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Clinical Research

Increase of prostate biopsy-related bacteremic complications in southern Finland, 2005–2013: a population-based analysis

Prostate Cancer and Prostatic Diseases volume 19, pages 417–422 (2016)Cite this article

Subjects

Abstract

BACKGROUND:

The most severe manifestations of prostate biopsy complications are bacteremic infections. These complications are increasing alarmingly.

METHODS:

A retrospective cohort study of 17 183 transrectal prostate biopsies performed at the Helsinki and Uusimaa hospital district in southern Finland during 2005–2013. Biopsies were linked to a database of positive blood cultures, yielding 111 bacteremic cases, and yearly bacteremia rates were determined. By multiple regression analysis, demographic risk factors of the whole biopsy cohort for developing bacteremia or fluoroquinolone (FQ)-resistant bacteremia were studied. Clinical risk factors for bacteremia caused by an FQ-resistant organism and for serious bacteremic outcomes were studied by univariate and multivariate analyzes.

RESULTS:

The average bacteremia rate was 0.7% (111 of 17 183 biopsies) and an increase was observed from 0.5% in 2005 (95% confidence interval (CI): 0.3–0.9) to 1.2% in 2012 (95% CI 0.8–1.8); 53.2% were caused by an FQ-resistant organism. In univariate regression analysis, previous biopsy sessions and increasing calendar year of biopsy associated with the risk of developing bacteremia (odds ratio (OR) 1.232, 95% CI: 1.020–1.488, P=0.030 and OR 1.164, 95% CI: 1.079–1.255, P<0.001, respectively), but only increasing calendar year of biopsy remained statistically significant (OR 1.155, 95% CI: 1.070–1.247, P<0.001) in multivariate analysis. Foreign travel within 3 months was associated with FQ resistance in multivariate analysis (OR 7.158, 95% CI: 1.042 to infinite, P=0.045). The study failed to show any significant clinical risk factors for serious bacteremic outcomes (requiring intensive care, developing deep infection foci or death).

CONCLUSIONS:

The postbiopsy bacteremia rate doubled during the study period and half of the cases were caused by FQ-resistant organisms. Recent foreign travel increased the risk for FQ resistance. Future research efforts should be aimed at better identifying risk factors, targeted prophylaxis and reducing the need for biopsies.

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Acknowledgements

This study was supported by a grant from the Finnish Cancer Society. We thank Tuomas Mirtti for helping with the data acquisition and Heikki Rannikko for advice regarding statistical analyses.

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Authors and Affiliations

  1. Department of Urology, Meilahti Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    K Lahdensuo, A Rannikko & H Santti

  2. Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    V-J Anttila & K Huotari

  3. Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland

    A Erickson

  4. Division of Clinical Microbiology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    A Pätäri-Sampo, M Rautio, E Tarkka & M Vaara

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  1. K Lahdensuo
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Correspondence to K Lahdensuo.

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Competing interests

Dr Santti reports personal fees and non-financial support from Astellas, personal fees from Amgen, non-financial support from Sanofi, personal fees from Janssen-Cilag and non-financial support from Intuitive Surgical, outside the submitted work. The other authors declare no conflict of interest.

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Lahdensuo, K., Rannikko, A., Anttila, VJ. et al. Increase of prostate biopsy-related bacteremic complications in southern Finland, 2005–2013: a population-based analysis. Prostate Cancer Prostatic Dis 19, 417–422 (2016). https://doi.org/10.1038/pcan.2016.36

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