Alfred Health, Melbourne, VIC, Australia; Epworth Healthcare, Melbourne, VIC, Australia; Cabrini Health, Melbourne, VIC, Australia; Monash University, Melbourne, VIC, Australia.
BJU Int. 2014 Sep;114(3):384-8. doi: 10.1111/bju.12536. Epub 2014 Feb 19.
To determine the rate of hospital re-admission for sepsis after transperineal (TP) biopsy using both local data and worldwide literature, as there is growing interest in TP biopsy as an alternative to transrectal ultrasonography (TRUS)-guided biopsy for patients undergoing repeat prostate biopsy.
Pooled prospective databases on TP biopsy from multiple centres in Melbourne were queried for rates of re-admission for infection. A literature review of PubMed and Embase was also conducted using the search terms: 'prostate biopsy, fever, infection, sepsis, septicaemia and complications'.
In all, 245 TP biopsies were performed (111 at Alfred Health, 92 at Epworth Healthcare, 38 at Peter MacCallum Cancer Centre, and four at other institutions). The rate of hospital re-admission for infection was zero. The literature review showed that the rate of sepsis after TRUS biopsy appears to be rising with increasing rates of multi-resistant bacteria found in rectal flora, and is as high as 5%. However, the rate of sepsis from published series of TP biopsy approached zero.
Both local and international data suggest a negligible rate of sepsis with TP biopsy. This compares to a concerning rise in the rate of sepsis after TRUS biopsy due to the increasing prevalence of multi-resistant bacteria in rectal flora. Although TRUS biopsy is convenient, cheap and quick to perform, we think that TP biopsy should now be offered as an option, not only to patients undergoing repeat prostate biopsy, but to all patients in whom a prostate biopsy is indicated.
通过当地数据和全球文献，确定经会阴（TP）活检后脓毒症的再入院率，因为越来越多的人对 TP 活检作为经直肠超声（TRUS）引导活检的替代方法感兴趣，适用于接受重复前列腺活检的患者。
对来自墨尔本多个中心的 TP 活检的汇总前瞻性数据库进行了查询，以确定感染再入院的比率。还使用以下搜索词在 PubMed 和 Embase 上进行了文献综述：“前列腺活检、发热、感染、脓毒症、败血症和并发症”。
总共进行了 245 次 TP 活检（111 次在阿尔弗雷德健康中心，92 次在伊普斯威奇保健中心，38 次在彼得麦卡伦癌症中心，4 次在其他机构）。感染的再入院率为零。文献综述表明，随着直肠菌群中发现的多耐药菌的比例增加，TRUS 活检后的脓毒症发生率似乎在上升，高达 5%。然而，从已发表的 TP 活检系列中，脓毒症的发生率接近零。
当地和国际数据均表明 TP 活检后发生脓毒症的几率可忽略不计。相比之下，由于直肠菌群中多耐药菌的流行率不断上升，TRUS 活检后的脓毒症发生率令人担忧。虽然 TRUS 活检方便、便宜且快速，但我们认为现在应该将 TP 活检作为一种选择提供给患者，不仅是接受重复前列腺活检的患者，而且还适用于所有需要进行前列腺活检的患者。
