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Analysis of risk factors for infection after transrectal ultrasound-guided prostate biopsy and analysis of the value of preoperative prophylactic antimicrobial use

  • Jing Li1,*,
  • Linjie Wang2

1Hospital infection management office, the First Affiliated Hospital of Shihezi University, 832008 Shihezi, Xinjiang Uygur Autonomous Region, China

2First Clinical College, Changsha Medical University, 410219 Changsha, Hunan, China

DOI: 10.22514/jomh.2023.130 Vol.19,Issue 12,December 2023 pp.60-65

Submitted: 07 July 2023 Accepted: 25 October 2023

Published: 30 December 2023

*Corresponding Author(s): Jing Li E-mail: lj6526@163.com

Abstract

This study aimed to identify risk factors associated with infections after Transrectal ultrasound-guided prostate biopsy (TRUSPB) and to analyze the efficacy of preoperative prophylactic antimicrobial administration. A retrospective analysis was conducted on 766 patients who underwent TRUSPB at our hospital from January 2020 to January 2023. Among them, 450 patients were given a three-day prophylactic course of antimicrobial fluoroquinolones before TRUSPB (Group A), while the remaining 316 patients were administered a single dose of 750 mg oral ciprofloxacin 1 h before TRUSPB (Group B). We calculated the incidence of post-TRUSPB infections in both groups and employed a binary logistic regression model to analyze factors influencing post-TRUSPB infections and evaluate the effectiveness of prophylactic antimicrobial use. Among the 766 patients who underwent prostate biopsy, 62 cases (8.1%) developed post-TRUSPB infections, and there was no statistically significant difference in the rate of post-TRUSPB infections and types of infections between Group A and Group B. Blood and urine cultures from all the 62 infected patients were positive, with Escherichia coli being the most commonly detected pathogen, demonstrating a positive detection rate of 100.0% and accounting for 76% of all infections. Logistic regression analysis identified age (Odds ratio (OR) = 1.15, 95% Confidence Interval (CI) 1.05–1.25), a history of diabetes mellitus (OR = 1.31, 95%CI 1.12–1.52), and history of indwelling urinary catheter within 7 days before biopsy (OR = 1.43, 95% CI 1.15–1.77) as risk factors for post-TRUSPB infections. In summary, a single application of ciprofloxacin demonstrated similar efficacy in reducing the risk of post-TRUSPB infection compared to a three-day course of oral fluoroquinolones before biopsy while also reducing the risk of quinolone resistance. Conversely, advanced age, comorbid diabetes mellitus, and a 7-day history of indwelling urinary catheter before TRUSPB increased the risk of post-TRUSPB infection.


Keywords

Antibiotic prophylaxis; Paracentesis; Wound infection


Cite and Share

Jing Li,Linjie Wang. Analysis of risk factors for infection after transrectal ultrasound-guided prostate biopsy and analysis of the value of preoperative prophylactic antimicrobial use. Journal of Men's Health. 2023. 19(12);60-65.

References

[1] Chung JH, Park BK. Transrectal ultrasound features and biopsy outcomes of transition PI-RADS 5. Acta Radiologica. 2022; 63: 559–565.

[2] Choe S, Patel HD, Lanzotti N, Okabe Y, Rac G, Shea SM, et al. MRI vs transrectal ultrasound to estimate prostate volume and PSAD: impact on prostate cancer detection. Urology. 2023; 171: 172–178.

[3] Panzone J, Byler T, Bratslavsky G, Goldberg H. Transrectal ultrasound in prostate cancer: current utilization, integration with mpMRI, HIFU and other emerging applications. Cancer Management and Research. 2022; 14: 1209–1228.

[4] Ding XF, Luan Y, Lu SM, Zhou GC, Huang TB, Zhu LY, et al. Risk factors for infection complications after transrectal ultrasound-guided transperineal prostate biopsy. World Journal of Urology. 2021; 39: 2463–2467.

[5] Grant A, Henegan J, Jones A, Ahmadi N, Thomas R, Stanton R, et al. Patterns of infection following transrectal ultrasound-guided biopsy of the prostate in a regional New South Wales Centre. Australian Journal of Rural Health. 2020; 28: 301–306.

[6] Kalkanlı A, Gezmiş CT, Özkan A, Çilesiz NC, Yanaral F, Aydın M, et al. Comparison of single and prolonged fluoroquinolone prophylaxis and risk factors for infectious complications after transrectal prostate biopsy. Balkan Medical Journal. 2018; 35: 373–377.

[7] Farag M, Riddell S, Daffy J, Wong L. Comparing infective complications from transrectal ultrasound guided prostate biopsy following transition to single dose oral ciprofloxacin prophylaxis. Investigative and Clinical Urology. 2019; 60: 54–60.

[8] Dasgupta P, Davis J, Hughes S. NICE guidelines on prostate cancer 2019. BJU International. 2019; 124: 1.

[9] Okarska-Napierała M, Wasilewska A, Kuchar E. Urinary tract infection in children: Diagnosis, treatment, imaging—comparison of current guidelines. Journal of Pediatric Urology. 2017; 13: 567–573.

[10] Williams IS, McVey A, Perera S, O’Brien JS, Kostos L, Chen K, et al. Modern paradigms for prostate cancer detection and management. Medical Journal of Australia. 2022; 217: 424–433.

[11] Rajwa P, Quhal F, Pradere B, Gandaglia G, Ploussard G, Leapman MS, et al. Prostate cancer risk, screening and management in patients with germline BRCA1/2 mutations. Nature Reviews Urology. 2023; 20: 205–216.

[12] Zhang X, Hong H, Liang D. The combined value of mpUS and mpMRI-TRUS fusion for the diagnosis of clinically significant prostate cancer. Cancer Imaging. 2022; 22: 60.

[13] Häggman M, Dahlman P, Ahlberg M, Liss P, Cantera Ahlman R, Dragomir A, et al. Bi-parametric MRI/TRUS fusion targeted repeat biopsy after systematic 10-12 core TRUS-guided biopsy reveals more significant prostate cancer especially in anteriorly located tumors. Acta Radiologica Open. 2022; 11: 20584601221085520.

[14] Hanske J, Risse Y, Roghmann F, Pucheril D, Berg S, Tully KH, et al. Comparison of prostate cancer detection rates in patients undergoing MRI/TRUS fusion prostate biopsy with two different software-based systems. The Prostate. 2022; 82: 227–234.

[15] Parkin CJ, Gilbourd D, Grills R, Chapman S, Weinstein S, Joshi N, et al. Transrectal ultrasound-guided prostate needle biopsy remains a safe method in confirming a prostate cancer diagnosis: a multicentre Australian analysis of infection rates. World Journal of Urology. 2022; 40: 453–458.

[16] Brassil M, Li Y, Ordon M, Colak E, Vlachou P. Infection complications after transrectal ultrasound-guided prostate biopsy: a radiology department’s experience and strategy for improvement. Canadian Urological Association Journal. 2022; 16: E523–E527.

[17] Lenihan C, Daly E, Bernard M, Murphy C, Lauhoff S, Power M, et al. Introduction of surgical site surveillance post transrectal ultrasound (TRUS) guided prostate biopsy and the impact on infection rates. Infection Prevention in Practice. 2022; 4: 100247.

[18] Yang L, Gao L, Chen Y, Tang Z, Liu L, Han P, et al. Prophylactic antibiotics in prostate biopsy: a meta-analysis based on randomized controlled trials. Surgical Infections. 2015; 16: 733–747.

[19] Castellani D, Pirola GM, Law YXT, Gubbiotti M, Giulioni C, Scarcella S, et al. Infection rate after transperineal prostate biopsy with and without prophylactic antibiotics: results from a systematic review and meta-analysis of comparative studies. Journal of Urology. 2022; 207: 25–34.

[20] Shobeirian F, Zerafatjou N, Ghomi Z, Vafaei M, Darabi M. Intraprostatic prophylactic antibiotic injection in patients undergoing transrectal ultrasonography-guided prostate biopsy. International Journal of Urology. 2021; 28: 683–686.

[21] Gabriel M, Reddy U, Rochester M, Farag F. Sepsis rates after template prostate biopsy with single-dose prophylactic antibiotic. Central European Journal of Urology. 2022; 75: 205–208.

[22] Yang L, Tang Z, Gao L, Li T, Chen Y, Liu L, et al. The augmented prophylactic antibiotic could be more efficacious in patients undergoing transrectal prostate biopsy: a systematic review and meta-analysis. International Urology and Nephrology. 2016; 48: 1197–1207.

[23] Utsumi T, Endo T, Sugizaki Y, Mori T, Somoto T, Kato S, et al. Risk assessment of multi-factorial complications after transrectal ultrasound-guided prostate biopsy: a single institutional retrospective cohort study. International Journal of Clinical Oncology. 2021; 26: 2295–2302.

[24] Lei H, Dong X, Li L, Huan F, Zhong X, Wu Q, et al. Retrospective study of the etiology and risk factors of systemic inflammatory response syndrome after systematic transrectal ultrasound-guided prostate biopsy. Infection and Drug Resistance. 2020; 13: 3187–3193.

[25] Wu YP, Li XD, Ke ZB, Chen SH, Chen PZ, Wei Y, et al. Risk factors for infectious complications following transrectal ultrasound-guided prostate biopsy. Infection and Drug Resistance. 2018; 11: 1491–1497.

[26] Gokalp F, Koras O, Gursoy D, Sigva H, Porgali SB, Tamkac N, et al. A novel enema method can prevent infectious complications of transrectal ultrasound-guided prostate biopsy: a single‐centre experience. International Journal of Clinical Practice. 2021; 75: e14923.

[27] Bajpai RR, Razdan S, Sanchez-Gonzalez MA, Razdan S. Minimizing transrectal prostate biopsy-related infections; a prospective randomized trial of povidone-iodine intrarectal cleaning versus formalin needle disinfection. Indian Journal of Urology. 2021; 37: 254–260.

[28] Begier E, Rosenthal NA, Gurtman A, Kartashov A, Donald RGK, Lockhart SP. Epidemiology of invasive escherichia coli infection and antibiotic resistance status among patients treated in US hospitals: 2009–2016. Clinical Infectious Diseases. 2021; 73: 565–574.

[29] Lin S, Lin C, Huang W, Jou Y, Tzai T, Tsai Y. History of urinary retention is a risk factor for infection after prostate biopsy: a nationwide, population-based cohort study. Surgical Infections. 2019; 20: 202–207.


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