Örtegren Joakim, Kohestani Kimia, Elvstam Olof, Janson Håkan, Åberg Daniel, Kjölhede Henrik, Kahlmeter Gunnar, Bratt Ola
Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Göteborg, Sweden.
Section of Urology, Department of Surgery, Region Kronoberg, Växjö, Sweden.
Eur Urol Open Sci. 2024 Jul 13;67:1-6. doi: 10.1016/j.euros.2024.06.015. eCollection 2024 Sep.
Infection after transrectal prostate biopsy (TPBx) is a well-known risk. A comprehensive investigation of risk factors may identify measures for safe TPBx as an alternative to a change in biopsy route. The aim of this study was to identify risk factors for infection after TPBx.
We included all outpatient TPBx cases in Region Kronoberg, Sweden, from January 2010 to December 2019. The primary outcome was post-TPBx infection, defined as prescription of antibiotics indicated for urinary tract infection (UTI) or inpatient care for infection within 30 d. We analysed the following factors in relation to post-TPBx infection: age, diabetes mellitus, prostate cancer diagnosed at index biopsy, previous prostate biopsy, two or more biopsies in the past 24 mo, a positive urine culture, two or more negative urine cultures (UCs) in the past 24 mo, antibiotic treatment grouped as four types, and medication for benign prostatic hyperplasia (BPH). Logistic regression was used to calculate odds ratios (ORs).
Of 5788 TPBx procedures in 4040 patients, 405 (7.0%) led to an infection and 170 (2.9%) to inpatient care for infection. Risk factors for post-TPBx infection (ORs 1.5-2.5) were diabetes mellitus, antibiotic treatment for a UTI, fluoroquinolone treatment, and a positive urine culture. Weaker risk factors (ORs 1.3-1.5) were non-UTI antibiotic treatment, BPH medication, and negative UCs before TPBx.
Our results confirm that diabetes mellitus and previous UTI are risk factors for infection after TPBx. Lower urinary tract symptoms and treatment with any kind of antibiotic were associated with infection, which has not been previously reported.
In a large population-based study from Sweden, we investigated which clinical factors increase the risk of an infection after transrectal prostate biopsy. Our results confirm that diabetes and a previous urinary tract infection are risk factors. We also found two new factors associated with the risk of infection after biopsy: lower urinary tract symptoms and any antibiotic treatment.
经直肠前列腺穿刺活检（TPBx）后感染是一种众所周知的风险。对风险因素进行全面调查可能会确定安全进行TPBx的措施，作为活检途径改变的替代方法。本研究的目的是确定TPBx后感染的风险因素。
我们纳入了2010年1月至2019年12月瑞典克鲁努贝里地区所有门诊TPBx病例。主要结局是TPBx后感染，定义为在30天内开具用于治疗尿路感染（UTI）的抗生素处方或因感染住院治疗。我们分析了以下与TPBx后感染相关的因素：年龄、糖尿病、在初次活检时诊断出前列腺癌、既往前列腺活检、在过去24个月内进行过两次或更多次活检、尿培养阳性、在过去24个月内有两次或更多次尿培养阴性（UCs）、分为四种类型的抗生素治疗以及良性前列腺增生（BPH）用药。采用逻辑回归计算比值比（OR）。
在4040例患者的5788次TPBx操作中，405例（7.0%）发生感染，170例（2.9%）因感染住院治疗。TPBx后感染的风险因素（OR为1.5 - 2.5）包括糖尿病、UTI抗生素治疗、氟喹诺酮类治疗以及尿培养阳性。较弱的风险因素（OR为1.3 - 1.5）包括非UTI抗生素治疗、BPH用药以及TPBx前UCs阴性。
我们的结果证实糖尿病和既往UTI是TPBx后感染的风险因素。下尿路症状和任何类型的抗生素治疗与感染相关，这在以前尚未有报道。
在一项来自瑞典的基于人群的大型研究中，我们调查了哪些临床因素会增加经直肠前列腺穿刺活检后感染的风险。我们的结果证实糖尿病和既往尿路感染是风险因素。我们还发现了两个与活检后感染风险相关的新因素：下尿路症状和任何抗生素治疗。
