Infective complications after prostate biopsy

Outcome of the Global Prevalence Study of Infections in Urology (GPIU) 2010 and 2011, A prospective multinational multicentre prostate biopsy study

Florian M E Wagenlehner, Edgar Van Oostrum, P. Tenke, Zafer Tandogdu, Mete Çek, Magnus Grabe, Björn Wullt, Robert Pickard, Kurt G. Naber, Adrian Pilatz, Wolfgang Weidner, Truls E. Bjerklund-Johansen

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Abstract

Background: Infection is a serious adverse effect of prostate biopsy (P-Bx), and recent reports suggest an increasing incidence. Objective: The aim of this multinational multicentre study was to evaluate prospectively the incidence of infective complications after P-Bx and identify risk factors. Design, setting, and participants: The study was performed as an adjunct to the Global Prevalence Study of Infections in Urology (GPIU) during 2010 and 2011. Men undergoing P-Bx in participating centres during the 2-wk period commencing on the GPIU study census day were eligible. Outcome measurements and statistical analysis: Baseline data were collected and men were questioned regarding infective complications at 2 wk following their biopsy. The Fisher exact test, Student t test, Mann-Whitney U test, and multivariate regression analysis were used for data analysis. Results and limitations: A total of 702 men from 84 GPIU participating centres worldwide were included. Antibiotic prophylaxis was administered prior to biopsy in 98.2% of men predominantly using a fluoroquinolone (92.5%). Outcome data were available for 521 men (74%). Symptomatic urinary tract infection (UTI) was seen in 27 men (5.2%), which was febrile in 18 (3.5%) and required hospitalisation in 16 (3.1%). Multivariate analysis did not identify any patient subgroups at a significantly higher risk of infection after P-Bx. Causative organisms were isolated in 10 cases (37%) with 6 resistant to fluoroquinolones. The small sample size per participating site and in compared with other studies may have limited the conclusions from our study. Conclusions: Infective complications after transrectal P-Bx are important because of the associated patient morbidity. Despite antibiotic prophylaxis, 5% of men will experience an infective complication, but none of the possible factors we examined appeared to increase this risk. Our study confirms a high incidence of fluoroquinolone resistance in causative bacteria.

Original languageEnglish
Pages (from-to)521-527
Number of pages7
JournalEuropean Urology
Volume63
Issue number3
DOIs
Publication statusPublished - Mar 2013

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Urology
Prostate
Cross-Sectional Studies
Biopsy
Infection
Fluoroquinolones
Antibiotic Prophylaxis
Incidence
Multivariate Analysis
Statistical Data Interpretation
Censuses
Nonparametric Statistics
Urinary Tract Infections
Sample Size
Multicenter Studies
Hospitalization
Fever
Regression Analysis
Students
Morbidity

Keywords

  • Antibiotic resistance
  • Infective complications
  • Prostate biopsy
  • Urinary tract infection

ASJC Scopus subject areas

  • Urology

Cite this

Infective complications after prostate biopsy : Outcome of the Global Prevalence Study of Infections in Urology (GPIU) 2010 and 2011, A prospective multinational multicentre prostate biopsy study. / Wagenlehner, Florian M E; Van Oostrum, Edgar; Tenke, P.; Tandogdu, Zafer; Çek, Mete; Grabe, Magnus; Wullt, Björn; Pickard, Robert; Naber, Kurt G.; Pilatz, Adrian; Weidner, Wolfgang; Bjerklund-Johansen, Truls E.

In: European Urology, Vol. 63, No. 3, 03.2013, p. 521-527.

Research output: Contribution to journalArticle

Wagenlehner, FME, Van Oostrum, E, Tenke, P, Tandogdu, Z, Çek, M, Grabe, M, Wullt, B, Pickard, R, Naber, KG, Pilatz, A, Weidner, W & Bjerklund-Johansen, TE 2013, 'Infective complications after prostate biopsy: Outcome of the Global Prevalence Study of Infections in Urology (GPIU) 2010 and 2011, A prospective multinational multicentre prostate biopsy study', European Urology, vol. 63, no. 3, pp. 521-527. https://doi.org/10.1016/j.eururo.2012.06.003
Wagenlehner, Florian M E ; Van Oostrum, Edgar ; Tenke, P. ; Tandogdu, Zafer ; Çek, Mete ; Grabe, Magnus ; Wullt, Björn ; Pickard, Robert ; Naber, Kurt G. ; Pilatz, Adrian ; Weidner, Wolfgang ; Bjerklund-Johansen, Truls E. / Infective complications after prostate biopsy : Outcome of the Global Prevalence Study of Infections in Urology (GPIU) 2010 and 2011, A prospective multinational multicentre prostate biopsy study. In: European Urology. 2013 ; Vol. 63, No. 3. pp. 521-527.
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abstract = "Background: Infection is a serious adverse effect of prostate biopsy (P-Bx), and recent reports suggest an increasing incidence. Objective: The aim of this multinational multicentre study was to evaluate prospectively the incidence of infective complications after P-Bx and identify risk factors. Design, setting, and participants: The study was performed as an adjunct to the Global Prevalence Study of Infections in Urology (GPIU) during 2010 and 2011. Men undergoing P-Bx in participating centres during the 2-wk period commencing on the GPIU study census day were eligible. Outcome measurements and statistical analysis: Baseline data were collected and men were questioned regarding infective complications at 2 wk following their biopsy. The Fisher exact test, Student t test, Mann-Whitney U test, and multivariate regression analysis were used for data analysis. Results and limitations: A total of 702 men from 84 GPIU participating centres worldwide were included. Antibiotic prophylaxis was administered prior to biopsy in 98.2{\%} of men predominantly using a fluoroquinolone (92.5{\%}). Outcome data were available for 521 men (74{\%}). Symptomatic urinary tract infection (UTI) was seen in 27 men (5.2{\%}), which was febrile in 18 (3.5{\%}) and required hospitalisation in 16 (3.1{\%}). Multivariate analysis did not identify any patient subgroups at a significantly higher risk of infection after P-Bx. Causative organisms were isolated in 10 cases (37{\%}) with 6 resistant to fluoroquinolones. The small sample size per participating site and in compared with other studies may have limited the conclusions from our study. Conclusions: Infective complications after transrectal P-Bx are important because of the associated patient morbidity. Despite antibiotic prophylaxis, 5{\%} of men will experience an infective complication, but none of the possible factors we examined appeared to increase this risk. Our study confirms a high incidence of fluoroquinolone resistance in causative bacteria.",
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AU - Van Oostrum, Edgar

AU - Tenke, P.

AU - Tandogdu, Zafer

AU - Çek, Mete

AU - Grabe, Magnus

AU - Wullt, Björn

AU - Pickard, Robert

AU - Naber, Kurt G.

AU - Pilatz, Adrian

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AB - Background: Infection is a serious adverse effect of prostate biopsy (P-Bx), and recent reports suggest an increasing incidence. Objective: The aim of this multinational multicentre study was to evaluate prospectively the incidence of infective complications after P-Bx and identify risk factors. Design, setting, and participants: The study was performed as an adjunct to the Global Prevalence Study of Infections in Urology (GPIU) during 2010 and 2011. Men undergoing P-Bx in participating centres during the 2-wk period commencing on the GPIU study census day were eligible. Outcome measurements and statistical analysis: Baseline data were collected and men were questioned regarding infective complications at 2 wk following their biopsy. The Fisher exact test, Student t test, Mann-Whitney U test, and multivariate regression analysis were used for data analysis. Results and limitations: A total of 702 men from 84 GPIU participating centres worldwide were included. Antibiotic prophylaxis was administered prior to biopsy in 98.2% of men predominantly using a fluoroquinolone (92.5%). Outcome data were available for 521 men (74%). Symptomatic urinary tract infection (UTI) was seen in 27 men (5.2%), which was febrile in 18 (3.5%) and required hospitalisation in 16 (3.1%). Multivariate analysis did not identify any patient subgroups at a significantly higher risk of infection after P-Bx. Causative organisms were isolated in 10 cases (37%) with 6 resistant to fluoroquinolones. The small sample size per participating site and in compared with other studies may have limited the conclusions from our study. Conclusions: Infective complications after transrectal P-Bx are important because of the associated patient morbidity. Despite antibiotic prophylaxis, 5% of men will experience an infective complication, but none of the possible factors we examined appeared to increase this risk. Our study confirms a high incidence of fluoroquinolone resistance in causative bacteria.

KW - Antibiotic resistance

KW - Infective complications

KW - Prostate biopsy

KW - Urinary tract infection

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