Radical prostatectomy in the presence of ongoing refractory ESBL Escherichia coli bacterial prostatitis.

Abstract

A 44-year-old Indian national with a prostate-specific antigen of 5.4 ng/mL underwent 12-core transrectal ultrasound-guided prostate biopsies. Following this, he had three hospital admissions with severe urosepsis secondary to extended spectrum β lactamase (ESBL) producing Escherichia coli. He had recurrent sepsis immediately after discontinuation of intravenous meropenem to which the ESBL was sensitive. He proceeded to radical prostatectomy for intermediate-high risk Gleason 7 prostate cancer, while still on intravenous meropenem, 2 months after his biopsy. His prostatectomy involved a difficult dissection due to inflammatory changes and fibrosis after multiple septic episodes. He had complete resolution of infection after surgery with discontinuation of antibiotics on the third postoperative day, without any recurrence of sepsis.

• Authors: Louise Catherine McLoughlin, T E D McDermott, John Alan Thornhill
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2014 (Oct 14 2014) ISSN: 1757-790X [Electronic] England
• PMID: 25315803 (Publication Type: Case Reports, Journal Article)
• Copyright: 2014 BMJ Publishing Group Ltd.

Chemical References

• Anti-Bacterial Agents
• Thienamycins
• Meropenem

Topics

• Adenocarcinoma (surgery)
• Adult
• Anti-Bacterial Agents (therapeutic use)
• Drug Resistance, Bacterial
• Escherichia coli Infections (complications, drug therapy)
• Humans
• Image-Guided Biopsy (adverse effects)
• Male
• Meropenem
• Neoplasm Grading
• Prostatectomy
• Prostatic Neoplasms (surgery)
• Prostatitis (complications, drug therapy)
• Recurrence
• Thienamycins (therapeutic use)