Korean J Urol.  2014 Oct;55(10):660-664. 10.4111/kju.2014.55.10.660.

Febrile Urinary Tract Infection After Prostate Biopsy and Quinolone Resistance

• Choi JW
• Kim TH
• Chang IH
• Kim KD
• Moon YT
• Myung SC
• Kim JW
• Kim MS
• Kwon JK

• KMID: 2069789
• DOI: http://doi.org/10.4111/kju.2014.55.10.660

Abstract

PURPOSE
Complications after prostate biopsy have increased and various causes have been reported. Growing evidence of increasing quinolone resistance is of particular concern. In the current retrospective study, we evaluated the incidence of infectious complications after prostate biopsy and identified the risk factors.
MATERIALS AND METHODS
The study population included 1,195 patients who underwent a prostate biopsy between January 2007 and December 2012 at Chung-Ang University Hospital. Cases of febrile UTI that occurred within 7 days were investigated. Clinical information included age, prostate-specific antigen, prostate volume, hypertension, diabetes, body mass index, and biopsy done in the quinolone-resistance era. Patients received quinolone (250 mg intravenously) before and after the procedure, and quinolone (250 mg) was orally administered twice daily for 3 days. We used univariate and multivariate analysis to investigate the predictive factors for febrile UTI.
RESULTS
Febrile UTI developed in 39 cases (3.1%). Core numbers increased from 2007 (8 cores) to 2012 (12 cores) and quinolone-resistant bacteria began to appear in 2010 (quinolone-resistance era). In the univariate analysis, core number> or =12 (p=0.024), body mass index (BMI)>25 kg/m2 (p=0.004), and biopsy done in the quinolone-resistance era (p=0.014) were significant factors. However, in the multivariate analysis adjusted for core number, the results were not significant, with the exception of BMI>25 kg/m2 (p=0.011) and biopsy during the quinolone-resistance era (p=0.035), which were significantly associated with febrile UTI.
CONCLUSIONS
Quinolone resistance is the main cause of postbiopsy infections in our center. We suggest that further evaluation is required to validate similar trends. Novel strategies to find alternative prophylactic agents are also necessary.

Keyword

Prostate biopsy; Prostatitis; Quinolone resistance

MeSH Terms

Aged
Anti-Bacterial Agents/*therapeutic use
Antibiotic Prophylaxis/methods
Cross Infection/etiology/prevention & control
*Drug Resistance, Bacterial
Fluoroquinolones/*therapeutic use
Humans
Image-Guided Biopsy/*adverse effects/methods
Incidence
Male
Middle Aged
Prostatic Neoplasms/*pathology
Republic of Korea/epidemiology
Retrospective Studies
Risk Factors
Ultrasonography, Interventional
Urinary Tract Infections/epidemiology/*etiology/prevention & control
Anti-Bacterial Agents
Fluoroquinolones

Figure

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  FIG. 1 Actual and predict incidence rate of postbiopsy urinary tract infection.

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