Incidence of infectious complications following transrectal ultrasound-guided prostate biopsy in Calgary, Alberta, Canada: A retrospective population-based analysis

Authors

  • Jan Krzysztof Rudzinski Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
  • Jun Kawakami Southern Alberta Institute of Urology Calgary, Alberta, Canada

DOI:

https://doi.org/10.5489/cuaj.1751

Keywords:

TRUS-guided prostate biopsy, Escherichia coli, sepsis, urinary tract infections (UTI), fluoroquinolones

Abstract

Introduction: We have seen an increased risk of infectious complications following transrectal ultrasound-guided prostate biopsy (TRUS-PB). Fluoroquinolone (FQ) antibiotics are common for prophylaxis prior to TRUS-PB. We evaluate whether increasing FQ resistance correlates with increased incidence of post-biopsy infectious complications at our institution.

Methods: We conducted a retrospective chart and electronic health record review on 927 patients who underwent TRUS-PB between January and July of 2012 in Calgary, Alberta, Canada. We prospectively collected the following variables: age, pre-biopsy prostate-specific antigen, and date of biopsy. We documented presentation to an emergency department within 30 days of TRUS-PB for infectious and non-infectious complications.

Results: Of the 927 patients, 58 patients (6.3%) were admitted to the emergency department due to post-TRUS-PB complications within 30 days post-biopsy. The most common infectious complications were sepsis in 21 patients (2.2%), followed by urinary tract infection (UTI) in 9 (0.9%), and prostatitis in 4 (0.4%). We found that 83% of the septic episodes and 66.6% of the UTIs were attributed to ciprofloxacin resistant Escherichia coli (E. coli). The incidence of non-infectious complications was as follows: urinary retention in 12 (1.2%), hematuria in 9 (0.9%), and rectal bleeding in 8 (0.8%).

Conclusion: Our results suggest an increased incidence of infectious complications caused by FQ resistant organisms following TRUS-PB. This finding could be attributed to increasing community resistance to ciprofloxacin. The current antimicrobial prophylactic regimen needs to be re-evaluated, and a novel approach may need to be considered.

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Author Biographies

Jan Krzysztof Rudzinski, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada

2014 MD Candidate, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada


Jun Kawakami, Southern Alberta Institute of Urology Calgary, Alberta, Canada

MD FRCSC, staff Urologist at Southern Alberta Institute of Urology, Calgary, Alberta, Canada

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Published

2014-05-21

How to Cite

Rudzinski, J. K., & Kawakami, J. (2014). Incidence of infectious complications following transrectal ultrasound-guided prostate biopsy in Calgary, Alberta, Canada: A retrospective population-based analysis. Canadian Urological Association Journal, 8(5-6), e301–5. https://doi.org/10.5489/cuaj.1751

Issue

Section

Original Research