1030Temporal trends of infectious complications following transrectal ultrasound-guided prostate biopsy at a Canadian tertiary cancer center
Bibliographic record
Abstract
Background. Antimicrobial prophylaxis prior to transrectal ultrasound (TRUS)-guided prostate biopsy reduces the risk of infectious complications. Despite increasing E. coli resistance to fluoroquinolones, oral ciprofloxacin remains the most widely used agent for this indication. We reviewed the temporal trends of infection-related complications following TRUS-guided prostate biopsy at Princess Margaret Cancer Center, a Canadian tertiary care hospital where ciprofloxacin prophylaxis is used. Methods. Surveillance for complications following TRUS-guided prostate biopsy at our center has been conducted since 2003. Complications that occurred within 30-days of the procedure were included. Definite infections were defined as either a positive blood or urine culture in a patient meeting National Healthcare Safety Network (NHSN) criteria for bloodstream or urinary tract infection, respectively. Possible infections were defined as empiric treatment for cystitis, pyelonephritis, prostatitis, epididymo-orchitis, or sepsis without culture confirmation. Results. Of 19279 men who underwent TRUS-guided prostate biopsy between 2003 and 2013, 159 (0.8%) developed infectious complications. Between 2006 and 2013, definite urinary tract infection increased from 0.05% to 0.8% (p < .0001); bloodstream infections increased from 0.1% to 0.6% (p < 0.0001); and overall infections, including definite and possible infections, increased from 0.3% to 1.9% (p < .0001) (Figure). E. coli represented (85/89) 95% of isolates from urine and blood cultures of which 93% were resistant to ciprofloxacin. Resistance of E. coli to trimethoprim/sulfamethoxazole, gentamicin, cefazolin, ceftriaxone, and nitrofurantoin was 58%, 42%, 33%, 32%, and 8%, respectively. Conclusion. The proportion of TRUS-guided prostate biopsies associated with infectious complications has increased significantly over the past decade, likely driven by the emergence of E. coli resistance to ciprofloxacin. Emerging antibiotic resistance may make current prophylaxis strategies with ciprofloxacin less effective, emphasizing the need for prospective evaluation of other prophylactic regimens and other non-antibiotic prevention strategies. Disclosures. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".