Febrile urinary tract infection after prostate biopsy and quinolone resistance
Joong Won Choi1, Tae Hyoung Kim1, In Ho Chang1
1Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
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≥12 (p=0.024), body mass index (BMI)>25 kg/m(2) (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/m(2) (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.
Insights
Rising quinolone resistance is linked to increased infectious complications after prostate biopsies. Body mass index over 25 and biopsies during the quinolone-resistance era were significant risk factors for febrile urinary tract infections.
Area of Science:
- Urology
- Infectious Diseases
- Public Health
Background:
- Infectious complications following prostate biopsy are a growing concern.
- Increasing quinolone resistance among bacteria is a significant contributing factor.
Purpose of the Study:
- To evaluate the incidence of infectious complications after prostate biopsy.
- To identify risk factors associated with these complications, particularly febrile urinary tract infections (UTI).
Main Methods:
- Retrospective analysis of 1,195 patients undergoing prostate biopsy from 2007-2012.
- Investigation of febrile UTI cases within 7 days post-biopsy.
- Univariate and multivariate analyses to identify predictive factors for febrile UTI, including body mass index (BMI) and the quinolone-resistance era.
Main Results:
- Febrile UTI occurred in 3.1% of patients.
- Higher BMI (>25 kg/m²) and biopsies performed during the quinolone-resistance era were significantly associated with febrile UTI in multivariate analysis.
- Core numbers increased over time, coinciding with the emergence of quinolone-resistant bacteria.
Conclusions:
- Quinolone resistance is identified as the primary driver of post-biopsy infections in this center.
- Further research is needed to confirm these trends and explore alternative prophylactic agents.
- Strategies to mitigate infections due to antibiotic resistance are necessary.
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