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.
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.


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Department of Urology, Paediatric Urology and Andrology of the Justus-Liebig-University, Giessen, Germany. Wagenlehner@aol.com
Florian M E
FM
Wagenlehner
Edgar
E
van Oostrum
Peter
P
Tenke
Zafer
Z
Tandogdu
Mete
M
Çek
Magnus
M
Grabe
Björn
B
Wullt
Robert
R
Pickard
Kurt G
KG
Naber
Adrian
A
Pilatz
Wolfgang
W
Weidner
Truls E
TE
Bjerklund-Johansen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy / Q000009:adverse effects* / Q000706:statistics & numerical data; D004351:Drug Resistance; D024841:Fluoroquinolones / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D038622:Internationality; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology*
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones