Utrera Natalia Miranda, Álvarez María Blanco, Polo José Medina, Sánchez Angel Tejido, Martínez Juan Passas, González Rafael Díaz
Urology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
Arch Esp Urol. 2011 Sep;64(7):605-10.
To establish the rate of infectious complications derived from the use of transrectal ultrasound-guided prostate biopsy (TRUS), identify its microbiological profile and related risk factors.
We designed a prospective non-randomized study in which we enrolled 220 patients undergoing TRUS biopsy at our centre between April and September 2008. The inclusion criteria were: suspicious digital rectal examination, PSA >10 ng/ml, and free/total ratio of PSA is assessed in patients with PSA 4-10 ng/ml. The exclusion criteria were: having an indwelling urinary catheter, the administration of antibiotic treatment in the week before the needle biopsy, manipulation of the urinary tract in the month prior to the needle biopsy, allergy to quinolones and risk of endocarditis, failure to comply with the antibiotic prophylaxis regimen and loss to follow-up. We analyzed the relationship between diabetes, immunodepression, previous UTI or prostatitis and positive prebiopsy urine culture with the appearance of fever, dysuria or bacteriuria following needle biopsy.
Mean age was 69.5 years (+/-7.9), mean total PSA 12.7 ng/ml (+/-28.7), mean prostate volume 50.6 cc (+/-29.6) and mean number of cores obtained by needle biopsy 13.5 (+/-1.7). 25% of the patients had dysuria following needle biopsy, 3.2% fever and 4.5% bacteriuria. E.coli was the pathogen most frequently found in pre- and post-biopsy urine cultures. No statistically significant relationship was found between the appearance of dysuria and fever and being diabetic, having immunosuppression, previous UTI or prostatitis, prostate volume and number of cores obtained in the biopsy. Only the existence of a positive pre-biopsy urine culture and biopsy with more than 14 cores proved to have a statistically significant association with the existence of bacteriuria following biopsy, p=0.007 and p= 0.018, respectively.
Our rate of infectious complications was similar to that described in other series. The existence of a positive prebiopsy urine culture and obtaining more than 14 cores per biopsy was related, with statistical significance, to the existence of bacteriuria following the biopsy. E.coli was the most frequently isolated pathogen.
确定经直肠超声引导下前列腺穿刺活检（TRUS）所致感染性并发症的发生率，明确其微生物学特征及相关危险因素。
我们设计了一项前瞻性非随机研究，纳入了2008年4月至9月间在我们中心接受TRUS活检的220例患者。纳入标准为：直肠指检可疑、PSA>10 ng/ml，以及对PSA 4 - 10 ng/ml的患者评估游离/总PSA比值。排除标准为：留置导尿管、穿刺活检前一周内使用抗生素治疗、穿刺活检前一个月内有泌尿道操作、对喹诺酮类过敏及有感染性心内膜炎风险、未遵守抗生素预防方案以及失访。我们分析了糖尿病、免疫抑制、既往尿路感染或前列腺炎以及穿刺活检前尿培养阳性与穿刺活检后发热、排尿困难或菌尿出现之间的关系。
平均年龄为69.5岁（±7.9），平均总PSA为12.7 ng/ml（±28.7），平均前列腺体积为50.6 cc（±29.6），穿刺活检获取的平均芯数为13.5（±1.7）。25%的患者穿刺活检后出现排尿困难，3.2%出现发热，4.5%出现菌尿。大肠杆菌是活检前后尿培养中最常发现的病原体。在排尿困难和发热的出现与糖尿病、免疫抑制、既往尿路感染或前列腺炎、前列腺体积以及活检获取的芯数之间未发现统计学上的显著关系。仅穿刺活检前尿培养阳性以及活检获取芯数超过14个被证明与活检后菌尿的存在有统计学上的显著关联，p值分别为0.007和0.018。
我们的感染性并发症发生率与其他系列报道相似。穿刺活检前尿培养阳性以及每次活检获取芯数超过14个与活检后菌尿的存在有统计学上的显著关联。大肠杆菌是最常分离出的病原体。
