Tohi Yoichiro, Fujiwara Kengo, Harada Satoshi, Matsuda Iori, Ito Ayako, Yamasaki Mari, Miyauchi Yasuyuki, Matsuoka Yuki, Kato Takuma, Taoka Rikiya, Tsunemori Hiroyuki, Ueda Nobufumi, Sugimoto Mikio
Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Res Rep Urol. 2021 Sep 7;13:691-698. doi: 10.2147/RRU.S333724. eCollection 2021.
To investigate the association between urine culture before transperineal prostate biopsy and post-biopsy febrile urinary tract infection (fUTI).
We retrospectively reviewed 307 patients who underwent urine culture before transperineal prostate biopsy between April 2017 and September 2020. Patients with indwelling urinary catheters (n=7) were excluded. Urine culture was performed 1-3 days before the biopsy, and all patients received prophylactic cefazolin regardless of culture results. A urine culture was defined as positive if cell density was more than 1×10 colony-forming units per mL. Baseline characteristics and the incidence of post-biopsy fUTI were compared between patients showing positive pre-biopsy culture results and those showing negative findings.
Out of 300, seven patients (2.3%) had positive urine culture results before the biopsy. Age (p=0.077); prostate-specific antigen at diagnosis (p=0.267); prostate volume (p=0.78); number of biopsy cores (p=0.277); percentage of patients testing positive for cancer on biopsy (p=0.71); and percentages of patients with a history of biopsy (p>0.999), diabetes mellitus (p=0.604), and immunosuppressive medication use (p>0.999) were similar between the two groups. No patient in the positive urine culture group had post-biopsy fUTI. However, 1.7% (five patients) of the negative urine culture group had the disease (p>0.999) (four patients with prostatitis and one with pyelonephritis). Among them, two patients were diagnosed by urine culture at the time of post-biopsy fUTI.
In asymptomatic patients, positive pre-biopsy cultures were not associated with the development of post-biopsy fUTI.
探讨经会阴前列腺穿刺活检前尿培养与活检后发热性尿路感染（fUTI）之间的关联。
我们回顾性分析了2017年4月至2020年9月期间307例行经会阴前列腺穿刺活检前进行尿培养的患者。排除留置导尿管的患者（n = 7）。在活检前1 - 3天进行尿培养，无论培养结果如何，所有患者均接受预防性头孢唑林治疗。如果细胞密度超过每毫升1×10菌落形成单位，则尿培养定义为阳性。比较活检前培养结果为阳性的患者与培养结果为阴性的患者的基线特征和活检后fUTI的发生率。
在300例患者中，7例（2.3%）活检前尿培养结果为阳性。两组患者的年龄（p = 0.077）、诊断时的前列腺特异性抗原（p = 0.267）、前列腺体积（p = 0.78）、活检针数（p = 0.277）、活检时癌症检测阳性患者的百分比（p = 0.71）以及有活检史（p>0.999）、糖尿病（p = 0.604）和使用免疫抑制药物（p>0.999）的患者百分比相似。尿培养阳性组中无患者发生活检后fUTI。然而，尿培养阴性组中有1.7%（5例患者）发生了该疾病（p>0.999）（4例前列腺炎患者和1例肾盂肾炎患者）。其中，2例患者在活检后fUTI时通过尿培养确诊。
在无症状患者中，活检前培养阳性与活检后fUTI的发生无关。
