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Multi-drug-resistant bacteremia after transrectal ultrasound guided prostate biopsies in hospital employees and their relatives.

机译:经直肠超声引导医院员工及其亲属进行前列腺活检后的多重耐药菌血症。

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摘要

OBJECTIVES: To evaluate the incidence of multi-drug-resistant (MDR) organisms causing bacteremia in hospital employees and their relatives after transrectal ultrasound (TRUS) guided prostate biopsies. METHODS: We retrospectively reviewed all TRUS-guided prostate biopsies between November 2006 and November 2007. Of the 378 patients, we identified 4 cases of post-procedure bacteremia requiring hospital admission. All 4 of these patients had MDR organisms causing bacteremia. These patients were then contacted to determine whether they or their relatives were hospital employees. RESULTS: We identified 4 patients among a total of 378 who developed MDR bacteremia after TRUS prostate biopsy (1.06%). Three of these patients or their relatives were hospital employees (75%). All 3 of these patients had bacteremia caused by Escherichia coli that was resistant to ciprofloxacin and levofloxacin, the perioperative antibiotic given. CONCLUSIONS: In addition to the standard TRUS biopsy preoperative questions it is beneficial to ask patients whether they are hospital employees or live in the same household as hospital employees. This way, if patients return postoperatively with fever and chills, there is a higher index of suspicion that bacteremia may be caused by MDR organisms and empiric broad spectrum parenteral antibiotics can be started immediately.
机译:目的:评估经直肠超声(TRUS)引导的前列腺活检后,在医院员工及其亲属中引起菌血症的多重耐药(MDR)生物的发生率。方法:我们回顾性研究了2006年11月至2007年11月之间所有TRUS指导的前列腺活检。在378例患者中,我们确定了4例需要住院的术后菌血症。这些患者中的所有4位均具有引起菌血症的MDR生物。然后联系这些患者以确定他们或他们的亲戚是否是医院工作人员。结果:我们在总共378例TRUS前列腺活检后发生MDR菌血症的患者中识别出4例(1.06%)。其中三名患者或其亲属是医院工作人员(75%)。这些患者中的所有3例均具有由大肠杆菌引起的菌血症,对环丙沙星和左氧氟沙星(围手术期给予的抗生素)耐药。结论:除了标准的TRUS活检术前问题外,询问患者是医院工作人员还是与医院工作人员住在同一家庭是有益的。这样,如果患者因发烧和发冷而术后返回,则存在更高的怀疑指数,即可能由耐多药微生物引起菌血症,并且可以立即开始使用经验性广谱肠胃外抗生素。

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