Risk Factors for Infection after Prostate Biopsy in the United States

Shoag, Jonathan; Gaffney, Christopher; Pantuck, Morgan; Sun, Tung‐Tien; Gorin, Michael A.; Schaeffer, Edward M.; Sedrakyan, Art; Hu, Jim C.

doi:10.1016/j.urology.2019.12.023

Cited by 15 publications

(7 citation statements)

References 25 publications

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“…The overall incidence of self-reported (12%) and microbiologically documented (4%) post TRUS-PB UTI appears high (from 2-to 12-fold increase) as compared to the rate reported in France and in the literature (1%-7%) and highlights the issues in the definition used (Djavan et al, 2001;Carignan et al, 2012;Food and Drug Administration, 2018;Nam et al, 2013;Campeggi et al, 2014;Shoag et al, 2019;Anastasiadis et al, 2015). In our study, the rate of post TRUS-PB UTI was not significantly different between the FT and FQ arms, across the definition used for UTI.…”

Section: Discussionmentioning

confidence: 89%

“…In patients receiving FQ, we were not able to demonstrate an association between prior rectal carriage of FQ resistance and an increased in post TRUS-PB UTI (Liss et al, 2015;Van Besien et al, ). Furthermore, none of the patients receiving FT developed post TRUS-PB UTI due to FT-resistant strain, despite a high rate of in vitro mutations in the literature (10 À7 to 10 À6 cells among Gramnegatives) (Shoag et al, 2019). On the other hand, in patients with UTI treated with FT, a low likelihood of mutation was described (<1%) (Nilsson et al, 2003).…”

Section: Discussionmentioning

confidence: 94%

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Fosfomycin-trometamol (FT) or fluoroquinolone (FQ) as single-dose prophylaxis for transrectal ultrasound-guided prostate biopsy (TRUS-PB): A prospective cohort study

Delory

Goujon

Masson-Lecomte

et al. 2021

International Journal of Infectious Diseases

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The increasing incidence of fluoroquinolones (FQ) resistance may lower its efficacy in preventing UTI following transrectal ultrasound-guided prostate biopsy (TRUS-PB). We assessed the efficacy and safety of FQ and fosfomycin-trometamol (FT) in patients undergoing TRUS-PB. Methods: A prospective observational study was conducted between April 2017 and June 2019 and enrolled men undergoing TRUS-PB and receiving a single-dose of FQ (FQ-arm) or FT (FT-arm) for UTI prophylaxis per physician's choice. The primary efficacy endpoint was self-reported TRUS-PB UTI. We assessed baseline factors associated with UTI with logistic regression. Results: A total of 222 men were enrolled, 141/222 (64%) received FQ, and 81/222 (36%) FT. The median age was 67.6 years [IQR, 61.4-72.1] and the Charlson score was 3 [IQR, 3-5]. The overall incidence of selfreported TRUS-PB UTI was 12% (24/197, (95%CI, 8%-17%)): 15% (17/116, (95% CI, 10%-17%)) in FQ-arm, versus 9% (7/81, 95% CI (5%-13%)) in FT-arm (RR = 0.55 (95% CI, 0.22-1.40), p-value = 0.209). No baseline characteristic was significantly associated with TRUS-PB UTI. Safety was similar between the arms: the rate of the reported adverse event was 31% (36/116, (95% CI, 25%-37%) in the FQ-arm versus 36% (28/81, (95% CI, 28%-41%)) in the FT-arm (RR = 1.17 (95% CI, 0.64-2.15), p = 0.602). Conclusions: TRUS-PB UTI prophylaxis with FT and FQ has similar efficacy and safety. A randomized comparison of these two antibiotics is warranted.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 94%

Fosfomycin-trometamol (FT) or fluoroquinolone (FQ) as single-dose prophylaxis for transrectal ultrasound-guided prostate biopsy (TRUS-PB): A prospective cohort study

Delory

Goujon

Masson-Lecomte

et al. 2021

International Journal of Infectious Diseases

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“…The decision to perform a biopsy can be complex, and predictive nomograms for PCa with varying degrees of accuracy, feasibility, and usefulness have been developed to assist clinicians in deciding whether a prostate biopsy is necessary. Thus, naïve patients with benign lesions can avoid unnecessary biopsies, and complications, such as infection and bleeding, caused by prostate biopsy can be reduced (31,32).…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram based on multiparametric magnetic resonance imaging and elastography-derived data for the stratification of patients with prostate cancer

Ding

Song

Wu³

et al. 2021

Quant Imaging Med Surg

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Background: This study sought to develop and validate a nomogram combining the elastographic Q-analysis score (EQS), the Prostate Imaging Reporting and Data System (PI-RADS) score, and clinical parameters for the stratification of patients with prostate cancer (PCa). Methods: A retrospective study was conducted of 375 patients with 375 lesions who underwent volumenavigation transrectal ultrasound (TRUS) and multiparametric magnetic resonance imaging (MP-MRI)fusion targeted biopsies between April 2017 and January 2020. Based on a multivariate logistic regression model, a nomogram was created to assess any PCa and high-risk PCa [Gleason score (GS) ≥4+3] using data from patients diagnosed between April 2017 and June 2019 (n=271), and was validated in patients diagnosed after July 2019 (n=104). The nomogram's performance was evaluated based on its discrimination, calibration, and clinical usefulness.Results: The areas under the curve (AUCs) of the nomogram for predicting any PCa and high-risk PCa were 0.949 [95% confidence interval (CI), 0.921 to 0.978] and 0.936 (95% CI, 0.906 to 0.965), respectively, in the training cohort, and 0.946 (95% CI, 0.894 to 0.997) and 0.971 (95% CI, 0.9331 to 1), respectively, in the validation cohort. The nomogram was well calibrated, and no significant difference was found between the predicted and observed probabilities. A decision curve analysis (DCA) for the nomogram with and without the EQS showed that the threshold probability of for any PCa was <67%. Conclusions:The nomogram that combined elastography-derived and MP-MRI data was more clinically useful than the model based on PI-RADS and clinical parameters alone. Our nomogram could aid urologists to make decisions and avoid unnecessary biopsies.

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“…It is necessary to develop diagnostic models or nomograms on the basis of the Asian population. Patients could profit from these diagnostic models and nomograms, which could avoid unnecessary prostate biopsy that may cause severe complications and even death ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Construction and Comparison of Different Models in Detecting Prostate Cancer and Clinically Significant Prostate Cancer

Zhou

Cui

et al. 2022

Front. Oncol.

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BackgroundWith the widespread adoption of prostatic-specific antigen (PSA) screening, the detection rates of prostate cancer (PCa) have increased. Due to the low specificity and high false-positive rate of serum PSA levels, it was difficult to diagnose PCa accurately. To improve the diagnosis of PCa and clinically significant prostate cancer (CSPCa), we established novel models on the basis of the prostate health index (PHI) and multiparametric magnetic resonance imaging (mpMRI) in the Asian population.MethodsWe retrospectively collected the clinical indicators of patients with TPSA at 4–20 ng/ml. Furthermore, mpMRI was performed using a 3.0-T scanner and reported in the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS). Univariable and multivariable logistic analyses were performed to construct the models. The performance of different models based on PSA derivatives, PHI derivatives, PI-RADS, and a combination of PHI derivatives and PI-RADS was evaluated.ResultsAmong the 128 patients, 47 (36.72%) patients were diagnosed with CSPCa and 81 (63.28%) patients were diagnosed with non-CSPCa. Of the 81 (63.28%) patients, 8 (6.25%) patients were diagnosed with Gleason Grade 1 PCa and 73 (57.03%) patients were diagnosed with non-PCa. In the analysis of the receiver operator characteristic (ROC) curves in TPSA 4–20 ng/ml, the multivariable model for PCa was significantly larger than that for the model based on the PI-RADS (p = 0.004) and that for the model based on the PHI derivatives (p = 0.031) in diagnostic accuracy. The multivariable model for CSPCa was significantly larger than that for the model based on the PI-RADS (p = 0.003) and was non-significantly larger than that for the model based on the PHI derivatives (p = 0.061) in diagnostic accuracy. For PCa in TPSA 4–20 ng/ml, a multivariable model achieved the optimal diagnostic value at four levels of predictive variables. For CSPCa in TPSA 4–20 ng/ml, the multivariable model achieved the optimal diagnostic value at a sensitivity close to 90% and 80%.ConclusionsThe models combining PHI derivatives and PI-RADS performed better in detecting PCa and CSPCa than the models based on either PHI or PI-RADS.

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Risk Factors for Infection after Prostate Biopsy in the United States

Cited by 15 publications

References 25 publications

Fosfomycin-trometamol (FT) or fluoroquinolone (FQ) as single-dose prophylaxis for transrectal ultrasound-guided prostate biopsy (TRUS-PB): A prospective cohort study

Fosfomycin-trometamol (FT) or fluoroquinolone (FQ) as single-dose prophylaxis for transrectal ultrasound-guided prostate biopsy (TRUS-PB): A prospective cohort study

Development and validation of a nomogram based on multiparametric magnetic resonance imaging and elastography-derived data for the stratification of patients with prostate cancer

Construction and Comparison of Different Models in Detecting Prostate Cancer and Clinically Significant Prostate Cancer

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