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Obesity was an independent risk factor for febrile infection after prostate biopsy: A 10-year single center study in South China.

Abstract To detect the best antibiotic protocol for prostate biopsy and to assess the potential risk factors postbiopsy in Chinese patients.A total of 1526 patients underwent biopsy were assessed retrospectively. The effect of 3 antibiotic protocols was compared, including fluoroquinolone (FQ) monotherapy, third-generation cephalosporin combined with FQ and targeted antibiotics according to the prebiopsy rectal swab culture result. Postbiopsy infection (PBI) was defined as fever and/or active urinary tract symptoms such as dysuria or frequency with pyuria and/or leucocytosis, sepsis is defined as the presence of clinically or microbiologically documented infection in conjunction with systemic inflammatory response syndrome. The relationship between infections and clinical characteristics of patients was assessed. Data were first picked out in univariate analysis and then enter multivariate logistic regression.Thirty-three (2.2%) patients developed febrile infection. The combination antibiotic prophylaxis could significantly decrease the rate of PBI than FQ monotherapy (1.0% vs 4.0%, P = .000). The infection rate of the targeted antibiotic group was 1.1%, but there was no significant statistic difference compared with FQ alone (P = .349). Escherichia coli was the most predominant pathogen causing infection. Rectal swab revealed as high as 47.1% and 36.0% patients harbored FQ resistant and ESBL-producing organisms, respectively. In univariate analysis, overweight (BMI between 25 and 28 kg/m), obesity (BMI > 28 kg/m), diabetes were picked out as potential risk factors. Obesity remained as risk factor (OR = 12.827, 95% CI: 0.983-8.925, P = .001) while overweight and diabetes were close to significance (P = .052, .053, respectively).The combined cephalosporin with FQ prophylaxis could significantly decrease the risk of infectious complications. Obesity was an independent risk factor for PBI.
PMID
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Authors

Mayor MeshTerms

Antibiotic Prophylaxis

Keywords
Journal Title medicine
Publication Year Start




PMID- 29505534
OWN - NLM
STAT- MEDLINE
DCOM- 20180309
LR  - 20180309
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 1
DP  - 2018 Jan
TI  - Obesity was an independent risk factor for febrile infection after prostate
      biopsy: A 10-year single center study in South China.
PG  - e9549
LID - 10.1097/MD.0000000000009549 [doi]
AB  - To detect the best antibiotic protocol for prostate biopsy and to assess the
      potential risk factors postbiopsy in Chinese patients.A total of 1526 patients
      underwent biopsy were assessed retrospectively. The effect of 3 antibiotic
      protocols was compared, including fluoroquinolone (FQ) monotherapy,
      third-generation cephalosporin combined with FQ and targeted antibiotics
      according to the prebiopsy rectal swab culture result. Postbiopsy infection (PBI)
      was defined as fever and/or active urinary tract symptoms such as dysuria or
      frequency with pyuria and/or leucocytosis, sepsis is defined as the presence of
      clinically or microbiologically documented infection in conjunction with systemic
      inflammatory response syndrome. The relationship between infections and clinical 
      characteristics of patients was assessed. Data were first picked out in
      univariate analysis and then enter multivariate logistic regression.Thirty-three 
      (2.2%) patients developed febrile infection. The combination antibiotic
      prophylaxis could significantly decrease the rate of PBI than FQ monotherapy
      (1.0% vs 4.0%, P = .000). The infection rate of the targeted antibiotic group was
      1.1%, but there was no significant statistic difference compared with FQ alone (P
      = .349). Escherichia coli was the most predominant pathogen causing infection.
      Rectal swab revealed as high as 47.1% and 36.0% patients harbored FQ resistant
      and ESBL-producing organisms, respectively. In univariate analysis, overweight
      (BMI between 25 and 28 kg/m), obesity (BMI > 28 kg/m), diabetes were picked out
      as potential risk factors. Obesity remained as risk factor (OR = 12.827, 95% CI: 
      0.983-8.925, P = .001) while overweight and diabetes were close to significance
      (P = .052, .053, respectively).The combined cephalosporin with FQ prophylaxis
      could significantly decrease the risk of infectious complications. Obesity was an
      independent risk factor for PBI.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Wu, Xiang
AU  - Wu X
AD  - Department of Urology, Fujian Provincial Hospital, Provincial Clinical College of
      Fujian Medical University, Fuzhou, Fujian, PR China.
FAU - Yu, Chenbo
AU  - Yu C
FAU - Li, Tao
AU  - Li T
FAU - Lin, Le
AU  - Lin L
FAU - Xu, Qiong
AU  - Xu Q
FAU - Zhu, QingGuo
AU  - Zhu Q
FAU - Ye, Liefu
AU  - Ye L
FAU - Gao, Xiangxun
AU  - Gao X
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Cephalosporins)
RN  - 0 (Fluoroquinolones)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - *Antibiotic Prophylaxis
MH  - Biopsy/adverse effects
MH  - Cephalosporins/therapeutic use
MH  - China
MH  - Fluoroquinolones/therapeutic use
MH  - Humans
MH  - Infection/etiology
MH  - Male
MH  - Middle Aged
MH  - Obesity/*complications
MH  - Prostate/*surgery
MH  - Prostatitis/etiology/*prevention & control
EDAT- 2018/03/06 06:00
MHDA- 2018/03/10 06:00
CRDT- 2018/03/06 06:00
PHST- 2018/03/06 06:00 [entrez]
PHST- 2018/03/06 06:00 [pubmed]
PHST- 2018/03/10 06:00 [medline]
AID - 10.1097/MD.0000000000009549 [doi]
AID - 00005792-201801050-00031 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Jan;97(1):e9549. doi: 10.1097/MD.0000000000009549.