Urogenit Tract Infect.  2016 Apr;11(1):17-24. 10.14777/uti.2016.11.1.17.

Infectious Complications after Prostate Biopsy: A Prospective Multicenter Prostate Biopsy Study

Affiliations
  • 1Department of Urology, Chonnam National University Medical School, Gwangju, Korea. drjsi@yahoo.co.kr
  • 2Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
  • 3Department of Urology, Chung-Ang University School of Medicine, Seoul, Korea.
  • 4Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea.
  • 5Department of Urology, Jeju National University School of Medicine, Jeju, Korea.
  • 6Department of Urology, Chosun University School of Medicine, Gwangju, Korea.
  • 7Department of Urology, National Police Hospital, Seoul, Korea.
  • 8Department of Urology, Dankook University Medical College, Cheonan, Korea.
  • 9Department of Urology, Dongguk University School of Medicine, Gyeongju, Korea.
  • 10Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
  • 11Department of Urology, Myongji Hospital, Seonam University, Goyang, Korea.
  • 12Department of Urology, Veterans Health Service Medical Center, Seoul, Korea.
  • 13Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 14Department of Urology, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea.
  • 15Department of Urology, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
  • 16Department of Urology, Konkuk University School of Medicine, Chungju, Korea.
  • 17Department of Urology, Chungnam National University School of Medicine, Daejeon, Korea.
  • 18Department of Urology, Kwangju Christian Hospital, Gwangju, Korea.
  • 19Department of Urology, Soon Chun Hyang University Bucheon Hospital, Bucheon, Korea.
  • 20Department of Urology, Dong-A University College of Medicine, Busan, Korea.
  • 21Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
  • 22Department of Urology, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.
  • 23Department of Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
  • 24Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
Recent studies have highlighted an increasing trend of infectious complications due to fluoroquinolone-resistant organisms among men undergoing transrectal prostate biopsy. This study evaluated the current incidence of infective complications after trans-rectal prostate biopsy for identification of risk factors in Korean men who received fluoroquinolone prophylaxis.
MATERIALS AND METHODS
A prospective, multicenter study was conducted in Korea from January to December 2015. Prostate biopsies performed with fluoroquinolone prophylaxis during 3 months in each center were included. A pre-biopsy questionnaire was used for identification of patient characteristics. Clinical variables including underlying disease, antibiotic prophylaxis, enema, povidone-iodine cleansing of the rectum, and infectious complications were evaluated. The primary outcome was the post-biopsy infection rate after fluoroquinolone prophylaxis. Univariable and multivariable analyses were used for identification of risk factors for infectious complications.
RESULTS
The study included 827 patients, of whom 93 patients (11.2%) reported receiving antibiotics in the previous 6 months and 2.5% had a history of prostatitis. The infectious complication rate was 2.2%. Post-biopsy sepsis was reported in 2 patients (0.2%). In multivariable analysis predictors of post-biopsy sepsis included person performing biopsy (adjusted odds ratio [OR], 4.05; 95% confidence interval [CI], 1.31-12.5; p=0.015) and operation history within 6 months (adjusted OR, 5.65; 95% CI, 1.74-18.2; p=0.004).
CONCLUSIONS
The post-prostate biopsy infectious complication rate in this study was 2.2%. Person performing biopsy (non-urologists) and recent operation history were independent risk factors for infectious complications after trans-rectal prostate biopsy.

Keyword

Biopsy; Escherichia coli; Fluoroquinolones; Infection; Prostate

MeSH Terms

Anti-Bacterial Agents
Antibiotic Prophylaxis
Biopsy*
Enema
Escherichia coli
Fluoroquinolones
Humans
Incidence
Korea
Male
Odds Ratio
Povidone-Iodine
Prospective Studies*
Prostate*
Prostatitis
Rectum
Risk Factors
Sepsis
Anti-Bacterial Agents
Fluoroquinolones
Povidone-Iodine
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