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

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초록

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 fluoroqui-nolone 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.

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 fluoroqui-nolone 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.

참고문헌 (28)

  1. Loeb S, "Systematic review of complications of prostate biopsy", Eur Urol, 64, pp.876~892 (2013)
  2. Drusano GL, "A population pharmacokinetic analysis of the penetration of the prostate by levofloxacin", Antimicrob Agents Chemother, 44, pp.2046~2051 (2000)
  3. Heidenreich A, "European Association of Urology. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update 2013", Eur Urol, 65, pp.124~137 (2014)
  4. Loeb S, "Complications after prostate biopsy : data from SEER-Medicare", J Urol, 186, pp.1830~1834 (2011)
  5. Nam RK, "Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy", J Urol, 189(1 Suppl), pp.S12~S17 (2013)
  6. Loeb S, "Infectious complications and hospital admissions after prostate biopsy in a European randomized trial", Eur Urol, 61, pp.1110~1114 (2012)
  7. Ozden E, "Incidence of acute prostatitis caused by extendedspectrum beta-lactamase-producing Escherichia coli after transrectal prostate biopsy", Urology, 74, pp.119~123 (2009)
  8. Williamson DA, "Infectious complications following transrectal ultrasound-guided prostate biopsy : new challenges in the era of multidrug-resistant Escherichia coli", Clin Infect Dis, 57, pp.267~274 (2013)
  9. Levy SB, "The 2000 Garrod lecture. Factors impacting on the problem of antibiotic resistance", J Antimicrob Chemother, 49, pp.25~30 (2002)
  10. Hillelsohn JH, "Variability of transrectal ultrasound-guided prostate biopsy prophylactic measures", Can J Urol, 19, pp.6573~6577 (2012)
  11. Steensels D, "Fluoroquinolone-resistant E. coli in intestinal flora of patients undergoing transrectal ultrasoundguided prostate biopsy--should we reassess our practices for antibiotic prophylaxis?", Clin Microbiol Infect, 18, pp.575~581 (2012)
  12. Roberts MJ, "Baseline prevalence of antimicrobial resistance and subsequent infection following prostate biopsy using empirical or altered prophylaxis: a bias-adjusted metaanalysis", Int J Antimicrob Agents, 43, pp.301~309 (2014)
  13. Taylor AK, "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", J Urol, 187, pp.1275~1279 (2012)
  14. Cho YH, "Antimicrobial susceptibilities of extended-spectrum betalactamase-producing Escherichia coli and Klebsiella pneumoniae in health care-associated urinary tract infection: focus on susceptibility to fosfomycin", Int Urol Nephrol, 47, pp.1059~1066 (2015)
  15. Wolf JS Jr, "Best practice policy statement on urologic surgery antimicrobial prophylaxis", J Urol, 179, pp.1379~1390 (2008)
  16. Hwang EC, "Risk factors for and prophylactic effect of povidone-iodine rectal cleansing on infectious complications after prostate biopsy: a retrospective cohort study.", Int Urol Nephrol, 47, pp.595~601 (2015)
  17. Park DS, "Control of infective complications of transrectal prostate biopsy", Surg Infect (Larchmt), 15, pp.431~436 (2014)
  18. 최중원, "Febrile Urinary Tract Infection After Prostate Biopsy and Quinolone Resistance", Investigative and Clinical Urology, 55(10), pp.660~664 (2014), 대한비뇨기과학회
  19. Wagenlehner FM, "GPIU investigators. Infective complications after prostate biopsy: outcome of the Global Prevalence Study of Infections in Urology (GPIU) 2010 and 2011, a prospective multinational multicentre prostate biopsy study", Eur Urol, 63, pp.521~527 (2013)
  20. Carignan A, "Increasing risk of infectious complications after transrectal ultrasound-guided prostate biopsies: time to reassess antimicrobial prophylaxis?", Eur Urol, 62, pp.453~459 (2012)
  21. Feliciano J, "The incidence of fluoroquinolone resistant infections after prostate biopsy--are fluoroquinolones still effective prophylaxis?", J Urol, 179, pp.952~955 (2008)
  22. 방준호, "Microbiological Characteristics of Acute Prostatitis After Transrectal Prostate Biopsy", Investigative and Clinical Urology, 54(2), pp.117~122 (2013), 대한비뇨기과학회
  23. Zani EL, "Antibiotic prophylaxis for transrectal prostate biopsy", Cochrane Database Syst Rev, (5), pp.CD006576~ (2011)
  24. Pu C, "Reducing the risk of infection for transrectal prostate biopsy with povidoneiodine : a systematic review and meta-analysis", Int Urol Nephrol, 46, pp.1691~1698 (2014)
  25. Abughosh Z, "A prospective randomized trial of povidone-iodine prophylactic cleansing of the rectum before transrectal ultrasound guided prostate biopsy", J Urol, 189, pp.1326~1331 (2013)
  26. Liss MA, "Prevalence and significance of fluoroquinolone resistant Escherichia coli in patients undergoing transrectal ultrasound guided prostate needle biopsy", J Urol, 185, pp.1283~1288 (2011)
  27. "Guidelines on urological infections 2015" (2015)[URL]
  28. Bruyere F, "Prosbiotate: a multicenter, prospective analysis of infectious complications after prostate biopsy", J Urol, 193, pp.145~150 (2015)

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