title: Prosbiotate: a multicenter, prospective analysis of infectious complications after prostate biopsy.
abstract: OBJECTIVE
  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.
  
  
  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.
authors: 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.
authors: Franck
authors: F
authors: Bruyère
authors: Unité Opérationnelle en Hygiène, Epidemiology Department, Centre Hospitalier Universitaire Rangueil, Toulouse, France.
authors: Sandra
authors: S
authors: Malavaud
authors: 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.
authors: Philippe
authors: P
authors: Bertrand
authors: Urology Department, Centre Hospitalier Régional Universtaire, Tours, France.
authors: Aliette
authors: A
authors: Decock
authors: 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.
authors: Gérard
authors: G
authors: Cariou
authors: Urology Department, Centre Hospitalier Versailles, Versailles, France.
authors: Jean Dominique
authors: JD
authors: Doublet
authors: 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.
authors: Louis
authors: L
authors: Bernard
authors: Urology Department, Centre Hospitalier Intercommunal Elbeuf-Louviers, Val De Reuil, France.
authors: Hubert
authors: H
authors: Bugel
authors: Department of Urology, Hôpital Cochin, Paris Descartes University, Paris, France.
authors: Sophie
authors: S
authors: Conquy
authors: Infectious Disease Department, Centre Hospitalier Régional Universtaire Nîmes and Institut National de la Santé et de la Recherche Médicale U1047, UFR Médecine, Nîmes, France.
authors: Albert
authors: A
authors: Sotto
authors: Urology Department, Centre Hospitalier Universtaire Gabriel Montpied, Clermont Ferrand, France.
authors: Jean Paul
authors: JP
authors: Boiteux
authors: Urology Department, Centre Hospitalier Chalons-en-Champagne, Chalons-en-Champagne, France.
authors: Bertrand
authors: B
authors: Pogu
authors: Urology Department, Clinique Beau Soleil, Montpellier, France.
authors: Xavier
authors: X
authors: Rebillard
authors: 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.
authors: Pierre
authors: P
authors: Mongiat-Artus
authors: Urology Department, Centre Hospitalier René Dubos, Pontoise, France.
authors: Patrick
authors: P
authors: Coloby
mesh_terms: D000368:Aged; D001706:Biopsy / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D018570:Risk Assessment; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology*
keywords: biopsy; prostate; prostatitis; risk; sepsis