PURPOSE: Prostate biopsy-related infectious complications are associated with significant morbidity.
The risk of infectious complications in prostate cancer patients on active surveillance (AS) remains understudied.
MATERIALS AND METHODS: 591 consecutive men who underwent prostate biopsy were prospectively enrolled in a study evaluating prostate biopsy-related complications between January 2011 and January 2012. Of these, 403 were previously diagnosed with prostate cancer and included in this study. They received a 14-core transrectal ultrasound guided prostate biopsy as part of an AS regimen. A nurse contacted all men within 14 days of biopsy, and information was collected on potential complications, antibiotics received and bacterial culture results.
RESULTS: Fourteen patients (3.5%) had infectious complications including 13 requiring hospitalization. Five patients had positive urine cultures and fluoroquinolone (FQ)-resistant isolates were identified in 4 patients, including 2 patients with extended-spectrum beta-lactamase (ESBL)-producing isolates. We evaluated the impact of risk factors including diabetes, benign prostatic hypertrophy (BPH), and antibiotic regimen; however only the number of previous prostate biopsies was significantly associated with an increased risk of infectious complications (p=0.041). For every previous biopsy, odds of an infection increases 1.3 times (odds ratio 1.33, 95% confidence interval 1.01-1.74).
CONCLUSIONS: In men with prostate cancer on AS, the number of previous prostate biopsies is associated with significant risk of infectious complications and every previous biopsy increases the risk of infectious complication. FQ-resistant and ESBL-producing isolates represent the most commonly identified organisms. Men with prostate cancer on AS should be informed of the risks associated with serial repeat prostate biopsies.
Written by:
Ehdaie B, Vertosick E, Spaliviero M, Giallo-Uvino A, Taur Y, O'Sullivan M, Livingston J, Sogani P, Eastham J, Scardino P, Touijer K. Are you the author?
Urology Service, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Reference: J Urol. 2013 Sep 6. pii: S0022-5347(13)05336-6.
doi: 10.1016/j.juro.2013.08.088
PubMed Abstract
PMID: 24018237
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