Name: povidone iodine rectal preparation at time of prostate needle biopsy is a simple and reproducible means to reduce risk of procedural infection
Uploaded: 2015-09-21T14:00:00
Description: Watch this Scientific Journal Video about Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection at JoVE.com

The authors acknowledge the Carefusion Foundation for support via a clinical excellence grant of this work titled &#8220;Prospective evaluation of procedural povidone iodine rectal preparation to reduce infectious complications following ultrasound guided prostate needle biopsy.&#8221;

这名患者的相关研究经机构审查委员会（IRB）对人类的研究。 1.患者准备和定位<ol><li>把病人的程序套件，并将其放置在他们的右侧或左侧膝盖弯曲至胸前。 </li><li>执行手术超时即病人，手术过程，并指示进行审查和确认。 </li><li>当指出，通过麻醉服务管理静脉镇静。 </li></ol> 2.进行直肠指诊（DRE） <ol><li>将大小合适的手套到双手。 </li><li>将戴手套的手...

<ol>
	<li>Nam, R. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Increasing+hospital+admission+rates+for+complications+after+transrectal+ultrasound+guided+prostate+biopsy.">Increasing hospital admission rates for complications after transrectal ultrasound guided prostate biopsy.</a> J Urol. 189, S12-S17 (2013).</li><li>Feliciano, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+incidence+of+fluoroquinolone+resistant+infections+after+prostate+biopsy+are+fluoroquinolones+still+effective+prophylaxis.">The incidence of fluoroquinolone resistant infections after prostate biopsy are fluoroquinolones still effective prophylaxis.</a> J Urol. 179 (3), 952-955 (2008).</li><li>Kehinde, O., Al-Maghrebi, M., Sheikh, M., Anim, J. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Combined+ciprofloxacin+and+amikacin+prophylaxis+in+the+prevention+of+septicemia+after+transrectal+ultrasound+guided+biopsy+of+the+prostate.">Combined ciprofloxacin and amikacin prophylaxis in the prevention of septicemia after transrectal ultrasound guided biopsy of the prostate.</a> J Urol. 189 (3), 911-915 (2013).</li><li>Taylor, A. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Targeted+antimicrobial+prophylaxis+using+rectal+swab+cultures+in+men+undergoing+transrectal+ultrasound+guided+prostate+biopsy+is+associated+with+reduced+incidence+of+postoperative+infectious+complications+and+cost+of+care.">Targeted antimicrobial prophylaxis using rectal swab cultures in men undergoing transrectal ultrasound guided prostate biopsy is associated with reduced incidence of postoperative infectious complications and cost of care.</a> J Urol. 187 (4), 1275-1279 (2012).</li><li>Gyorfi, J. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peri+procedural+povidone+iodine+rectal+preparation+reduces+microorganism+counts+and+infectious+complications+following+ultrasound-guided+needle+biopsy+of+the+prostate.">Peri procedural povidone iodine rectal preparation reduces microorganism counts and infectious complications following ultrasound-guided needle biopsy of the prostate.</a> World J Urol. 32 (4), 905-909 (2014).</li><li>Park, D. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Control+of+infective+complications+of+transrectal+prostate+biopsy.">Control of infective complications of transrectal prostate biopsy.</a> Surg Infect Larchmt. 15 (4), 431-436 (2014).</li><li>Park, D. S., Oh, J. J., Lee, J. H., Jang, W. K., Hong, Y. K., Hong, S. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Simple+use+of+the+suppository+type+povidone+iodine+can+prevent+infectious+complications+in+transrectal+ultrasound+guided+prostate+biopsy.">Simple use of the suppository type povidone iodine can prevent infectious complications in transrectal ultrasound guided prostate biopsy.</a> Adv Urol. , (2009).</li><li>AbuGhosh, Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+prospective+randomized+trial+of+povidone+iodine+prophylactic+cleansing+of+the+rectum+before+transrectal+ultrasound+guided+prostate+biopsy.">A prospective randomized trial of povidone iodine prophylactic cleansing of the rectum before transrectal ultrasound guided prostate biopsy.</a> J Urol. 189 (4), 1326-1331 (2013).</li><li>Gerber, G. S., Brendler, C. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+the+Urological+Patient:+History,+Physical+Exam,+and+Urinalysis.">Evaluation of the Urological Patient: History, Physical Exam, and Urinalysis.</a> Campbell Walsh Urology. , (2015).</li><li>Hodge, K. K., McNeal, J. E., Terris, M. K., Stamey, T. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Random+systematic+versus+directed+ultrasound+guided+transrectal+core+biopsies+of+the+prostate.">Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate.</a> J Urol. 142 (1), 71-74 (1989).</li><li>Donoghue, P. M., McSweeney, S. E., Jhaveri, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genitourinary+imaging:+current+and+emerging+applications.">Genitourinary imaging: current and emerging applications.</a> J Postgrad Med. 56 (2), 131-139 (2010).</li></ol>

下面TRUS PNB感染继发于直肠跳马细菌易位进入富含血管的前列腺。基于该原理，我们已经探索使用主题防腐剂如聚烯吡酮碘，以减少前，前列腺活检微生物菌落计数的简单方法。我们的经验突出了从4.3％下降至0.6％（P = 0.02），在使用这个PIRP方案的活检的时间。此外，我们假设在直肠保管库的微生物的减少97％是本降低全身性感染的基本原理的因素。 我们与外用聚维酮的结果?...

前列腺癌是最常见的癌症的男性和癌症相关死亡的第二大原因。在2014年，大约233000箱子将被诊断在美国有近3万人屈服于这种恶性肿瘤。1在前列腺特异性抗原（PSA）验血和直肠指诊（DRE）发挥前列腺癌筛查的重要作用，经直肠超声引导下前列腺穿刺活检（TRUS PNB）更是获得了病理组织学诊断最常用的手段。 TRUS PNB过程​​包括将超声探头插入病人的直肠，然后通常获得12-14活检正好位于前方前列腺的周边区。每个穿刺活检需要一个18G的针头通过直肠前壁通道进入富含血管的前列腺。因此，出血和感染引起的细菌易位的理论风险存在以下的步骤。无theless，精算并发症发生率后处理过程在历史上仍然很低。 预防性抗生素前TRUS PNB是常规处方与喹诺酮类抗生素是最常用的药物。尽管有足够的预防，当代研究牵连增加感染并发症后活检。2。此外，有研究认为这上升的感染并发症TRUS PNB以喹诺酮类耐药微生物尤其是大肠杆菌的出现大肠杆菌 。3 喹诺酮类药物耐药性的这种上涨的幅度意味着需要替代预防方案的TRUS PNB程序。为此，几个不同的途径正在调查中。一种方法涉及一个静脉内或肌内抗生素的给药在活检时间结合的口服喹诺酮4虽然这种策略可以减少以下TRUS PNB败血症事件这种方法的一个主要限制是进一步发展抗性微生物此抗生素家族的潜力。另一最近研究方法融合使用预活检直肠拭子筛选患者定植喹诺酮耐药直肠菌群5如果检测到这样的生物体，一个“针对性”抗生素治疗方案可以基于所识别的耐药性细菌的灵敏度分布可以采用株。虽然该方法是优雅的，取得这样的棉签，有选择地对喹诺酮类药物的选择性培养基中培养，和剪裁抗生素的实际过程之后要求可能缺乏的许多临床实践的临床和实验室的基础设施。 政府防腐剂，以减少可能出现其他的方法来限制​​TRUS PNB感染活检前直肠金库微生物菌落计数的一个话题。聚维酮iodone是一种廉价的，容易得到的试剂是当应用到手术部位记录，以减少细菌的数量。在两种结直肠癌和妇科手术应用是公知的。因此，使用povidine碘作为直肠制剂会提出一个可生产，简单，经济有效的方法，以减少TRUS PNB感染，而无需进行前活组织检查额外的准备。相对于泌尿文献，先前的工作已经指出，在下面的TRUS PNB临床感染的降低。6-9本视频演示PIRP的技术中，突出的容易和简单地集成到临床实践。 所有接受TRUS PNB患者最初出现在一个专业泌尿外科就诊转诊或初步评估前列腺癌筛查。该评估entailed患者的血清前列腺特异性抗原（PSA）及直肠指诊（DRE）的表现进行了审查。无论是PSA或DRE异常提示的建议一个TRUS PNB。 该TRUS PNB过程​​，所有的病人和包括感染，出血相关风险的讨论，和尿潴留进行了澄清。所有患者接受口服抗生素预防三天无论是喹诺酮类药物（如环丙沙星）或磺胺（复方新诺明）前活检。

<table border="0" cellpadding="0" cellspacing="0">
	<tbody>
		<tr>
			<td>Povidone Iodine Solution, 10% Topical Microbicide Antiseptic, 8 fl oz.</td>
			<td>Equate</td>
			<td>4067979</td>
			<td></td>
		</tr>
		<tr>
			<td>4x4 sterile gauze pads, white</td>
			<td>Dukal Corporation</td>
			<td>DKL1412</td>
			<td></td>
		</tr>
		<tr>
			<td>disposable gynecologic swab&#160;</td>
			<td>numerous vendors</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>1% lidocaine gel&#160;</td>
			<td>numerous vendors</td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

povidone iodine rectal preparation at time of prostate needle biopsy is a simple and reproducible means to reduce risk of procedural infection

单一的机构和人群为基础的研究强调，感染并发症经直肠超声引导前列腺穿刺活检（直肠PNB）正在增加。这种感染主要由于喹诺酮类其中殖民直肠跳马和被转运到活检手术过程中血液性微生物。聚维酮碘直肠制剂（PIRP）活检的时间是一个简单的，可重复的方法，以减少下TRUS PNB直肠微生物菌落计数，因此产生的感染。 所有患者施用的口服抗生素治疗前三天活检。该PIRP技术包括最初的定位病人的标准方式的TRUS PNB。以下直肠指检，15毫升市售聚维酮碘的10％溶液中，用5毫升1％利多卡因果冻混合以创建浆料。 4cm的×4厘米的无菌纱布是SOA的KED在该浆料，然后插入之后将其除去直肠保管库2分钟。此后，一次性妇科棉拭子用于绘制两肛门周围区域和直肠拱顶至3厘米从肛门的距离。聚维酮碘溶液然后使其干燥2 - 继续进行标准经直肠超声检查和随后的活组织检查之前3分钟。 此PIRP技术已在我们的机构自2012年三月在实践与相关联的减少后的活检感染的从4.3％至0.6％（P = 0.02）。这种预防治疗方案的主要优点是它的简单性和可重复性，以采用容易获得，便宜的试剂，以减少感染。此外，该技术避免了暴露患者额外全身性抗生素具有多重耐药生物的潜在进一步传播。 PIRP在TRUS PNB的使用，但是，是不适用的患者碘或贝类一个llergies。

自2012年一月份（截止目前）有165例患者已纳入本质量改进措施，这PIRP技术已经在实践中。在这个时候，只有一个病人（0.6％）经历了全身性败血症的形式的感染性并发症。这名患者定植一个多重抗药性E.大肠杆菌菌株 。该患者下面PIRP给予直肠拭子指出，直肠跳马仍然定植2.1×10 5 CFU / ml的细菌，从而质疑PIRP是否适当治疗直肠保管库。 一个当代人口进行TRUS PNB 20...

Watch this Scientific Journal Video about Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection at JoVE.com

Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection

Here, we present a protocol for use at the time of transrectal ultrasound guided prostate needle biopsy (TRUS PNB) that is a simple and cost-effective means to reduce infections following the procedure.

聚维酮碘直肠准备在前列腺穿刺活检的时间是一个简单的和可重复的手段，以减少程序感染的风险

Single institution and population-based studies highlight that infectious complications following transrectal ultrasound guided prostate needle biopsy ...

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