Published online by Cambridge University Press: 02 January 2015
Infectious complications following transrectal ultrasound-guided biopsy of the prostate (TRUBP)—including urinary tract infections, prostatitis, epididymo-orchitis, and bacteremia—have increased dramatically in recent years. Traditionally, fluoroquinolones have been the mainstay for perioperative prophylaxis. Likely as a result of a combination of this selective pressure and temporal shifts in the clonal composition of the rectal microbiota, most post-TRUBP infections today are caused by fluoroquinolone-resistant Escherichia coli, especially those from sequence type 131 (ST131), an emerging multidrug-resistant strain that is highly prevalent among pre-TRUBP rectal isolates. Clinicians need improved approaches for preventing these complications. Fortunately, helpful guidance is beginning to appear.