1244 THE IMPACT OF REPEAT BIOPSIES ON INFECTIOUS COMPLICATIONS IN MEN WITH PROSTATE CANCER ON ACTIVE SURVEILLANCE: A PROSPECTIVE STUDY (2013)

You have accessJournal of UrologyProstate Cancer: Detection & Screening (I)1 Apr 20131244 THE IMPACT OF REPEAT BIOPSIES ON INFECTIOUS COMPLICATIONS IN MEN WITH PROSTATE CANCER ON ACTIVE SURVEILLANCE: A PROSPECTIVE STUDY Behfar Ehdaie, Massimiliano Spaliviero, Anna Giallo-Uvino, Marryellen O'Sullivan, Jennifer Livingston, James Eastham, Peter Scardino, and Karim Touijer Behfar EhdaieBehfar Ehdaie New York, NY More articles by this author , Massimiliano SpalivieroMassimiliano Spaliviero New York, NY More articles by this author , Anna Giallo-UvinoAnna Giallo-Uvino New York, NY More articles by this author , Marryellen O'SullivanMarryellen O'Sullivan New York, NY More articles by this author , Jennifer LivingstonJennifer Livingston New York, NY More articles by this author , James EasthamJames Eastham New York, NY More articles by this author , Peter ScardinoPeter Scardino New York, NY More articles by this author , and Karim TouijerKarim Touijer New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2598AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate biopsy related infectious complications are associated with significant morbidity. Fluoroquinolone (FQ) resistant and extended spectrum beta-lactam (ESBL)-producing Escherichia coli have been increasingly recovered and contribute to the rising incidence of sepsis after prostate biopsy. Meanwhile, active surveillance is being increasingly used as treatment for low-risk prostate cancer, requiring men to undergo serial trans-rectal ultrasound (TRUS)-guided prostate biopsies. The risk of infectious complications associated with active surveillance remains understudied. METHODS 615 consecutive men who underwent TRUS-guided prostate biopsy were enrolled prospectively between January 2011 and January 2012 at Memorial Sloan-Kettering Cancer Center. Of these men, 433 were previously diagnosed with prostate cancer and received a 14-core TRUS-guided prostate biopsy as part of an active surveillance regimen or for confirmatory purposes prior to enrollment into active surveillance. Following the biopsy procedure, all men received a phone call by a nurse within 7 days, and information was collected on potential complications, potential antibiotic received and urine culture results in patients with infectious complications. RESULTS Twelve patients (2.8%) had infectious complications requiring hospitalization after TRUS-guided biopsy. Five patients (41.7%) had FQ-resistant isolates (most Escherichia coli), and 2 (16.7%) were ESBL-producing isolates. The mean age of men with previous diagnosis of prostate cancer was 63. A total of 268 patients (61.9%) were found to have prostate cancer on the current biopsy. The median number of previous prostate biopsies was 1 (range 1-12). We evaluated the impact of other risk factors including history of BPH, previous infectious complications, and antibiotic regimen; however only the number of previous prostate biopsies was significantly associated with an increased risk of infectious complications (p=0.036). For every previous biopsy, the odds of an infection increase 1.3 times (OR 1.34, 95% CI 1.02-1.76). CONCLUSIONS In men with prostate cancer on active surveillance, the number of previous prostate biopsies is associated with significant risk of infectious complications and every previous biopsy increases the risk an infectious complication. FQ-resistant and ESBL-producing isolates represent the most commonly identified organisms in this population. Men treated with active surveillance should be aware of the risks associated with serial repeat prostate biopsies. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189 Issue 4S April 2013 Page: e509 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Metrics Author Information Behfar Ehdaie New York, NY More articles by this author Massimiliano Spaliviero New York, NY More articles by this author Anna Giallo-Uvino New York, NY More articles by this author Marryellen O'Sullivan New York, NY More articles by this author Jennifer Livingston New York, NY More articles by this author James Eastham New York, NY More articles by this author Peter Scardino New York, NY More articles by this author Karim Touijer New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...