Department of Surgical and Perioperative Sciences, Urology, Andrology, Umeå University, Umeå, Sweden.
Regional Cancer Centre, Uppsala University Hospital, Uppsala, Sweden.
J Urol. 2014 Oct;192(4):1116-22. doi: 10.1016/j.juro.2014.04.098. Epub 2014 May 9.
Transrectal ultrasound guided biopsy is the gold standard for detecting prostate cancer but international reports suggest that increasing risks are associated with the procedure. We estimated incidence and risk factors for infection after prostate biopsy as well as 90-day mortality using a nationwide Swedish sample.
We performed a population based study of 51,321 men from PCBaSe between 2006 and 2011. Primary outcome measures were dispensed prescriptions of antibiotics for urinary tract infection and hospitalization with a discharge diagnosis of urinary tract infection. Multivariable logistic regression was used to examine risk factors for infection in men who underwent prostate biopsy.
During the 6 months before biopsy the background incidence of urinary tract infection was approximately 2%. Within 30 days after biopsy 6% of the men had a dispensed prescription for urinary tract antibiotics and 1% were hospitalized with infection. The strongest risk factors for an antibiotic prescription were prior infection (OR 1.59, 95% CI 1.45-1.73), high Charlson comorbidity index (OR 1.25, 95% CI 1.11-1.41) and diabetes (OR 1.32, 95% CI 1.17-1.49). Risk of an antibiotic prescription after biopsy decreased from 2006 to 2011 (OR 0.79, 95% CI 0.70-0.90) but the risk of hospital admission increased (OR 2.14, 95% CI 1.58-2.94). No significant increase was observed in 90-day mortality.
Severe infections with hospitalization after prostate biopsy are increasing in Sweden. The risk of post-biopsy infection is highest in men with a history of urinary tract infection and those with significant comorbidities.
经直肠超声引导下前列腺活检是诊断前列腺癌的金标准，但国际报告表明该操作与风险增加相关。我们利用全国性的瑞典样本估计了前列腺活检后感染的发生率和危险因素以及 90 天死亡率。
我们对 2006 年至 2011 年间 PCBaSe 中 51321 名男性进行了一项基于人群的研究。主要结局指标为开具用于治疗尿路感染的抗生素处方以及因尿路感染住院的情况。采用多变量逻辑回归分析来检查接受前列腺活检的男性感染的危险因素。
在活检前 6 个月，尿路感染的背景发生率约为 2%。在活检后 30 天内，有 6%的男性开具了用于治疗尿路感染的抗生素处方，有 1%的男性因感染而住院。抗生素处方的最强危险因素是既往感染（OR 1.59，95%CI 1.45-1.73）、高 Charlson 合并症指数（OR 1.25，95%CI 1.11-1.41）和糖尿病（OR 1.32，95%CI 1.17-1.49）。与 2006 年相比，2011 年后活检后开具抗生素处方的风险降低（OR 0.79，95%CI 0.70-0.90），但住院风险增加（OR 2.14，95%CI 1.58-2.94）。未观察到 90 天死亡率的显著增加。
瑞典前列腺活检后严重感染并住院的情况正在增加。有尿路感染史和合并症严重的男性发生活检后感染的风险最高。
