Increasing rates of urinary- and bloodstream infections following transrectal prostate biopsy in South Sweden

• ObjectiveTo report trends and characteristics of post-biopsy infections, with regard to etiology and resistance patterns, in a large unique cohort from a single-centre using the same antibiotic prophylactic regimens during a 15-year period.MethodsThis is an observational cross sectional cohort study, including all patients who underwent transrectal prostate biopsy (TR PBx) guided by ultrasound for the suspicion of prostate cancer at the Department of Urology, Skåne University Hospital between 1st May 2003 and 31st December 2017. Positive blood and urinary cultures were considered markers of bloodstream infection (BSI) and urinary tract infection (UTI), respectively. For all patients, details regarding blood or urine cultures from the date of the prostate biopsy and 14 days onwards were retrieved.ResultsIn total, 8,973 transrectal biopsy procedures were performed in 6,597 men during the study period. Over time, there was a trend towards a changing case-mix, with biopsy procedures increasingly being performed in older patients, patients with lower PSA values and higher prostate volume. During the study period, the number of biopsy procedures performed increased for each time period and we found an increasing rate of infectious complications in the last period. Overall, the rates of BSI and UTI with at least one relevant pathogen were 1 % (88/8,973) and 1.8% (159/8,973), respectively. In total, 16 of 90 strains (18%) were ESBL-producing, with an increasing proportion over time. The proportion of ciprofloxacin-resistant pathogens did not increase over time.ConclusionDuring the 15 years of this study, BSI and UTI after TR PBx increased. The rise of infectious complications post TR PBx in this population is unlikely to be explained by quinolone-resistance, as ciprofloxacin-resistance did not increase in the blood and urinary samples obtained during the study period. Future longitudinal studies are warranted to investigate why infectious complications after TR PBx are increasing.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Urology and Nephrology (hsv//eng)

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