Choi Joong Won, Kim Tae Hyoung, Chang In Ho, Kim Kyung Do, Moon Young Tae, Myung Soon Chul, Kim Jin Wook, Kim Min Su, Kwon Jong Kyou
Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
Department of Urology, Seoul Medical Center, Seoul, Korea.
Korean J Urol. 2014 Oct;55(10):660-4. doi: 10.4111/kju.2014.55.10.660. Epub 2014 Oct 10.
Complications after prostate biopsy have increased and various causes have been reported. Growing evidence of increasing quinolone resistance is of particular concern. In the current retrospective study, we evaluated the incidence of infectious complications after prostate biopsy and identified the risk factors.
The study population included 1,195 patients who underwent a prostate biopsy between January 2007 and December 2012 at Chung-Ang University Hospital. Cases of febrile UTI that occurred within 7 days were investigated. Clinical information included age, prostate-specific antigen, prostate volume, hypertension, diabetes, body mass index, and biopsy done in the quinolone-resistance era. Patients received quinolone (250 mg intravenously) before and after the procedure, and quinolone (250 mg) was orally administered twice daily for 3 days. We used univariate and multivariate analysis to investigate the predictive factors for febrile UTI.
Febrile UTI developed in 39 cases (3.1%). Core numbers increased from 2007 (8 cores) to 2012 (12 cores) and quinolone-resistant bacteria began to appear in 2010 (quinolone-resistance era). In the univariate analysis, core number≥12 (p=0.024), body mass index (BMI)>25 kg/m(2) (p=0.004), and biopsy done in the quinolone-resistance era (p=0.014) were significant factors. However, in the multivariate analysis adjusted for core number, the results were not significant, with the exception of BMI>25 kg/m(2) (p=0.011) and biopsy during the quinolone-resistance era (p=0.035), which were significantly associated with febrile UTI.
Quinolone resistance is the main cause of postbiopsy infections in our center. We suggest that further evaluation is required to validate similar trends. Novel strategies to find alternative prophylactic agents are also necessary.
前列腺活检后的并发症有所增加，且已报道了多种原因。喹诺酮耐药性不断增加的证据日益受到关注。在当前的回顾性研究中，我们评估了前列腺活检后感染性并发症的发生率并确定了危险因素。
研究人群包括2007年1月至2012年12月在中央大学医院接受前列腺活检的1195例患者。对7天内发生的发热性尿路感染病例进行调查。临床信息包括年龄、前列腺特异性抗原、前列腺体积、高血压、糖尿病、体重指数以及在喹诺酮耐药时代进行的活检。患者在手术前后接受静脉注射喹诺酮（250mg），并口服喹诺酮（250mg），每日两次，共3天。我们使用单因素和多因素分析来研究发热性尿路感染的预测因素。
39例（3.1%）发生了发热性尿路感染。穿刺针数从2007年的8针增加到2012年的12针，2010年开始出现喹诺酮耐药菌（喹诺酮耐药时代）。在单因素分析中，穿刺针数≥12针（p=0.024）、体重指数（BMI）>25kg/m²（p=0.004）以及在喹诺酮耐药时代进行活检（p=0.014）是显著因素。然而，在对穿刺针数进行校正的多因素分析中，除BMI>25kg/m²（p=0.011）和在喹诺酮耐药时代进行活检（p=0.035）与发热性尿路感染显著相关外，其他结果均不显著。
喹诺酮耐药是我们中心活检后感染的主要原因。我们建议需要进一步评估以验证类似趋势。寻找替代预防药物的新策略也很有必要。
