title: Febrile urinary tract infection after prostate biopsy and quinolone resistance.
abstract: OBJECTIVE
  Complications after prostate biopsy have increased and various causes have been reported. Growing evidence of increasing quinolone resistance is of particular concern. In the current retrospective study, we evaluated the incidence of infectious complications after prostate biopsy and identified the risk factors.
  
  
  METHODS
  The study population included 1,195 patients who underwent a prostate biopsy between January 2007 and December 2012 at Chung-Ang University Hospital. Cases of febrile UTI that occurred within 7 days were investigated. Clinical information included age, prostate-specific antigen, prostate volume, hypertension, diabetes, body mass index, and biopsy done in the quinolone-resistance era. Patients received quinolone (250 mg intravenously) before and after the procedure, and quinolone (250 mg) was orally administered twice daily for 3 days. We used univariate and multivariate analysis to investigate the predictive factors for febrile UTI.
  
  
  RESULTS
  Febrile UTI developed in 39 cases (3.1%). Core numbers increased from 2007 (8 cores) to 2012 (12 cores) and quinolone-resistant bacteria began to appear in 2010 (quinolone-resistance era). In the univariate analysis, core number≥12 (p=0.024), body mass index (BMI)>25 kg/m(2) (p=0.004), and biopsy done in the quinolone-resistance era (p=0.014) were significant factors. However, in the multivariate analysis adjusted for core number, the results were not significant, with the exception of BMI>25 kg/m(2) (p=0.011) and biopsy during the quinolone-resistance era (p=0.035), which were significantly associated with febrile UTI.
  
  
  CONCLUSIONS
  Quinolone resistance is the main cause of postbiopsy infections in our center. We suggest that further evaluation is required to validate similar trends. Novel strategies to find alternative prophylactic agents are also necessary.
authors.affiliation: Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Joong Won
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Tae Hyoung
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: In Ho
authors.initials: IH
authors.lastname: Chang
authors.affiliation: Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Kyung Do
authors.initials: KD
authors.lastname: Kim
authors.affiliation: Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Moon
authors.affiliation: Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Soon Chul
authors.initials: SC
authors.lastname: Myung
authors.affiliation: Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Urology, Seoul Medical Center, Seoul, Korea.
authors.forename: Min Su
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Urology, Yonsei University Health System, Seoul, Korea.
authors.forename: Jong Kyou
authors.initials: JK
authors.lastname: Kwon
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods; D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control; D024881:Drug Resistance, Bacterial; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects* / Q000379:methods; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D018084:Ultrasonography, Interventional; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones
keywords: Prostate biopsy; Prostatitis; Quinolone resistance