Epidemiology and O-Serotypes of Extraintestinal Pathogenic Escherichia coli Disease in Patients Undergoing Transrectal Ultrasound Prostate Biopsy: A Prospective Multicenter Study
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Purpose: Extraintestinal pathogenic Escherichia coli (ExPEC) are a leading cause of invasive infections in adults.The study aimed to evaluate the incidence of microbiologically confirmed invasive ExPEC disease in patients undergoing transrectal ultrasound-guided prostate needle biopsy (TRUS-PNB), O-serotype distribution and antibiotic resistance profiles of associated E. coli isolates.Materials and Methods: Adult men (18 years) undergoing TRUS-PNB were enrolled.The TRUS-PNB procedure was performed according to local standard of care, including preferences of prophylactic antibiotics.Clinical and microbiological data were collected.Results: Of the 4,951 patients (mean age 66.9 years) enrolled 4,935 (99.7%) underwent TRUS-PNB (95.1% received prophylactic antibiotics); 98.9% completed the study.Overall incidence of invasive ExPEC disease was 0.67% (33/4,935 patients; 95% CI 0.46e0.94);highest incidence was in the U.S. (0.97%, 14/1,446; 95% CI 0.53e1.62).Prevalence of the 10 selected O-serotypes O1, O2, O4, O6, O8, O15, O16, O18, O25 and O75 was 52.0% (95% CI 31.3e72.2).E. coli isolates showed highest resistance rates to levofloxacin and ciprofloxacin (76%; 95% CI 54.8e90.6 for both).Among fluoroquinolone-resistant ExPEC isolates, prevalence of the 10 selected O-serotypes was 60%.Conclusions: This study provides an estimate of microbiologically confirmed invasive ExPEC disease incidence following TRUS-PNB.Information on E. coli O-serotype distribution and associated antibiotic resistance profiles from invasive ExPEC disease cases in the first 30 days following TRUS-PNB may help guiding antibiotic use and inform development of a prophylactic ExPEC vaccine.
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E. coli Nissle 1917 is characterized by an LPS-type O6, commonly found in extra-intestinal pathogenic E. coli.
“E. coli Nissle 1917 is characterized by an LPS-type, O6, commonly found in extra-intestinal pathogenic E. coli [29, 30, 146].”
From Selection, Comparative Genomics, and Potential Probiotic Features of Escherichia coli 5C, a pks-Negative Strain Isolated from Healthy Infant Donor Feces (2026) · cites this paper as [146]
The Phenotypic Characterization section identifies O6 as an O-serotype studied in extraintestinal pathogenic E. coli, and Table 3 reports O6 in 2 of 25 isolates (8%) from patients undergoing prostate biopsy. The paper does not characterize E. coli Nissle 1917 or establish that O6 is commonly found in extraintestinal pathogenic E. coli generally. (LLM, conf=0.84)
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- Authors
- Rosenberg, S., Bonten, M., Haazen, W., Spiessens, B., Abbanat, D., Go, O., Wagenlehner, F., Shore, N., Hagiwara, Y., Ibarra de Palacios, P., Geurtsen, J., Hermans, P., & Poolman, J.
- Affiliations
- The Iowa Clinic, West Des Moines, Iowa
- University Medical Center Utrecht (NL)
- Janssen (Belgium) (BE)
- Janssen Research & Development (United States) (US)
- Clinic for Urology, Pediatric Urology and Andrology, Justus-Liebig University, Giessen, Germany
- Carolina Urologic Research Center (US)
- Janssen Pharmaceutical K.K. (Japan) (JP)
- Janssen Vaccines, Bern, Switzerland
- Janssen (Netherlands) (NL)
- Venue
- Journal of Urology
- Published
- 2021-03
- Volume
- 205
- Issue
- 3
- Pages
- 826-832
- ISSN
- 0022-5347 (ISSN-L)
- 1527-3792
- OpenAlex
- W3094538887
- Cited by
- 13
- References
- 11
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2023: 2 · 2022: 1 · 2021: 1
- FWCI
- 0.62
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- The Journal of Urology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Escherichia coli research studies
- Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
- Keywords
- extraintestinal pathogenic Escherichia coli, transrectal ultrasound-guided biopsy, O serotypes, antibiotic resistance, fluoroquinolone resistance, levofloxacin resistance, ciprofloxacin resistance, antibiotic prophylaxis, incidence, post-biopsy infection
- MeSH terms
- Extraintestinal Pathogenic Escherichia coli, Aged, Escherichia coli Infections, Humans, Male, Microbial Sensitivity Tests, Prospective Studies, Prostate, Serotyping, Incidence, Antibiotic Prophylaxis, Ultrasound, High-Intensity Focused, Transrectal, Image-Guided Biopsy
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