Urology Service, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York.
Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York.
J Urol. 2014 Mar;191(3):660-4. doi: 10.1016/j.juro.2013.08.088. Epub 2013 Sep 7.
Prostate biopsy related infectious complications are associated with significant morbidity. The risk of infectious complications in patients with prostate cancer on active surveillance remains under studied.
A total of 591 consecutive men who underwent prostate biopsy were prospectively enrolled in a study evaluating prostate biopsy related complications between January 2011 and January 2012. Of these men 403 were previously diagnosed with prostate cancer and were included in this study. They underwent a 14-core transrectal ultrasound guided prostate biopsy as part of an active surveillance regimen. A nurse contacted all men within 14 days of biopsy, and information was collected on potential complications, antibiotics received and bacterial culture results.
Fourteen patients (3.5%) had infectious complications including 13 requiring hospitalization. Five patients had positive urine cultures, and fluoroquinolone resistant isolates were identified in 4 patients, including 2 with extended spectrum beta-lactamase producing isolates. We evaluated the impact of risk factors including diabetes, benign prostatic hyperplasia and antibiotic regimen. However, only the number of previous prostate biopsies was significantly associated with an increased risk of infectious complications (p = 0.041). For every previous biopsy the odds of an infection increased 1.3 times (OR 1.33, 95% CI 1.01-1.74).
In men with prostate cancer on active surveillance the number of previous prostate biopsies is associated with a significant risk of infectious complications and every previous biopsy increases the risk of infectious complication. Fluoroquinolone resistant and extended spectrum beta-lactamase producing isolates represent the most commonly identified organisms. Men with prostate cancer on active surveillance should be informed of the risks associated with serial repeat prostate biopsies.
前列腺活检相关感染并发症与显著的发病率有关。在主动监测的前列腺癌患者中，感染并发症的风险仍研究不足。
2011 年 1 月至 2012 年 1 月，前瞻性地纳入了一项评估前列腺活检相关并发症的研究，共 591 例连续男性接受了前列腺活检。其中 403 例男性之前被诊断为前列腺癌，纳入了这项研究。他们接受了 14 核经直肠超声引导下前列腺活检，作为主动监测方案的一部分。护士在活检后 14 天内联系所有男性，并收集潜在并发症、抗生素使用情况和细菌培养结果。
14 例（3.5%）患者发生感染性并发症，其中 13 例需要住院治疗。5 例患者的尿液培养呈阳性，4 例患者的氟喹诺酮类耐药分离株，包括 2 例产超广谱β-内酰胺酶分离株。我们评估了包括糖尿病、良性前列腺增生和抗生素方案在内的风险因素的影响。然而，只有以前前列腺活检的次数与感染性并发症的风险增加显著相关（p = 0.041）。每次以前的活检，感染的几率增加 1.3 倍（OR 1.33，95% CI 1.01-1.74）。
在接受主动监测的前列腺癌患者中，以前前列腺活检的次数与感染性并发症的显著风险相关，每次以前的活检都会增加感染并发症的风险。氟喹诺酮类耐药和产超广谱β-内酰胺酶的分离株是最常见的病原体。接受主动监测的前列腺癌患者应被告知与重复前列腺活检相关的风险。
