Retrospective study of infectious complications of prostate biopsies

doi:10.3877/cma.j.issn.1674-1358.2017.06.008

Abstract

Abstract:

Objective

To investigate the risk factors of infection-related complications after prostate biopsies and to select an efficacy and suitable prophylactic regimen.

Methods

Clinical data of 750 patients who underwent prostate biopsy from January 2013 to April 2016 were analyzed, retrospectively; these patients were divided into two groups according to different prophylactic antibiotics as Group A (n = 237, quinolone oral applied) and Group B (n = 513, intravenous third generation cephalosporin). Baseline data and complications within one week following prostate biopsies were collected and the infectious complications were compared stratified by possible influence factors and two kinds of different prophylactic antibiotic.

Results

The occurrence of infectious complications of total 750 cases was 6.4%. The infection rate of patients ≥ 75 years, combined with diabetic, hematuresis, hematospermia, bloody stool after prostate biopsies and with retention catheterization in one week was higher than other patients (all P < 0.05). The infection rate of group A was higher than that of group B with three conditions: age ≥ 75 years, retention catheterization before biopsies in 1 week hematuresis, hematospermia, bloody stool after prostate biopsies, but was not related to other factors (all P > 0.05).

Conclusions

Diabetes, age, retention catheterization and hematuresis, hematospermia, bloody stool were the independent risk factors of infection after prostate biopsy. Intravenous third generation cephalosporin vein application could have better preventive effect.

Key words: Prostate biopsy, Infection rate, Risk factors, Antibacterial agent

Long Cheng, Yisheng Chen, Bin Zou, Lingsong Tao, Jian Kong, Guangbiao Zhu, Jiawei Wang, Liangjun Tao. Retrospective study of infectious complications of prostate biopsies[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(06): 561-567.

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项目	A组（237例）	B组（513例）	F值	P值
年龄（岁）	70.6 ± 10.6	71.7 ± 11.8	0.470	0.411
身高（cm）	171.5 ± 6.7	171.2 ± 6.9	0.213	0.736
体重（kg）	69.3 ± 9.3	69.6 ± 11.2	0.209	0.716
体质指数	23.98 ± 1.89	23.84 ± 1.92	0.397	0.578
穿刺前体温（℃）	36.5 ± 0.3	36.5 ± 0.7	1.025	0.218
呼吸频率（次/min）	18.2 ± 1.7	18.3 ± 1.9	0.315	0.719
心率（次/min）	76.6 ± 6.3	76.5 ± 6.6	0.117	0.892
收缩压（mmHg）	129.9 ± 11.7	129.7 ± 13.2	0.206	0.811
舒张压（mmHg）	78.7 ± 7.5	76.3 ± 8.6	0.987	0.112
PSA（ng/ml）	14.2 ± 6.1	14.1 ± 6.5	0.990	0.213
前列腺体积（ml）	50.1 ± 15.1	52.1 ± 17.4	0.682	0.343

项目	A组（237例）	B组（513例）	F值	P值
年龄（岁）	70.6 ± 10.6	71.7 ± 11.8	0.470	0.411
身高（cm）	171.5 ± 6.7	171.2 ± 6.9	0.213	0.736
体重（kg）	69.3 ± 9.3	69.6 ± 11.2	0.209	0.716
体质指数	23.98 ± 1.89	23.84 ± 1.92	0.397	0.578
穿刺前体温（℃）	36.5 ± 0.3	36.5 ± 0.7	1.025	0.218
呼吸频率（次/min）	18.2 ± 1.7	18.3 ± 1.9	0.315	0.719
心率（次/min）	76.6 ± 6.3	76.5 ± 6.6	0.117	0.892
收缩压（mmHg）	129.9 ± 11.7	129.7 ± 13.2	0.206	0.811
舒张压（mmHg）	78.7 ± 7.5	76.3 ± 8.6	0.987	0.112
PSA（ng/ml）	14.2 ± 6.1	14.1 ± 6.5	0.990	0.213
前列腺体积（ml）	50.1 ± 15.1	52.1 ± 17.4	0.682	0.343

指标		总例数（n = 750）	感染例数（n = 48）	χ²值	P值	A组（感染例数/总例数）	B组（感染例数/总例数）	χ²值	P值
年龄（岁）				2.173	0.095	21/237	27/513	3.546	0.077
	< 60	84	3	0.651	0.347	1/37	2/47	0.315	0.728
	60～75	396	21	0.804	0.232	9/132	12/264	0.649	0.349
	≥ 75	270	24	4.830	0.043	11/68	13/202	7.277	0.024
BMI（kg/m²）				0.270	0.866
	< 20	121	7	0.391	0.675	3/36	4/85	0.640	0.423
	20～25	522	33	0.285	0.872	14/169	19/353	0.801	0.248
	≥ 25	107	8	0.377	0.668	4/32	4/75	0.787	0.236
血压（mmHg）				0.956	0.161
	正常	516	30	0.438	0.503	14/172	16/344	0.971	0.115
	高血压病史< 15年	143	8	0.303	0.849	3/38	5/105	0.603	0.438
	高血压病史≥ 15年	91	10	3.947	0.067	4/27	6/64	0.563	0.476
前列腺体积（ml）				0.189	0.922
	< 30	132	8	0.336	0.752	3/45	5/87	0.173	1.000
	30～60	326	20	0.270	0.881	9/106	11/220	0.725	0.337
	≥ 60	292	20	0.324	0.760	9/86	11/206	0.918	0.130
糖尿病				6.250	0.042
	无	654	35			15/214	20/440	0.860	0.198
	有	96	13			6/23	7/73	0.197	0.075
术前7 d内曾留置导尿				5.830	0.016
	无	686	39			16/220	23/466	1.030	0.220
	有	64	9			5/17	4/47	5.843	0.048
术后7 d内出现血尿、血精、血便				5.173	0.038
	无	501	25			10/173	15/328	0.428	0.667
	有	249	23			11/64	12/185	9.025	0.021
病理结果				0.255	0.936
	非CP非Pca	284	17	0.316	0.761	5/86	12/198	0.273	0.936
	CP	239	16	0.299	0.873	7/67	9/172	0.939	0.153
	Pca	227	15	0.312	0.872	7/79	8/148	0.672	0.401

指标		总例数（n = 750）	感染例数（n = 48）	χ²值	P值	A组（感染例数/总例数）	B组（感染例数/总例数）	χ²值	P值
年龄（岁）				2.173	0.095	21/237	27/513	3.546	0.077
	< 60	84	3	0.651	0.347	1/37	2/47	0.315	0.728
	60～75	396	21	0.804	0.232	9/132	12/264	0.649	0.349
	≥ 75	270	24	4.830	0.043	11/68	13/202	7.277	0.024
BMI（kg/m²）				0.270	0.866
	< 20	121	7	0.391	0.675	3/36	4/85	0.640	0.423
	20～25	522	33	0.285	0.872	14/169	19/353	0.801	0.248
	≥ 25	107	8	0.377	0.668	4/32	4/75	0.787	0.236
血压（mmHg）				0.956	0.161
	正常	516	30	0.438	0.503	14/172	16/344	0.971	0.115
	高血压病史< 15年	143	8	0.303	0.849	3/38	5/105	0.603	0.438
	高血压病史≥ 15年	91	10	3.947	0.067	4/27	6/64	0.563	0.476
前列腺体积（ml）				0.189	0.922
	< 30	132	8	0.336	0.752	3/45	5/87	0.173	1.000
	30～60	326	20	0.270	0.881	9/106	11/220	0.725	0.337
	≥ 60	292	20	0.324	0.760	9/86	11/206	0.918	0.130
糖尿病				6.250	0.042
	无	654	35			15/214	20/440	0.860	0.198
	有	96	13			6/23	7/73	0.197	0.075
术前7 d内曾留置导尿				5.830	0.016
	无	686	39			16/220	23/466	1.030	0.220
	有	64	9			5/17	4/47	5.843	0.048
术后7 d内出现血尿、血精、血便				5.173	0.038
	无	501	25			10/173	15/328	0.428	0.667
	有	249	23			11/64	12/185	9.025	0.021
病理结果				0.255	0.936
	非CP非Pca	284	17	0.316	0.761	5/86	12/198	0.273	0.936
	CP	239	16	0.299	0.873	7/67	9/172	0.939	0.153
	Pca	227	15	0.312	0.872	7/79	8/148	0.672	0.401

危险因素	B值	S.E.值	Walds值	P值	OR（95%CI）
年龄≥ 75岁	0.116	0.059	3.833	0.048	1.123（0.965～1.211）
糖尿病	0.238	0.103	6.698	0.010	1.534（0.301～7.822）
术前7 d内曾留置导尿	0.219	0.841	4.731	0.033	1.472（0.232～4.381）
术后7 d内出现血尿血精血便	1.513	0.684	4.893	0.027	2.542（0.300～8.172）

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