Division of Urology, Department of Surgery, College of Medicine, The Pennsylvania State University, 500 University Drive, Hershey, PA, 17033-0850, USA.
Department of Veterinary Sciences, The Pennsylvania State University, University Park, PA, USA.
Int Urol Nephrol. 2018 Jan;50(1):21-24. doi: 10.1007/s11255-017-1752-2. Epub 2017 Nov 23.
To determine the clinical utility of preoperative urine cultures in asymptomatic men undergoing prostate needle biopsy (PNB).
One hundred fifty asymptomatic men had urine cultures obtained 14-days prior to PNB. As per study protocol, positive cultures were not treated. Antibiotic prophylaxis prior to PNB included ciprofloxacin 500 mg the night before and morning of the biopsy. Repeat urine cultures were obtained immediately prior to PNB with colony-forming units (CFUs) annotated. Infectious complications post-biopsy were recorded.
Of the 150 men, six patients (4%) had evidence of asymptomatic bacteriuria with > 10,000 CFU/mL on office urine culture. Repeat urine cultures on morning of biopsy in all 150 patients noted a mean bacterial count of 55 CFU/mL (range 0-1000). All six patients with positive office urine cultures had < 100 CFU/mL at time of PNB. Following biopsy, four patients (2.7%) developed an infectious complication including two with sepsis and two with culture-positive UTIs. The causative organism in all cases was quinolone-resistant E. coli. None of the six patients with preoperative positive urine cultures developed an infectious complication following PNB.
In this prospective observational study, under 5% of asymptomatic men had positive office cultures prior to PNB. Furthermore, repeat urine culture on the morning of biopsy showed resolution in these patients, and none developed post-biopsy infectious complications. Routine office urine culture in the asymptomatic male prior to PNB was unnecessary.
确定在接受前列腺针吸活检（PNB）的无症状男性中术前尿培养的临床实用性。
150 名无症状男性在 PNB 前 14 天获得尿培养。根据研究方案，阳性培养物未进行治疗。PNB 前的抗生素预防包括在活检前一晚和当天早上服用环丙沙星 500mg。在 PNB 前立即采集重复尿培养，并注明菌落形成单位（CFU）。记录活检后的感染并发症。
在 150 名男性中，有 6 名患者（4%）存在无症状菌尿症证据，办公室尿液培养中>10,000 CFU/mL。150 名患者的所有 150 名患者在活检当天早上的重复尿液培养中，平均细菌计数为 55 CFU/mL（范围 0-1000）。所有 6 名办公室尿液培养阳性的患者在 PNB 时的细菌计数均<100 CFU/mL。活检后，4 名患者（2.7%）发生感染性并发症，包括 2 例败血症和 2 例培养阳性的尿路感染。所有病例的病原体均为对喹诺酮类药物耐药的大肠杆菌。在 PNB 后，没有一名术前尿液培养阳性的 6 名患者发生感染性并发症。
在这项前瞻性观察研究中，不到 5%的无症状男性在 PNB 前有阳性办公室培养物。此外，在活检当天早上的重复尿液培养显示这些患者的病情已缓解，且没有发生活检后感染性并发症。在 PNB 前对无症状男性进行常规办公室尿液培养是不必要的。
