Rapid Identification of Rectal Multi-Drug Resistant E. coli Prior to Transrectal Prostate Biopsy.

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Rapid Identification of Rectal Multi-Drug Resistant E. coli Prior to Transrectal Prostate Biopsy.

Urology. 2015 Aug 20;

Authors: Tchesnokova VL, Otelly LL, Sakamoto K, Fierer J, Sokurenko E, Liss MA

Abstract
OBJECTIVE: To develop and evaluated a rapid multiplex-qPCR to identify fecal carriers of multi-drug resistant extra-intestinal pathogenic E. coli clonal groups.
METHODS: Men presenting for transrectal prostate biopsy (TPB) at the San Diego Veterans Affairs Medical Center underwent rectal culture immediately prior to TPB. Rectal swabs were streaked ciprofloxacin-supplemented (4 mg/L) MacConkey agar plates, identified, and susceptibility tested. The same swab was sent to the University of Washington for qPCR test (EST200) targeting two major MDR-ExPEC clonal groups - ST131 and ST69 that combined were expected to represent majority of fluoroquinolone as well as trimethoprim-sulfamethoxazole resistant E. coli. We calculate test characteristics including the area under the receiver operative curve (AUC).
RESULTS: We enrolled 104 men from 11/5/2013 to 6/10/2014. Fluoroquinolone -resistant E. coli were cultured from 19.2% (20/104) of rectal swabs and 26% (27/104) of all swabs were positive for EST200 by PCR. The test characteristics comparing the EST200 to the culture-based detection of fluoroquinolone-resistance were 75%, 86%, 94%, and 56%, respectively. The AUC was 0.84 for the EST200 to detect fluoroquinolone resistance prior to TPB.
CONCLUSIONS: Compared to the reference standard rectal culture, EST200 was able to detect majority of fluoroquinolone resistant E. coli on rectal swabs prior to prostate biopsy.

PMID: 26299464 [PubMed - as supplied by publisher]