Abstract：
OBJECTIVE: Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is associated with a 1-8% risk of post-biopsy sepsis (PBS). A recent study described an isopropyl alcohol needle washing protocol that significantly decreased PBS rates. The current study examined the efficacy of this technique in our clinic population.
METHODS: Data were reviewed for 1250 consecutive patients undergoing TRUS-Bx at the Charlie Norwood VA Medical Center from January 2017 to January 2023. Needle washing was adopted in February 2021. Complications occurring within 30 days after TRUS-Bx were recorded.
RESULTS: There were 912 patients in group 1 (without needle washing) and 338 in group 2 (with needle washing). Groups had equivalent demographic features, and men of African descent comprised 70% of patients. Standard 12 core biopsies were done in 83% and 82% in groups 1 and 2, respectively (p = 0.788). Total complication rates were 4% and 2% in groups 1 and 2, respectively (p = 0.077). There were 13 sepsis events in group 1 (1.4%) and none in group 2 (p = 0.027). Clavien-Dindo Grade I-III complications occurred in 25 (2.7%) and 7 (2.1%) patients in groups 1 and 2, respectively (p = 0.505). Standard antibiotic prophylaxis (PO fluoroquinolone and IM gentamicin) was given in 80% and 86% of patients in groups 1 and 2, respectively (p = 0.030). Subset analysis limited to patients who received standard prophylaxis showed a significant difference in sepsis rates (1.5% vs 0%; p = 0.036).
CONCLUSIONS: Adoption of isopropyl alcohol needle washing was associated with a significant decrease in PBS events.
METHODS: Data were reviewed for 1250 consecutive patients undergoing TRUS-Bx at the Charlie Norwood VA Medical Center from January 2017 to January 2023. Needle washing was adopted in February 2021. Complications occurring within 30 days after TRUS-Bx were recorded.
RESULTS: There were 912 patients in group 1 (without needle washing) and 338 in group 2 (with needle washing). Groups had equivalent demographic features, and men of African descent comprised 70% of patients. Standard 12 core biopsies were done in 83% and 82% in groups 1 and 2, respectively (p = 0.788). Total complication rates were 4% and 2% in groups 1 and 2, respectively (p = 0.077). There were 13 sepsis events in group 1 (1.4%) and none in group 2 (p = 0.027). Clavien-Dindo Grade I-III complications occurred in 25 (2.7%) and 7 (2.1%) patients in groups 1 and 2, respectively (p = 0.505). Standard antibiotic prophylaxis (PO fluoroquinolone and IM gentamicin) was given in 80% and 86% of patients in groups 1 and 2, respectively (p = 0.030). Subset analysis limited to patients who received standard prophylaxis showed a significant difference in sepsis rates (1.5% vs 0%; p = 0.036).
CONCLUSIONS: Adoption of isopropyl alcohol needle washing was associated with a significant decrease in PBS events.
摘要：
目的：经直肠超声引导下的前列腺活检（TRUS-Bx）与活检后败血症（PBS）的1-8％风险相关。最近的研究描述了显著降低PBS速率的异丙醇针头洗涤方案。当前的研究检查了该技术在我们的临床人群中的功效。
方法：对2017年1月至2023年1月在查理诺伍德VA医学中心接受TRUS-Bx的1250名连续患者的数据进行了回顾。2021年2月采用洗针。记录TRUS-Bx后30天内发生的并发症。
结果：第1组（未洗针）912例，第2组（洗针）338例。群体具有同等的人口统计特征，非洲裔男性占患者的70%。在第1组和第2组中分别有83%和82%的标准12个核心活检(p=0.788)。第1组和第2组的总并发症发生率分别为4%和2%(p=0.077)。第1组有13例脓毒症事件（1.4%），第2组无脓毒症事件（p=0.027）。Clavien-DindoI-III级并发症分别发生在第1组和第2组中的25例（2.7％）和7例（2.1％）患者中（p=0.505）。在第1组和第2组中，分别有80％和86％的患者接受了标准抗生素预防（PO氟喹诺酮和IM庆大霉素）（p=0.030）。仅限于接受标准预防的患者的子集分析显示，败血症发生率存在显着差异（1.5％vs0％；p=0.036）。
结论：采用异丙醇针头清洗与PBS事件的显著减少相关。
方法：对2017年1月至2023年1月在查理诺伍德VA医学中心接受TRUS-Bx的1250名连续患者的数据进行了回顾。2021年2月采用洗针。记录TRUS-Bx后30天内发生的并发症。
结果：第1组（未洗针）912例，第2组（洗针）338例。群体具有同等的人口统计特征，非洲裔男性占患者的70%。在第1组和第2组中分别有83%和82%的标准12个核心活检(p=0.788)。第1组和第2组的总并发症发生率分别为4%和2%(p=0.077)。第1组有13例脓毒症事件（1.4%），第2组无脓毒症事件（p=0.027）。Clavien-DindoI-III级并发症分别发生在第1组和第2组中的25例（2.7％）和7例（2.1％）患者中（p=0.505）。在第1组和第2组中，分别有80％和86％的患者接受了标准抗生素预防（PO氟喹诺酮和IM庆大霉素）（p=0.030）。仅限于接受标准预防的患者的子集分析显示，败血症发生率存在显着差异（1.5％vs0％；p=0.036）。
结论：采用异丙醇针头清洗与PBS事件的显著减少相关。
