Growing biopsy problem: Superbugs and Sepsis

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clocknut
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Date Joined Sep 2010
Total Posts : 2667
   Posted 5/6/2011 7:00 AM (GMT -6)   
I found this article on a news site this morning, warning about an increase in potentially deadly infections from "superbugs" following needle biopsies.  Possibly alarmist, but worth being aware of:  http://www.bloomberg.com/news/2011-05-05/prostate-exam-deaths-tied-to-superbug-ills-spur-cancer-test-inquiries.html

Post Edited (clocknut) : 5/6/2011 7:23:43 AM (GMT-6)


April6th
Regular Member


Date Joined May 2010
Total Posts : 264
   Posted 5/6/2011 8:01 AM (GMT -6)   
Thanks for posting. A lot of statistics posted in that article.

That would be a tough read for someone with a biopsy looming in their immediate future (especially if they have been to Asia or Africa recently). I guess one benefit of PCa treatment is that you don't have to worry about any future prostate biopsies.

Dan
Here are some of my stats:
Age:54
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean
PSA tested on 7/15/10: Zero Club membership card issued (trial membership with 90 day renewal)

SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 5/6/2011 11:43 AM (GMT -6)   
As a recipient of a drug resistant infection after biopsy, I find this article to be right on.  Within a day of my biopsy I became ill and suffered over a weekend feeling like I would die.  Oral antibiotics did not help so I spent two days in the hospital where a stent was placed leading down a vein in my upper arm to an area near my heart. This was followed by daily IV antibiotics at home for I believe 10 days.  The infection was finally stopped.  Uro said infections were rare, but increasing as antibiotics are overprescribed and bacteria is not phased by them. Mine was E-coli. But, all in all, I would still get the biopsy because it did confirm my cancer and lead to treatment. Just make sure you take the prebiopsy or post biopsy antibiotics that docs precscribe (I did - guess my bacteria are tough) . Squid.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 5/6/2011 12:01 PM (GMT -6)   
As I started to read this, I was expecting the usual "shared needles" or some other sinister reason. Once I got into the core of it, I realized how much risk some of us are at regardless of the doctor's practices. I've spent most of my life on antibiotics, and much of my life in some of the countries on the "at risk" list. By the end of the article, I woundered how I had gone through two such procedures (biopsy and the later Calypso markers, which use a larger needle) without issue.
 
Maybe it's not my time yet devil

Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 5/7/2011 8:43 PM (GMT -6)   
Almost immediately following my prostate biopsy I developed sepsis and made it to the Emergency Room the next morning and thereafter was admitted into Intensive Care where I had one foot in and one foot out of septic shock.  I was in the hospital for 3 days.
Age: 61 (58 at diagnosis - June, 2008)
April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior
June '08 had biopsy, 2 days later told results positive but in less than 1% of sample (Gleason's 3+3=6)
Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days
Dr. recommended robotic removal using da Vinci; Surgery 9/10/08
Northwestern Memorial Hospital, Chicago, IL; Dr. Robert Nadler, Urologist/Surgeon
Post-Op Gleason's: 3+3, Tertiary 4; Margins: Free ; Bladder & Urethral: Free
Seminal vesicles: Not involved; Lymphatic/Vascular Invasion: Not involved
Tumor: T2c; location: Bilateral; Volume: 20%; Catheter: Removed 12-days after surgery
Incontinent: Yes (1 to 2 light (woman's style) pad per day)
ED: Combination of Cialis and MUSE (alprostadil) once weekly: started 9-27-08
Returned to work 9-29-08 (18-19 days post-op)
PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0; 3/10: 0.0; 9/10: 0.0

SkeeterZX22v
Regular Member


Date Joined Apr 2011
Total Posts : 240
   Posted 5/8/2011 3:03 AM (GMT -6)   
I got an infection after my biopsy (4/26/11). I had been on cipro starting the night before and took it for a total of 5 days. On afternoon of 4/27 I got cold chills and fever. Felt terrible. Doc put me on levaquin for 5 days and that has seemed to knock the infection out. I go to the Doc on next Tuesday (5/10) and we'll get it checked. The article gave me almost a sick feeling, as I now wonder how close I came to being really sick. And I am someone who hadn't had an antibiotic in 15 years.
Age 61, psa 4.6, 30 days cipro, psa 4.3, biopsy 4/28/11, 2 of 12 cores positive, Gleason 6

rcroller
Regular Member


Date Joined May 2011
Total Posts : 326
   Posted 5/8/2011 5:38 AM (GMT -6)   
Wow. The night after my biopsy which I had on a Friday I started shivering and shaking uncontrolably and went to bed. I figured it was just a result of getting twelve holes poked in me, like shock to the body or something. My wife wrapped me up in blankets and I took some Xanax to knock myself out. Guess it's lucky I woke up in the morning. Live and learn and maybe dumb luck in the meantime...
-Bob R.

Post Edited (rcroller) : 5/8/2011 6:21:58 AM (GMT-6)


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 5/8/2011 10:27 AM (GMT -6)   
My prep and follow-up antibiotic was levaquin 500mg, based on the history I gave them of past antibiotic needs.
 
I had no real issues from the biopsy other than the old motor oil appearance of my "fluids" afterward.

Bamboozled
New Member


Date Joined May 2011
Total Posts : 2
   Posted 5/16/2011 12:25 PM (GMT -6)   
Dan is correct when he says this is a tough read for someone with an upcoming biopsy.
My husband is scheduled for biopsy in a few weeks, and we are starting to hear conflicting information - and trying to decide if we should take more steps before jumping to the biopsy.
 
Husband is 40 yrs old and recently had a PSA test because his father was diagnosed with PCa after watchful waiting over several years (father is scheduled for surgery this month).
PSA was performed 3 days after DRE by family dr., and result was 5.25.  Family Dr. stated that prostate felt enlarged.  Husband was referred to Urologist.
 
Urologist says due to family history and elevated PSA that biopsy is warranted.  His DRE was "normal."  So biopsy is scheduled.  Uro prescribed antibiotic for before and after procedure.
 
Here is where confusion comes in - a friend of the family is a Uro, and is adamant that husband take a 30 day course of antibiotics to clear up any possible infections and then re-test PSA.  He is concerned about risks of spreading infection and causing more problems.
 
After reading the referenced article, and others like it we are left to wonder what the next step should be.  Do the 30 days of antibiotics just in case (not for purposes of reducing PSA but for preventing infection), but still go through with the biopsy to rule out PCa?
Would the 30 days course of meds be any different than just taking the antibiotics the day before and after?
 
Husband still wants to know if he has cancer or not, and biopsy seems like the only option to know for sure - yet we don't want to risk complications.
 
Thoughts??  (Thanks!)
 

SkeeterZX22v
Regular Member


Date Joined Apr 2011
Total Posts : 240
   Posted 5/16/2011 12:35 PM (GMT -6)   
I did the 30 day antibiotic thing twice. In 2002 I had a psa of 5.9, took antibiotics for 30 days, and retested at 1.0. My psa remained in the 1-2 range for several years thereafter and then began a slow climb. This year it was 4.6, 30 days of antibiotics, but then still at 4.3. Biopsy confirmed 2 of 12 cores cancerous, gleason 6, T1c.

Can't tell you what to do obviously, but that is what I did. It worked once, but not the second time. My uro had no problem with the antibiotic regime. But, the biopsy is the only way to "know" for sure.

I am now on a follow-up 10 day course of levaquin 500mg, as my infection was "still there" at the time of my last visit to uro.
Age 61, psa 4.6, 30 days cipro, psa 4.3, biopsy 4/28/11, 2 of 12 cores positive, Gleason 6
T1c
Central Ky

Bamboozled
New Member


Date Joined May 2011
Total Posts : 2
   Posted 5/16/2011 12:47 PM (GMT -6)   
Thanks for your story Skeeter, it is very much appreciated!

Just to clarify, I think what you are saying is that even though you took 30 days antibiotics the second time, you still ended up having a prostate infection during biopsy?

SkeeterZX22v
Regular Member


Date Joined Apr 2011
Total Posts : 240
   Posted 5/16/2011 1:12 PM (GMT -6)   
I had an infection as a result of the prostate biopsy. As my uro said, "you're poking needles through the dirtiest part of your body." My initial symptoms were chills and fever the afternoon after the biopsy. Although I was on a 5 day cipro antibiotic starting the day before the biopsy, my uro changed me to 750mg levaquin for 5 days upon the infection revealing itself. By the third day of the levaquin my fever and chills were gone.

I continued to have a moderate burning pain when urinating, and upon my followup visit with my uro, urinalysis revealed some infection still around, thus the 10 days of levaquin 500mg. I am feeling better now and I think this last round of levaquin will take care of it. I hope so!

Having experienced a biopsy infection, I am still glad I had one, inasmuch as my PCa was found at an early stage.

Steve
Age 61, psa 4.6, 30 days cipro, psa 4.3, biopsy 4/28/11, 2 of 12 cores positive, Gleason 6
T1c
Central Ky

SkeeterZX22v
Regular Member


Date Joined Apr 2011
Total Posts : 240
   Posted 5/16/2011 1:16 PM (GMT -6)   
To be "perfectly clear" I had 30 days cipro between the psa tests, then 5 days cipro starting the night before the biopsy, then switched to levaquin 2 days after the biopsy, now on a followup course of 10 days levaquin 500mg.

Prior to this the last antibiotic I had had was in 2002 for a prior elevated psa, which was prostatitis.

Steve
Age 61, psa 4.6, 30 days cipro, psa 4.3, biopsy 4/28/11, 2 of 12 cores positive, Gleason 6
T1c
Central Ky

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 5/16/2011 1:24 PM (GMT -6)   
Bamboozled,
 
The routine of PSA tests and DRE is hotly debated, but generally I think we work under some "givens" (understanding we are not doctors) -
 
Blood for PSA tests would best be taken before the DRE, since there is the possibility that a DRE "stirs up" the PSA, and it reads higher than normal if the PSA is done in the following days. So in your case, was waiting three days enough? Can't answer that.
 
If you take a routine of antibiotics, and your PSA goes down, it may have been because there was an infection, so you reconsider with new data. If the PSA is effectively unchanged, the doctor would likely want the biopsy.
In my case the PSA was higher than the level for my age, and the DRE (a few days later) was abnormal, so off I went to biopsy without the 30-day antibiotic routine (but it was described as an option before the DRE was done).
 
The "30-day" routine is separate from the short course of antibiotics for the biopsy itself.
 
For the biopsy itself I was given a few days of levaquin 500mg. That was to counter any infection from the biopsy itself, nothing to do with any suspected general prostate infection.
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

gadget
Regular Member


Date Joined May 2011
Total Posts : 55
   Posted 5/16/2011 2:40 PM (GMT -6)   
Well that's just what I needed to see the day before a Biopsy, as if I don't have enough to worry about....and I just went to China literally 1 month ago.  I want to know what's causing my PSA to rise, and I have a low (very low, 3.4% fPSA) - only 48 - so I'll probably go forward, but then I'll be worried about every ache for the next week.  Maybe it'll take my mind off the waiting to see if its PCa or not....

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 5/16/2011 3:31 PM (GMT -6)   
Gadget,
 
If it were me, I would ask your Uro & GP both about the trip to China. It might change the antibiotic your Uro would use.
 
I traveled for years, and that was always a concern. I checked in with my GP before and after each trip to a "new" country.
 
The best suggestion I have is to not worry about it. I know that's hard, been there myself, but it doesn't change a thing for the better.
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 662
   Posted 5/16/2011 4:17 PM (GMT -6)   

Bamboo,

My PCP and Urologist both said that with my elevated PSA and the history of my father having advanced metastatic disease that a biopsy was in order regardless.  My two younger brothers were told the same thing.  I had 10 of 12 cores positive; my youngest brother (46) at the time had 6 of 12 positive. I had my biopsy done in the clinic setting.  MY OWN OPINION is that you are less likely to run into super-bugs (MDRO…multi drug resistant organisms) in the clinic setting as opposed to the hospital.  I have no proof of this what so ever, it is just a total unscientific musing.  My younger brother and I had our procedure done at the same place by the same Uro.  My other brother had his done at the local VA hospital.  None of us had any infection issues.  My best to you and your husband, this is a very emotional road to go down. 

Hero


Age 51 PSA 6.8
Bxy 10 of 12 Cores positive for Gleason 6. up to 75%
Robotic surg 11-02-09
Post op path. 20% neoplasm;4+3=7 Gleason
All nodes (14) and other related tissue negative for cancer
No EPE
Post op PSA x 3, all <0.01
walkbobwithjack.blogspot.com
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