed in 33 (5.49%) patients from group A and in 7 (1.28%) patients from group B (p < 0.0001), requiring hospitalization in 4.99 vs. 1.28%, respectively. IC and hospital admissions were reduced in 76.68 and 74.34%, respectively, following the implementation of RS.

Conclusions: RS and targeted antibiotic prophylaxis prior to PB was associated with a significant reduction in IC and hospital admissions. Ceftriaxone could be an alternative in cases of known resistance. Past history of FQ treatment is associated with increased resistance.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacterial Infections / epidemiology*
  • Biopsy / adverse effects
  • Biopsy / methods
  • Cohort Studies
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Prostate / pathology*
  • Rectum / microbiology*
  • Retrospective Studies