Download This Paper
Preprints with The Lancet is a collaboration between The Lancet Group of journals and SSRN to facilitate the open sharing of preprints for early engagement, community comment, and collaboration. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early-stage research papers that have not been peer-reviewed. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. The findings should not be used for clinical or public health decision-making or presented without highlighting these facts. For more information, please see the FAQs.
What is the Infectious Risk of Prostate Biopsy: The Global Prevalence of Infections in Urology (GPIU) Study
24 Pages Posted: 11 Aug 2020
More...Abstract
Background: Reports suggest an increase of life-threatening infectious complications following prostate biopsies (P-Bx).
Methods: Risk factors and time trends in rates of infectious complications were evaluated in the multicentre, worldwide, prospective Global Prevalence of Infections in Urology (GPIU) study 2010-2018. The primary outcome was infectious complications after P-Bx. Uni- and multivariate statistical analysis, two-sample t and chi-square tests were used.
Findings: Outcome data were available for 1556 men. Rates of symptomatic complications increased from 6.1% in 2010 to 10.2% in 2018. Prevalence of symptoms of urinary tract infections (UTI) justifying antibiotic treatment was 6.5%. Fluoroquinolone-based prophylaxis was administered in 79.7%. Transperineal P-Bx, repeated P-Bx, aminoglycosides as prophylaxis and histopathologic signs of inflammation in the prostate were risk factors to develop symptoms of UTI. Inflammation of the prostatic tissue was associated with a higher number of post-P-Bx symptoms. Of 88 urine cultures post-P-Bx, 33 were positive (37.5%). Escherichia coli was the most common causative uropathogen (75.8%). Resistance rate to fluoroquinolones was 60.0%. Following transrectal P-Bx, 3.9% of patients required hospitalization and 2.7% developed febrile infections. Two men (0.13%) died after transrectal P-Bx due to sepsis.
Interpretation: Symptoms of UTI after P-Bx increased during study period. Inflammation of the prostatic tissue is associated with a higher number of post-P-Bx symptoms. Transrectal P-Bx was a risk factor for severe complications, such as febrile UTIs and mortality.
Funding: European Section of Infections in Urology (ESIU), European Association of Urology (EAU), EAU Research Foundation (EAU RF), Technische Hochschule Mittelhessen (THM), Germany, Merian Iselin Foundation, Switzerland.
Declaration of Interests: Authors have no potential conflict of personal interest to disclose that could give the appearance of potentially influencing the submitted work.
Ethics Approval Statement: The GPIU study was approved by the Ethical Committee of the Justus Liebig University, Giessen, Germany (ethical vote: AZ:116/07). Due to the multicentric and multinational nature, obtaining regulatory approval was the responsibility of each study centre.
Keywords: prostate biopsy; antibiotic resistance; prostate cancer; antibiotics; fluoroquinolones
Suggested Citation: Suggested Citation