Febrile Urinary Tract Infection After Prostate Biopsy and Quinolone Resistance.
10.4111/kju.2014.55.10.660
- Author:
Joong Won CHOI
1
;
Tae Hyoung KIM
;
In Ho CHANG
;
Kyung Do KIM
;
Young Tae MOON
;
Soon Chul MYUNG
;
Jin Wook KIM
;
Min Su KIM
;
Jong Kyou KWON
Author Information
1. Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea. kthlmk@nate.com
- Publication Type:Original Article
- Keywords:
Prostate biopsy;
Prostatitis;
Quinolone resistance
- MeSH:
Aged;
Anti-Bacterial Agents/*therapeutic use;
Antibiotic Prophylaxis/methods;
Cross Infection/etiology/prevention & control;
*Drug Resistance, Bacterial;
Fluoroquinolones/*therapeutic use;
Humans;
Image-Guided Biopsy/*adverse effects/methods;
Incidence;
Male;
Middle Aged;
Prostatic Neoplasms/*pathology;
Republic of Korea/epidemiology;
Retrospective Studies;
Risk Factors;
Ultrasonography, Interventional;
Urinary Tract Infections/epidemiology/*etiology/prevention & control
- From:Korean Journal of Urology
2014;55(10):660-664
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: 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. MATERIALS AND 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> or =12 (p=0.024), body mass index (BMI)>25 kg/m2 (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/m2 (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.
