Infectious complications secondary to prostate biopsy

Abstract

Introduction: Prostate biopsy (PB) is a routine procedure performed by urologists in cases of suspected prostate cancer, any abnormality in the prostate-specific antigen (PSA) assay, and/or perceived by the digital rectal exam. Although this is a safe and rapid procedure, it is not without potentially serious complications, including infectious complications ranging from asymptomatic bacteriuria to acute prostatitis and even septic shock. Materials and methods: This work reports the experience of the urology department of the Hassan II University Hospital of Fez in the study of post-biopsy prostatitis through the analysis of a retrospective series of 538 cases during the period January 2014 - December 2018. Results: We report 11 cases of acute post-biopsy prostatitis diagnosed in the urology department of the Hassan II University Hospital in Fez. The bacteria most frequently involved in post-biopsy infections are gram-negative bacteria (Escherichia coli, Klebsiella pneumonia, Acinetobacter baumannii) although gram-positive cocci (Enterococcus faecalis and Staphylococcus saprophyticus) can also be responsible. Anaerobic bacteria are rarely found. The treatment of these post-biopsy infections is based on prolonged antibiotic therapy (3 to 6 weeks) using third-generation cephalosporins (Ceftriaxone). In our series, no death, septic shock, or prostatic abscess was found. The evolution was towards a good improvement under antibiotic treatment with discharge at home after 48 hours of apyrexia. Conclusion: The study of infectious complications secondary to prostate biopsy makes it possible to determine the most appropriate empirical (therapeutic and prophylactic) regimens to minimize the risks. Because of the prevalence of infection by multi-resistant bacteria, particularly to quinolones, the biopsy must be performed following the rules of antibiotic prophylaxis.