{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:40:07Z","timestamp":1747183207108,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T00:00:00Z","timestamp":1562198400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Sepsis following transrectal ultrasound (TRUS)\u2010guided prostate biopsy is a major complication. With the emergence of multidrug\u2010resistant organisms, empirical use of carbapenem antibiotics has been increasing. This study, conducted in the Illawarra Shoalhaven Local Health District (ISLHD), Australia, quantifies how much we can spare carbapenem use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective audit of patients who underwent TRUS prostate biopsy and were admitted post\u2010operatively with proven bacteraemia between January 2007 and April 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2719 TRUS procedures, 50 (1.84%) cases had bacteraemia. The most common isolate was <jats:italic>Escherichia coli<\/jats:italic> in 44 of 50 (88%) of which six of 50 (12%) were extended\u2010spectrum beta\u2010lactamase (ESBL)\u2010producing. Sixteen different empirical antimicrobial regimens were used, to which 42 of 50 (84%) of isolates were susceptible. Eight (16%) isolates were resistant to the chosen empiric combination, with five switched over to appropriate treatment once antimicrobial sensitivity results became available. Empirical carbapenem was utilized in 12 of 50 (24%) patients with only two of the ESBL isolates covered. A further 10 of 50 patients received carbapenems during their admission. Carbapenems could have been avoided in 18 of 22 (82%). A total of 86% of organisms (<jats:italic>n<\/jats:italic> =\u200943) were susceptible to the combination of amoxicillin\u2013clavulanate and gentamicin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although the rates of bacteraemia with ESBL\u2010producing organisms post\u2010TRUS biopsy are increasing, use of carbapenem\u2010free combination antimicrobials as empirical therapy appears to be safe and effective in our setting. Clinicians can utilize local resistance patterns to inform targeted and appropriate therapy for septic patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.15322","type":"journal-article","created":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T23:15:42Z","timestamp":1562282142000},"page":"935-939","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Carbapenem sparing in the management of post\u2010transrectal prostate biopsy bacteraemia"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4784-6073","authenticated-orcid":false,"given":"Mohamad\u2010Ali","family":"Trad","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Wollongong Hospital  Wollongong New South Wales Australia"},{"name":"School of Medicine University of Wollongong  Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mishael","family":"Materne","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Wollongong Hospital  Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemma","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Wollongong Hospital  Wollongong New South Wales Australia"},{"name":"School of Medicine University of Wollongong  Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinna","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Urology Wollongong Hospital  Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spiros","family":"Miyakis","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Wollongong Hospital  Wollongong New South Wales Australia"},{"name":"School of Medicine University of Wollongong  Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Skyring","sequence":"additional","affiliation":[{"name":"School of Medicine University of Wollongong  Wollongong New South Wales Australia"},{"name":"Department of Urology Wollongong Hospital  Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Newton","sequence":"additional","affiliation":[{"name":"School of Medicine University of Wollongong  Wollongong New South Wales Australia"},{"name":"NSW Health Pathology, Microbiology Wollongong Hospital  Wollongong New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.06.003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000296290"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit193"},{"key":"e_1_2_7_5_1","first-page":"501","article-title":"EAU guidelines on prostate cancer. Part I: screening, diagnosis, and treatment of clinically localised disease","volume":"35","author":"Heidenreich A","year":"2011","journal-title":"Eur. 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