Patterns of infection following transrectal ultrasound-guided biopsy of the prostate in a regional New South Wales Centre.

Objective: To determine the rates, severity and patterns of resistance in patients presenting with post-transrectal ultrasound infection in a regional centre in New South Wales, Australia.

Design: A single-centre retrospective review from August 2013 until August 2017.

Setting: Murrumbidgee Local Health District, New South Wales.

Participants: All patients who underwent transrectal ultrasonography biopsy of the prostate in the public health system.

Main Outcome Measures: Rate of infection and sepsis following biopsy of the prostate requiring readmission to hospital within 30 days from the procedure.

Results: A total of 317 men underwent transrectal ultrasound-guided biopsy of the prostate over the study period. Nineteen (6%) patients presented with clinical signs of post-transrectal ultrasound infection, of which 18 (5.7%) required readmission for intravenous antibiotics. Median time to readmission was 2 days (0-7), and the average length of hospital stay was 5 days (1-15). Three (0.3%) patients required admission to intensive care for inotropic support. Thirteen patients (68%) had positive blood cultures, and all were positive for Escherichia coli. Four of these patients (21%) had extended spectrum beta-lactamase producing isolates resistant to their preoperative antibiotics.

Conclusion: Prostate cancer is common in the elderly community with worse outcomes in regional settings. Infective complications from transrectal ultrasound biopsy were 6% in this regional setting with high rates of multi-resistant organisms. Awareness of this is important for rural health practitioners who are likely to be exposed to this patient population.