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Stable post-TRUS biopsy sepsis rates and antibiotic resistance over 5 years in patients from Newcastle, New South Wales

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To the Editor: Sepsis after transrectal ultrasound (TRUS)-guided prostate biopsy is a potentially serious complication. Antibiotic prophylaxis reduces the risk of sepsis; however, practices are highly variable among urologists.

Several reports show increasing incidence of bacterial resistance in patients with sepsis after TRUS-guided biopsy.13 Preprocedure screening of high-risk patients using cultures from rectal swabs would allow targeted prophylaxis.4,5 We performed a retrospective audit of all men undergoing a TRUS-guided prostate biopsy by one of nine urologists in Newcastle, New South Wales, to assess the incidence of bacteraemia and changes in antimicrobial susceptibility.

Unique patient data were collected retrospectively from private and public hospital records, including data on positive blood cultures from Hunter Area, Douglass Hanly Moir, Laverty and Healthscope pathology services. Patient and pathology records were cross-referenced and data were analysed using Microsoft Excel. This clinical audit did not require ethics committee approval, in accord with the NSW Health policy on authorisation to commence human research in public health organisations.

From 2008 to 2012, 4218 men underwent a TRUS-guided…