[Investigation of infection risk and the value of antibiotic prophylaxis during transrectal biopsy of the prostate by endotoxin determination].
OBJECTIVE
To clarify the value of endotoxin determination in evaluating the infection risk and antibiotic prophylaxis during transrectal biopsy of the prostate.


METHODS
Forty-eight patients were divided into four groups randomly. Group A (12 patients) were not treated before biopsy. Group B (13 patients) received antibiotic prophylaxis therapy. Group C (12 patients) underwent clusis. Group D (11 patients) received combined treatment. Urine and blood samples of the patients were obtained before and after prostatic biopsy. All samples were cultured for bacteria and investigated for endotoxin concentration by limulus quantitative azo color test.


RESULTS
No significant difference in either serum endotoxin or blood bacterial cultures was noted before and after prostatic biopsy (P < 0.05) in all the groups. A significant increase was observed in urine endotoxin after biopsy compared with that before biopsy in Groups A and B (P < 0.05). There was no significant increase in urine endotoxin after biopsy compared with that before biopsy in Group C and D. The positive incidence of urine bacterial culture was significantly increased (P < 0.05) in patients of Group A and B.


CONCLUSIONS
Circulation infection risk following prostatic biopsy was low. Changes of urinary infection were fewer in patients who had undergone clusis and/or antibiotic prophylaxis than in those who had received no or only antibiotic prophylaxis therapy. Endotoxin determination in urine is a reliable, sensitive and simple method for diagnosis of bacterial infection in patients undergoing transrectal biopsy of the prostate.
Wang
Hua
H
Department of Urology, the First Affiliated Hospital, Zhejiang University Medical College, Hangzhou, Zhejiang 310003, China. wangh@zju.edu.cn
Zhou
Xinmei
X
Chen
Shanwen
S
Zhu
Chunxia
C
Yu
Xiao
X
D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D016470:Bacteremia / Q000382:microbiology; D001424:Bacterial Infections / Q000209:etiology* / Q000517:prevention & control; D001437:Bacteriuria / Q000382:microbiology; D001707:Biopsy, Needle / Q000009:adverse effects*; D004731:Endotoxins / Q000032:analysis* / Q000097:blood / Q000652:urine; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*
D004731:Endotoxins