Skip to main content
    • Aa
    • Aa

Incidence of Urinary Tract Infection Following Transrectal Ultrasound Guided Prostate Biopsy at a Tertiary-Care Medical Center in Lebanon

  • Zaher K. Otrock (a1), Gerard O. Oghlakian (a1), Mariana M. Salamoun (a1), Maurice Haddad (a2) and Abdul Rahman N. Bizri (a3)...

To determine the incidence of urinary tract infections (UTIs) following transrectal ultrasound guided needle biopsy of the prostate (TRUBP) and the bacteriology of these infections.


Retrospective evaluation of the charts and records of all patients who underwent TRUBP between June 1, 2002, and August 31, 2003.


American University of Beirut Medical Center, a tertiary-care center in Lebanon.


Two hundred seven patients underwent TRUBP. All received prophylactic antibiotics. One hundred twenty (58%) received ciprofloxacin alone, whereas 87 (42%) received both ciprofloxacin and gentamicin. Sixty-one patients (29.5%) had an enema prior to the procedure, whereas 146 (70.5%) did not.


Thirteen patients (6.3%) were admitted with UTI. All had rigors and fever on admission. Symptoms appeared at a mean of 2.7 days and the mean hospital stay was 9.2 days. The mean duration of antibiotic treatment was 23.2 days. Ten (77%) of the patients had positive bacteriology. Urine cultures were positive in 8 (61.5%) of the patients and blood cultures in 6 (46.2%). All positive cultures grew Escherichia coli resistant to ciprofloxacin, with 5 isolates producing extended-spectrum beta-lactamases.


TRUBP continues to be associated with significant infectious complications, especially UTI. Given the increasing incidence of antibiotic resistance mainly among the Enterobacteriaceae, antimicrobial prophylaxis practices should be reevaluated and the universal administration of quinolones alone or in combination with aminoglycosides should be reconsidered.

Corresponding author
Infection Control Committee/Program, Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Lebanon, e-mail:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. K Griffiths , L Denis , A Turkes , MS Morton . Phytoestrogens and diseases of the prostate gland. Baillieres Clinical Endocrinology and Metabolism 1998;12:625647.

3. LV Rodriguez , MK Terris . Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol 1998;160:21152120.

4. CK Naughton , DC Miller , DE Mager , DK Ornstein , WJ Catalona . A prospective randomized trial comparing 6 versus 12 prostate biopsy cores: impact on cancer detection. J Urol 2000;164:388392.

5. M Davis , M Sofer , SS Kim , MS Soloway . The procedure of transrectal ultrasound guided biopsy of the prostate: a survey of patient preparation and biopsy technique. J Urol 2002;167:566570.

6. PR Sieber , FM Rommel , VE Agusta , JA Breslin , HW Huffnagle , LE Harpster . Antibiotic prophylaxis in ultrasound guided transrectal prostate biopsy. J Urol 1997;157:21992200.

8. R Tal , PM Livne , DM Lask , J Baniel . Empirical management of urinary tract infections complicating transrectal ultrasound guided prostate biopsy. J Urol 2003;169:17621765.

9. JM Carey , HJ Korman . Transrectal ultrasound guided biopsy of the prostate: do enemas decrease clinically significant complications? J Urol 2001;166:8285.

10. HM Taylor , JB Bingham . Antibiotic prophylaxis for transrectal prostate biopsy. J Antimicrob Chemother 1997;39:115117.

11. KC Shandera , GP Thibault , GE Deshon Jr. Variability in patient preparation for prostate biopsy among American urologists. Urology 1998;52:644646.

12. MB Roach , TE Figueroa , D McBride , WJ George , DE Neal Jr. Ciprofloxacin versus gentamicin in prophylaxis against bacteremia in transrectal prostate needle biopsy. Urology 1991;38:8487.

13. DA Kapoor , IW Klimberg , GH Malek , et al.Single-dose oral ciprofloxacin versus placebo for prophylaxis during transrectal prostate biopsy. Urology 1998;52:552558.

15. RW Brown , JJ Warner , BI Turner , LF Harris , RH Alford . Bacteremia and bacteriuria after transrectal prostatic biopsy. Urology 1981;18:145148.

18. E Sturenburg , D Mack . Extended-spectrum beta-lactamases: implications for the clinical microbiology laboratory, therapy, and infection control. J Infect 2003;47:273295.

21. PJ Sanderson . The role of methicillin-resistant Staphylococcus aureus in orthopaedic implant surgery. J Chemother 2001;13:8995.

22. CJ Hammond , J Gill , TE Peto , TA Cadoux-Hudson , IC Bowler . Investigation of prevalence of MRSA in referrals to neurosurgery: implications for antibiotic prophylaxis. Br J Neurosurg 2002;16:550554.

23. GE Hall , LM Baddour . Apparent failure of endocarditis prophylaxis caused by penicillin-resistant Streptococcus mitis. Am J Med Sci 2002;324:5153.

24. J Gilad , A Borer , N Maimon , K Riesenberg , M Klein , F Schlaeffer . Failure of ciprofloxacin prophylaxis for ultrasound guided transrectal prostatic biopsy in the era of multiresistant enterobacteriaceae. J Urol 1999:161:222.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 1 *
Loading metrics...

Abstract views

Total abstract views: 89 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 27th July 2017. This data will be updated every 24 hours.