“The most common complication of prostate biopsy is infection, with mild bleeding also reported, according to an update of the American Urological Association White Paper published in the August issue of The Journal of Urology.
“Michael A. Liss, M.D., from the University of Texas Health Science Center San Antonio, and colleagues conducted a literature review to examine the prevalence and prevention of common complications of prostate needlebiopsy. They focused on infection, bleeding, urinary retention, needle tract seeding, and erectile dysfunction in 346 articles identified for full text review and 119 articles that were included in the final data synthesis.”
“Women undergoing mastectomy with immediate reconstruction were at twice the risk for surgical site infections than women undergoing mastectomy alone, according to researchers from Washington University School of Medicine.
“Although the National Healthcare Safety Network (NHSN) estimates the incidence of surgical site infections (SSIs) following breast operations in the United States to be around 1% to 2%, SSI rates vary widely across institutions. According to Margaret A. Olsen, PhD, MPH, and colleagues, this may be due to ‘the type of breast operation, definitions used for infection, surveillance methods to identify infections, and the length of postoperative follow-up.’
“The researchers examined the incidence of infection in a much larger population of women treated at numerous facilities. Participants included 18,085 women with private health insurance who underwent 18,696 mastectomy procedures with and without immediate implant or flap reconstruction from 2004 to 2011.”
“A systematic, best-practice approach to colorectal surgery can decrease the risk of surgical site infections, according to a study published today in JAMA Surgery.
“While improving adherence to evidence-based practices during surgery can improve outcomes, this has not generally been shown to improve infection rates. In the current study, Christopher R. Mantyh, MD, of the department of surgery at the Duke University Medical in North Carolina, and colleagues tested whether a systematic approach known as a bundle’—which incorporates several optimal surgical techniques—could reduce the rates of infections in patients undergoing colorectal surgery.
“The researchers found that using the bundle approach lowered the rates of superficial surgical site infections from 19.3% to 5.7%, and postoperative sepsis from 8.5% to 2.4%.
“For the patient, the bundle approach included a disinfecting shower before surgery, antibiotics, and then specific wound-care instructions upon discharge. Surgeons and surgical room staff did a gown and glove change prior to closure of the wound, and a dedicated wound closure tray was used to seal up the skin. The approach, led by the team of colorectal surgeons, included the entire multidisciplinary team of surgeons, nurses, anesthesiologists, and hospital staff.”
“Researchers have identified Down syndrome as a major risk factor for infection-related mortality among pediatric patients with acute lymphoblastic leukemia (ALL) enrolled in the Medical Research Council UKALL 2003 trial.
“ ‘Our analysis demonstrated that a significant proportion of sepsis deaths occurred during induction and during periods of neutropenia,’ wrote researchers led by David O’ Connor, MD, of Imperial College London. ‘Thus increased awareness of the potential for septic complications is required when caring for patients during these high-risk periods.’ ”
“The currently reported rates of treatment-related mortality in trials of patients with ALL is between 2% and 4%, with the most common cause being infection. With ALL having such high survival rates in low-risk patients, reducing infection-related mortality is an important goal for improving outcomes with children with this disease, according to O’Connor and colleagues.”
The makers of lorvotuzumab mertansine (IMGN901) have halted a clinical trial investigating the use of the drug in extensive-stage small-cell lung cancer (SCLC). An independent monitoring group recommended ending the trial because patients treated with IMGN901 in addition to the chemotherapy agents etoposide (Etopophos) and carboplatin (Paraplatin) fared no better than patients treated with Etopophos and Paraplatin only. Furthermore, the patient group receiving IMGN901 appeared to have higher rates of infections and infection-related deaths, with at least one death potentially related to IMGN901.
In the last decade, the number of blood infections after prostate biopsy has increased drastically, often involving difficult-to-treat bacteria that are resistant to multiple antibiotics. To decrease risk of infection, doctors are being more careful about whom they select to biopsy, leading to a lower number of biopsies being performed across the country. One cancer center has started testing patients’ rectal bacteria for resistance to antibiotics prior to performing a prostate biopsy in order to make better treatment decisions in the event of infection.