Post-biopsy infections in Sweden: a national, 5-year assessment


The increasing incidence of infections associated with transrectal ultrasound (TRUS)-guided prostate biopsy is a topic we have touched on a number of times before. This has been clearly recorded in Canada and the USA and it now appears that the same trend can be well documented in Sweden too.

Lundström et al. carried out a national, population-based assessment of the incidence of infection, the risk factors for infection, and the 90-day mortality rate post-biopsy using data from the Prostate Cancer data Base (PCBaSe) Sweden. The study included data from  > 50,000 men who underwent prostate biopsy between 2006 and 2011. Primary outcome measures for the study were dispensed prescriptions of antibiotics for urinary tract infection (UTI) and hospitalizations with a discharge diagnosis of a urinary tract infection.

Here are the core findings from their study:

  • The total number of men on whom data were available was 51,321.
  • In the 6 months prior to biopsy, the background incidence of UTI was ~ 2 percent.
  • Within 30 days after biopsy,
    • 6 percent of patients (i.e., ~ 3,000) had a dispensed prescription for urinary tract antibiotics
    • 1 percent of patients (i.e., ~ 500) were hospitalized with an infection.
  • The strongest risk factors for an antibiotic prescription were
    • Prior infection (odds ratio [OR] = 1.59)
    • High Charlson comorbidity index (OR = 1.25)
    • Diabetes (OR = 1.32)
  • Risk for an antibiotic prescription after biopsy decreased from 2006 to 2011 (OR = 0.79), but  …
  • Risk of hospital admission after prostate biopsy increased (OR = 2.14).
  • There was  no significant increase in 90-day mortality.

The authors conclude that:

Severe infections with hospitalization after prostate biopsy are increasing in Sweden. The risk of post-biopsy infection is highest among men with a history of UTI and those with significant co-morbidities.

The good news, however, is the lack of significant impact on overall mortality and the fact that there seems to have been a decline in the numbers of milder infections that did not require hospitalization.

3 Responses

  1. Dr. Wheeler says the needles drags cancer cells and can cause cancer infection outside the gland, no mention of that.

  2. Dear Ron:

    Over the years Dr. Wheeler has said a lot of things, and he has been widely known to have a very high opinion of his own opinions.

    As noted earlier, in a separate post, he has just been told that his license to practice medicine has been suspended for a year by the Florida Board of Medicine.

  3. With all the biopsies that have been performed over the decades, there is no evidence that a prostate biopsies increase the risk of metastasis. Infection is the biggest risk associated with a prostate biopsy.

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