在MRI引导的跨关节前列腺活检之前,不需要抗生素预防
S F Westerhout1, S P Rynja2, J P Z van Steenbergen2
1Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, 3015 GD, Rotterdam, The Netherlands.
Urology
|August 9, 2025
概括
没有抗生素预防 (ABP) 的甲经前列腺活检 (TPBx) 是安全的,感染率低于1.0%. 这项研究没有发现活检后感染的重大风险因素,这表明即使在高风险患者中也可以省略ABP.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
背景情况:
- 抗生素预防 (ABP) 通常在前列腺活检前使用,以预防感染.
- 甲经前列腺活检 (TPBx) 是一种越来越多地使用的诊断程序.
- 对于TPBx的ABP的必要性,特别是在特定的患者群体中,需要进一步评估.
研究的目的:
- 评估在没有抗生素预防 (ABP) 进行的跨关节前列腺活检 (TPBx) 后的传染性和非传染性并发症率.
- 确定在没有ABP接受TPBx的患者中与活检后感染相关的潜在风险因素.
主要方法:
- 一项观察性队列研究包括在2020年2月至2023年10月期间在没有ABP的情况下进行的1966个TPBx手术.
- 感染被定义为UTI的抗生素处方在2周内或30天内感染后入院.
- 分析的风险因素包括年龄,PSA水平,前列腺体积,糖尿病,内置导管和免疫抑制剂使用.
主要成果:
- 总共分析了1966个TPBx程序.
- 18名患者 (0.9%) 发生了活检后感染,其中4名 (0.2%) 需要住院治疗.
- 没有发现感染的重大风险因素;非传染性并发症发生在1.0%的病例中.
结论:
- 没有ABP的TPBx后的传染性并发症很少见 (<1.0%),即使在糖尿病患者或内置导管患者中也是如此.
- 这些发现支持对TPBx的ABP的安全遗漏,包括在具有传统风险因素的患者中.
- 没有ABP的TPBx可以被认为是前列腺癌检测的安全替代品.
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