Emil Loldrup Fosbøl, Anna Stahl, Andreas Røder, Cecilie Bagi Nordsten, Lauge Østergaard, Thomas S G Sehested, Anders Dahl, Nikolaj Ihlemann, Henning Bundgaard, Kasper Iversen, Nana Valeur, Gunnar Gislason, Christian Torp-Pedersen, Marianne Voldstedlund, Per Bagi, Lars Køber
{"title":"经尿道前列腺切除术（turp）与感染性心内膜炎的相关风险","authors":"Emil Loldrup Fosbøl, Anna Stahl, Andreas Røder, Cecilie Bagi Nordsten, Lauge Østergaard, Thomas S G Sehested, Anders Dahl, Nikolaj Ihlemann, Henning Bundgaard, Kasper Iversen, Nana Valeur, Gunnar Gislason, Christian Torp-Pedersen, Marianne Voldstedlund, Per Bagi, Lars Køber","doi":"10.1007/s15010-024-02450-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Bacteremia is a well-known complication to surgery and may result in infective endocarditis (IE). Transurethral resection of the prostate (TUR-P) may give rise to bacteremia, but the associated risk of IE is not well described. We aimed to examine risk of infective endocarditis following TUR-P.</p><p><strong>Methods: </strong>We examined risk of IE following TUR-P between 2010 and 2020 in comparison with an age-matched (match-ratio 1:1) cohort from the background population. Patients were considered exposed to TUR-P related IE 6 months after TUR-P. Comparisons were estimated using cumulative incidences and multivariable time-dependent Cox regression models.</p><p><strong>Results: </strong>A total of 25,781 males underwent TUR-P (11.4% diagnosed with prostate cancer). Median age was 70.7 years (25-75 percentiles, 64.9-76.3 years). In the TUR-P group, 901 (3.5%) patients had bacteremia and 44 (0.2%) patients developed IE within 6 months following index. The most common microorganism in IE-cases was Enterococcus faecalis (72.7%). The incidence of IE was higher < 6 months after TUR-P (34.64 (25.78-46.55)) IEs per 10,000 person years) than 6-12 months after TUR-P (8.37 (5.46-12.84) IEs per 10,000 person years). TUR-P was associated with a higher hazard ratio of IE within 6 months (age-adjusted HR 8.16, 95% CI 3.06-21.79), but not 6-12 months after TUR-P (adj. HR 2.15 (0.91-5.07)).</p><p><strong>Conclusions: </strong>TUR-P was associated with an eight-fold higher risk of IE compared with age-matched controls within 6 months after surgery. Although the absolute risk was low, TUR-P seems to be a significant risk factor for IE and this warrant consideration for development of better prophylactic interventions.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Transurethral resection of the prostate (TUR-P) and associated risk of infective endocarditis.\",\"authors\":\"Emil Loldrup Fosbøl, Anna Stahl, Andreas Røder, Cecilie Bagi Nordsten, Lauge Østergaard, Thomas S G Sehested, Anders Dahl, Nikolaj Ihlemann, Henning Bundgaard, Kasper Iversen, Nana Valeur, Gunnar Gislason, Christian Torp-Pedersen, Marianne Voldstedlund, Per Bagi, Lars Køber\",\"doi\":\"10.1007/s15010-024-02450-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Bacteremia is a well-known complication to surgery and may result in infective endocarditis (IE). Transurethral resection of the prostate (TUR-P) may give rise to bacteremia, but the associated risk of IE is not well described. We aimed to examine risk of infective endocarditis following TUR-P.</p><p><strong>Methods: </strong>We examined risk of IE following TUR-P between 2010 and 2020 in comparison with an age-matched (match-ratio 1:1) cohort from the background population. Patients were considered exposed to TUR-P related IE 6 months after TUR-P. Comparisons were estimated using cumulative incidences and multivariable time-dependent Cox regression models.</p><p><strong>Results: </strong>A total of 25,781 males underwent TUR-P (11.4% diagnosed with prostate cancer). Median age was 70.7 years (25-75 percentiles, 64.9-76.3 years). In the TUR-P group, 901 (3.5%) patients had bacteremia and 44 (0.2%) patients developed IE within 6 months following index. The most common microorganism in IE-cases was Enterococcus faecalis (72.7%). The incidence of IE was higher < 6 months after TUR-P (34.64 (25.78-46.55)) IEs per 10,000 person years) than 6-12 months after TUR-P (8.37 (5.46-12.84) IEs per 10,000 person years). TUR-P was associated with a higher hazard ratio of IE within 6 months (age-adjusted HR 8.16, 95% CI 3.06-21.79), but not 6-12 months after TUR-P (adj. HR 2.15 (0.91-5.07)).</p><p><strong>Conclusions: </strong>TUR-P was associated with an eight-fold higher risk of IE compared with age-matched controls within 6 months after surgery. Although the absolute risk was low, TUR-P seems to be a significant risk factor for IE and this warrant consideration for development of better prophylactic interventions.</p>\",\"PeriodicalId\":13600,\"journal\":{\"name\":\"Infection\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2024-12-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s15010-024-02450-3\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s15010-024-02450-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Transurethral resection of the prostate (TUR-P) and associated risk of infective endocarditis.
Purpose: Bacteremia is a well-known complication to surgery and may result in infective endocarditis (IE). Transurethral resection of the prostate (TUR-P) may give rise to bacteremia, but the associated risk of IE is not well described. We aimed to examine risk of infective endocarditis following TUR-P.
Methods: We examined risk of IE following TUR-P between 2010 and 2020 in comparison with an age-matched (match-ratio 1:1) cohort from the background population. Patients were considered exposed to TUR-P related IE 6 months after TUR-P. Comparisons were estimated using cumulative incidences and multivariable time-dependent Cox regression models.
Results: A total of 25,781 males underwent TUR-P (11.4% diagnosed with prostate cancer). Median age was 70.7 years (25-75 percentiles, 64.9-76.3 years). In the TUR-P group, 901 (3.5%) patients had bacteremia and 44 (0.2%) patients developed IE within 6 months following index. The most common microorganism in IE-cases was Enterococcus faecalis (72.7%). The incidence of IE was higher < 6 months after TUR-P (34.64 (25.78-46.55)) IEs per 10,000 person years) than 6-12 months after TUR-P (8.37 (5.46-12.84) IEs per 10,000 person years). TUR-P was associated with a higher hazard ratio of IE within 6 months (age-adjusted HR 8.16, 95% CI 3.06-21.79), but not 6-12 months after TUR-P (adj. HR 2.15 (0.91-5.07)).
Conclusions: TUR-P was associated with an eight-fold higher risk of IE compared with age-matched controls within 6 months after surgery. Although the absolute risk was low, TUR-P seems to be a significant risk factor for IE and this warrant consideration for development of better prophylactic interventions.
期刊介绍：
Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings.
The journal covers a wide range of topics, including:
Etiology: The study of the causes of infectious diseases.
Pathogenesis: The process by which an infectious agent causes disease.
Diagnosis: The methods and techniques used to identify infectious diseases.
Treatment: The medical interventions and strategies employed to treat infectious diseases.
Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies.
Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections.
In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.
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