Prostate biopsy procedures generally deviate from what we understand to be critical infection prevention precautions required for tissue biopsy. The surgeon inserts a rectal probe with a sterile needle guide attached only once. During the procedure, he or she inserts an initially sterile needle through the needle guide, into and through the rectal tissue, and into the prostate gland up to 12 times, using a needle gun. Both the needle and guide are of course considered contaminated after the first biopsy. Researchers have weighed the benefit of removing the probe for each biopsy, removing the sterile needle guide each time, placing a new sterile needle guide on the probe, and reinserting the rectal probe and guide, with its associated time, invasiveness, and cost, against the standard practice of administering preprocedure antibiotics and using one probe, one needle guide, and one needle for one patient.The reported postprocedure infection rate is low for this approach. In one recent study of approximately 3,000 patients,the postprocedure infection rate was 2.8%, and no deaths were reported. The primary risk factor for infection identified in the multivariate analysis was noncompliance with antibiotic prophylaxis.For this procedure then, compliance with antibiotic prophylaxis guidelines must be adhered to, in addition to rigorous instrument reprocessing between patients, including the probe; comprehensive cleaning and
decontamination followed by sterilization of the needle guide between patients; and the use of one disposable sterile needle per patient. As with all other infection prevention measures, the IP’s role is to communicate, educate, and collaborate with the frontline clinical team by sharing information and knowledge.