The molecular mechanisms of fluoroquinolone resistance found in rectal swab isolates of Enterobacterales from men undergoing a transrectal prostate biopsy: the rationale for targeted prophylaxis

• DOI: 10.1186/s12941-021-00487-y
• Publication Date: 2021-12-07T08:02:52Z
• Authors: Katarzyna Piekarska; Katarzyna Zacharczuk; Tomasz Wołkowicz; Mateusz Mokrzyś; Natalia Wolaniuk; Magdalena Nowakowska; Stanisław Szempli...; Jakub Dobruch; Rafał Gierczyński
• Keywords: Quinolone; Prostate biopsy

Abstract Background Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is considered an essential urological procedure for the histological diagnosis of cancer. It is, however, a “contaminated” which may lead to infectious complications. Recent studies suggest significant share fluoroquinolone-resistant rectal flora in post-biopsy infections. Methods The molecular mechanisms fluoroquinolone resistance, including PMQR (plasmid-mediated quinolone resistance) as well mutation QRDRs (quinolone-resistance determining regions) gyrA , gyrB parC and parE among Enterobacterales isolated from 32 48 men undergoing between November 2015 April 2016 were investigated. Before TRUS-Bx procedure, all patients received oral antibiotic containing fluoroquinolones. Results In total, 41 isolates obtained swabs. MIC ciprofloxacin presence common determinants investigated isolates. Nine (21.9%) carried with qnrS only agent detected. DNA sequencing 18 ( E. coli n = 17 cloacae 1) ≥ 0.25 mg/l performed. Substitutions following codons found: GyrA—83 [Ser → Leu, Phe] 87 [Asp Asn]; GyrB codon—605 [Met Leu], ParC codons—80 Ile, Arg] 84 [Glu Gly, Met, Val, Lys], ParE codons—458 Ala], 461 Ala] 512 [Ala Thr]. Six 2 had at least one GyrA together . Conclusions This study provides information on PMQRs mg/l, TRUS-Bx. fact partially explain why some develop post-TRUS-Bx infections despite prophylaxis.