Franck Bruyère1, Sandra Malavaud2, Philippe Bertrand3, Aliette Decock4, Gérard Cariou5, Jean Dominique Doublet6, Louis Bernard7, Hubert Bugel8, Sophie Conquy9, Albert Sotto10, Jean Paul Boiteux11, Bertrand Pogu12, Xavier Rebillard13, Pierre Mongiat-Artus5, Patrick Coloby14. 1. Urology Department, Centre Hospitalier Régional Universtaire, Tours, France; Université Francois Rabelais de Tours, Pôle de Recherche et d'Enseignement Supérieur Centre, Val de Loire Université, Tours, France. Electronic address: f.bruyere@chu-tours.fr. 2. Unité Opérationnelle en Hygiène, Epidemiology Department, Centre Hospitalier Universitaire Rangueil, Toulouse, France. 3. Biostatistics Department, Centre Hospitalier Régional Universtaire, Tours, France; Université Francois Rabelais de Tours, Pôle de Recherche et d'Enseignement Supérieur Centre, Val de Loire Université, Tours, France. 4. Urology Department, Centre Hospitalier Régional Universtaire, Tours, France. 5. Urology Department, DUNEGO/Institut National de la Santé et de la Recherche Médicale UMR_S1165, Hôpital Saint-Louis-Assistance Publique-Hôpitaux de Paris, Université Paris 7 Denis Diderot, Sorbonne, Paris, France. 6. Urology Department, Centre Hospitalier Versailles, Versailles, France. 7. Infectious Disease Department, Centre Hospitalier Régional Universtaire, Tours, France; Université Francois Rabelais de Tours, Pôle de Recherche et d'Enseignement Supérieur Centre, Val de Loire Université, Tours, France. 8. Urology Department, Centre Hospitalier Intercommunal Elbeuf-Louviers, Val De Reuil, France. 9. Department of Urology, Hôpital Cochin, Paris Descartes University, Paris, France. 10. Infectious Disease Department, Centre Hospitalier Régional Universtaire Nîmes and Institut National de la Santé et de la Recherche Médicale U1047, UFR Médecine, Nîmes, France. 11. Urology Department, Centre Hospitalier Universtaire Gabriel Montpied, Clermont Ferrand, France. 12. Urology Department, Centre Hospitalier Chalons-en-Champagne, Chalons-en-Champagne, France. 13. Urology Department, Clinique Beau Soleil, Montpellier, France. 14. Urology Department, Centre Hospitalier René Dubos, Pontoise, France.
Abstract
PURPOSE: Prostate biopsy side effects have a role in the controversy over screening for prostate cancer. We measured the precise incidence of infection after prostate biopsy and determined risk factors. MATERIALS AND METHODS: We performed a prospective, multicenter study in France from April to June 2013. All prostate biopsies done during this period were included in study. A web based questionnaire was used to identify patient characteristics, biopsy methods and postoperative infectious episodes. External audit helped ensure data completeness. The primary outcome was the post-biopsy infection rate. We determined risk factors for infectious complications using univariate and multivariate analysis. RESULTS: The study included 2,718 patients, of whom 6% reported receiving antibiotics in the previous 6 months and 7.4% had a history of prostatitis. Recommended antibiotic prophylaxis consisting of 2 fluoroquinolone tablets 2 hours before examination for prostate biopsy was noted in 78.3% of cases. Post-biopsy sepsis was found in 76 subjects (2.8%). On multivariate analysis predictors of post-biopsy sepsis were noncompliance with antibiotic prophylaxis guidelines (OR 2.3, 95% CI 1.4-3.9, p = 0.001), antibiotic treatment in the previous 6 months (OR 2.1, 95% CI 1.1-3.9, p = 0.015) and a history of prostatitis (OR 1.7, 95% CI 1.2-2.4, p = 0.002). CONCLUSIONS: In this study the incidence of post-prostate biopsy sepsis was 2.8% and no deaths were reported. Risk factors identified on multivariate analysis were noncompliance with antibiotic prophylaxis according to guidelines, antibiotic treatment in the previous 6 months and a history of prostatitis.
PURPOSE: Prostate biopsy side effects have a role in the controversy over screening for prostate cancer. We measured the precise incidence of infection after prostate biopsy and determined risk factors. MATERIALS AND METHODS: We performed a prospective, multicenter study in France from April to June 2013. All prostate biopsies done during this period were included in study. A web based questionnaire was used to identify patient characteristics, biopsy methods and postoperative infectious episodes. External audit helped ensure data completeness. The primary outcome was the post-biopsy infection rate. We determined risk factors for infectious complications using univariate and multivariate analysis. RESULTS: The study included 2,718 patients, of whom 6% reported receiving antibiotics in the previous 6 months and 7.4% had a history of prostatitis. Recommended antibiotic prophylaxis consisting of 2 fluoroquinolone tablets 2 hours before examination for prostate biopsy was noted in 78.3% of cases. Post-biopsy sepsis was found in 76 subjects (2.8%). On multivariate analysis predictors of post-biopsy sepsis were noncompliance with antibiotic prophylaxis guidelines (OR 2.3, 95% CI 1.4-3.9, p = 0.001), antibiotic treatment in the previous 6 months (OR 2.1, 95% CI 1.1-3.9, p = 0.015) and a history of prostatitis (OR 1.7, 95% CI 1.2-2.4, p = 0.002). CONCLUSIONS: In this study the incidence of post-prostate biopsy sepsis was 2.8% and no deaths were reported. Risk factors identified on multivariate analysis were noncompliance with antibiotic prophylaxis according to guidelines, antibiotic treatment in the previous 6 months and a history of prostatitis.
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