Antibiotic prophylaxis may be still required among transperineal prostate biopsies of diabetics: a cohort study.

IF 3.1 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Frontiers in Medicine Pub Date : 2025-07-04 eCollection Date: 2025-01-01 DOI:10.3389/fmed.2025.1618631

Feiyue Ma, Yu Zhang

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引用次数: 0

Abstract

Background: Transperineal prostate biopsy (TP-PB) is considered the gold standard for suspected prostate cancer patients. However, the rate of transperineal prostate biopsy-related urinary tract infections (UTIs) has been calculated to be as high as 3%. This study aimed to discuss the incidence of transperineal prostate biopsy -related infections among diabetic patients who underwent antibiotic prophylaxis (AP) or not.

Methods: The monocentric, comparative, observational cohort study was carried out at Xiangshan County First People's Hospital Medical Health Group, China between January 2021 and January 2023. The study included 246 diabetic men suspected of having prostate cancer who underwent transperineal prostate biopsy. One group was transperineal prostate biopsy with no antibiotic prophylaxis (Group A-no AP, n = 120, 48.8%), and the other was given a 3 days of oral antibiotics (Group B-AP, n = 126, 51.2%). Data on primary symptoms, urine culture (UC), urinary tract infections incidence, and prostate biopsy -related sequela were gathered 2 weeks following the prostate biopsy.

Results: A total of 246 patients were involved, including 120 in Group A (67.4 ± 7.2 years) and 126 in Group B (68.5 ± 7.0 years) (p = 0.215). Prostate-specific antigen (PSA) levels were 16.1 ± 23.8 vs. 15.9 ± 22.3 ng/ml (p = 0.942), and the prostate cancer detection rate was 58% vs. 57.5% (p = 0.847). The incidence of asymptomatic bacteriuria was significantly higher (8/120, 6.7%) in Group A vs. Group B (1/126, 0.8%) (RR 8.4, 95% CI: 1.1-72.5, p < 0.001). Similarly, urinary irritation symptoms occurred in 30/120 (25.0%) vs. 5/126 (4.0%) patients (RR 6.3, 95% CI: 3.0-21.6, p < 0.001), fever in 9/120 (7.5%) vs. 1/126 (0.8%) (RR 9.5, 95% CI: 1.3-81.3, p = 0.001), and UTIs in 5/120 (4.2%) vs. 1/126 (0.8%) (RR 5.3, 95% CI: 0.63-47.2, p = 0.001), respectively. Notably, sepsis was not detected in either group.

Conclusion: Antibiotic prophylaxis could decrease the incidence of transperineal prostate biopsy-related infections among diabetic patients.

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糖尿病患者经会阴前列腺活检可能仍然需要抗生素预防：一项队列研究。

背景：经会阴前列腺活检（TP-PB）被认为是诊断前列腺癌的金标准。然而，经会阴前列腺活检相关尿路感染（uti）的发生率已被计算高达3%。本研究旨在探讨是否接受抗生素预防（AP）治疗的糖尿病患者经会阴前列腺活检相关感染的发生率。方法：于2021年1月至2023年1月在中国象山县第一人民医院医疗卫生集团进行单中心、比较、观察队列研究。该研究包括246名怀疑患有前列腺癌的糖尿病男性，他们接受了经会阴前列腺活检。一组患者行经会阴前列腺活检，无抗生素预防（a -no AP组，n = 120, 48.8%），另一组患者口服抗生素3 d （B-AP组，n = 126, 51.2%）。在前列腺活检后2周收集原发性症状、尿培养（UC）、尿路感染发生率和前列腺活检相关后遗症的数据。结果：共纳入246例患者，其中A组120例（67.4±7.2年），B组126例（68.5±7.0年）（p = 0.215）。前列腺特异性抗原（PSA）水平分别为16.1±23.8和15.9±22.3 ng/ml (p = 0.942)，前列腺癌检出率分别为58%和57.5% （p = 0.847）。A组无症状菌血症发生率（8/120,6.7%）显著高于B组（1/126,0.8%）（RR 8.4, 95% CI: 1.1 ~ 72.5, p < 0.001）。同样，30/120（25.0%）和5/126（4.0%）患者出现尿路刺激症状（RR = 6.3, 95% CI: 3.0-21.6, p < 0.001）， 9/120患者出现发热（7.5%）和1/126 (0.8%)(RR = 9.5, 95% CI: 1.3-81.3, p = 0.001)， 5/120患者出现尿路感染（4.2%）和1/126 (0.8%)（RR = 5.3, 95% CI: 0.63-47.2, p = 0.001）。值得注意的是，两组均未发现败血症。结论：抗生素预防可降低糖尿病患者经会阴前列腺活检相关感染的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Medicine Medicine-General Medicine

CiteScore

5.10

自引率

5.10%

发文量

3710

审稿时长

12 weeks

期刊介绍： Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate - the use of patient-reported outcomes under real world conditions - the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines - the scientific bases for guidelines and decisions from regulatory authorities - access to medicinal products and medical devices worldwide - addressing the grand health challenges around the world