Incidence of Febrile Urinary Tract Infection after 14-Core Schematic Transrectal Ultrasound-Guided Biopsy Prostate in Vajira Hospital

Main Article Content

Thitawat Wongampornpat


Background: Fourteen core schematic transrectal ultrasound-guided biopsy prostate was started in Vajira hospital in 2017 substituted standard 12 core transrectal ultrasound-guided biopsy prostate. This study aims to present incidence of postoperative febrile urinary tract infection after this procedure and compared incidence of infection between preoperative antibiotic regimens.

Method: A retrospective descriptive study was conducted. 346 patients who underwent 14 core schematic transrectal ultrasound (TRUS) -guided biopsy prostate between 2017-2020 were enrolled. Patients demographic data, prostate specific antigen (PSA), preoperative antibiotic regimen, post operative febrile urinary tract infection (UTI) data, and urine culture were retrospectively review from electronic medical record.

Results: Three hundred and forty-six patients were included in this study. The incidence of febrile UTI after operation was 4.04%. Incidence of febrile UTI in Ciprofloxacin group was 7.1%, in Ceftriaxone group was 1.01%, in Cefixime group was 0%, and in Ofloxacin group was 1.8 %. There were no statistically different between Ciprofloxacin group and other groups (P>0.05). Compared between Quinolone groups and third generation Cephalosporin group, the incidence of febrile UTI was higher in quinolone group with statistically significant (P = 0.04).

Conclusion: Fourteen core schematic TRUS-guided biopsy prostate is safe compared with other studies in the term of incidence of febrile UTI. Incidence of febrile UTI was higher in Ciprofloxacin group that should be monitored about rate of febrile UTI in the future in this group.


Download data is not yet available.

Article Details

Original Articles


Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, et al. Estimating the global cancer incidence and mortality in 2020: GLOBOCAN sources and methods. Int J Cancer 144(8):1941–53.

Wolf MDA, Wender CR, Etzioni BR, Thompson MI, AmicoVDA, Volk JR, et al. American cancer society guideline for the early detection of prostate cancer. CA Cancer J Clin 2010; 60: 70–98.

Choi JW, Kim TH, Chang IH, Kim KD, Moon YT, Myung SC, et al. Febrile Urinary Tract Infection After Prostate Biopsy and Quinolone Resistance. Korean J Urol 2014; 55:660-4.

Shahait M, Degheili J, El-Merhi F, Tamim H, Nasr R. Incidence of sepsis following transrectal ultrasound guided prostate biopsy at a tertiarycare medical center in Lebanon. Int Braz J Urol 2016;42 :60-8.

Wagenlehner FME, Oostrum EV, Tenke P, Tandogdu Z, Çek M, Grabe M, et al. Infective complications after prostate biopsy: Outcome of the global prevalence study of Infections in urology (GPIU) 2010 and 2011, a prospective multinational multicentre prostate biopsy Study. Eur Urol 2013;63: 521-7.

Song W, Choo SH, Sung HH, Han DH, Jeong BCH, Seo SI, et al. Incidence and management of extended-spectrum Beta-lactamase and Quinolone-resistant Escherichia coli infections after prostate biopsy. Urology 2014;84: 1001-7.

Sieczkowski M, Gibas A, Bronk M. Fluoroquinolonebased antimicrobial prophylaxis in patients undergoing transrectal ultrasound-guided prostate biopsy. Eur J Clin Microbiol Infect Dis 2015;34: 1815–21.

Feliciano J, Teper E, Ferrandino M, Macchia RJ, Blank W, Grunberger I, et al. The incidence of fluoroquinolone resistant infections after prostate biopsy--are fluoroquinolones still effective prophylaxis?. J Urol 2008; 179:952-5.

Nravejsakul K, Na song-kha B, Raksakul W, Wongumpornwat T, Nuanthaisong U. Extended 14-core schematic diagram mapping prostate biopsy increases both the cancer detection rate and the accuracy of Gleason Score. Insight Urol [Internet]. 2020 [cited 2021 Feb 1];41(2):75-80. Available from:

Lee JE, Shin SS, Kang TW, Kim JW, Heo SH, Jeong YY. Comparison of different rectal cleansing methods for reducing post-procedural infectious complications after transrectal ultrasoundguided prostate biopsy. Urol J [Internet]. 2020 [cited 2021 Feb 2];17(1):42-9. Available from:

Krailaksanawarapar C, Gosrisirikul C. The Prevalence of SIRS following intrarectal Povidone-Iodine and Xylocaine transrectal ultrasound guided prostate biopsy in Rajavithi hospital. Insight Urol [Internet]. 2020 [cited 2021 Feb 1];41(1):41-7. Available from:

Ergani B, Çetin T, Yalçın MY, Özbilen MH, Bildirici Ç, Karaca E, et al. Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. Turk J Urol 2020;46(2):159-64.

Yu-Chen Ch, Hao-Wei Ch, Shu-Pin H, Hsin-Chin Y, Ching-Chia L. Adequate rectal preparation reduces hospital admission for urosepsis after transrectal ultrasound - guided prostate biopsy.Int braz j urol [Internet]. 2018 [cited 2021 Feb 01]; 44 (6): 1122-28. Available from:

Loeb S, Vellekoop A, Ahmed HU, Catto J, Emberton M, Nam R, et al. Systematic Review of Complications of Prostate Biopsy. Eur Urol 2013; 64:876-92.

Adamczyk P, Juszczak K, Prondzinska M, Kędzierska A, Szwajkert-Sobiecka H, Drewa T. Fluoroquinolone-resistant Escherichia coli in intestinal flora of patients undergoing transrectal ultrasound-guided prostate biopsy - possible shift in biopsy prophylaxis. Cent European J Urol 2017; 70:192-6.

Liss MA, Peeples AN, Peterson EM. Detection of fluoroquinolone-resistant organisms from rectal swabs by use of selective media prior to a transrectal prostate biopsy. J Clin Microbiol 2011; 49:1116-8.

Steensels D, Slabbaert K, Wever DJ, Vermeersch P, Poppel VH, Verhaegen J. Fluoroquinoloneresistant E. coli in intestinal flora of patients undergoing transrectal ultrasound-guided prostate biopsy-should we reassess our practices for antibiotic prophylaxis?,Clinical Microbiology and Infection 2012; 18: 575-81.

Mottet N, Bellmunt J, Briers E, Bolla M, Bourke L, Cornford P, De Santis M, et al. Members of the EAU – ESTRO – ESUR –SIOG Prostate Cancer Guidelines Panel. EAU – ESTRO – ESUR – SIOG Guidelines on Prostate Cancer. [Internet]. 2020 [cited 2021 Mar 22]. Available from:

Taneja SS, Bjurlin MA, Carter HB, Cookson MS, Gomella LG, Penso DF, et al. Optimal Techniques of Prostate Biopsy and Specimen Handling. [Internet]. 2015 [cited 2021 Mar 22 ]. Available from :

Trabulsi EJ, Halpern EJ, Gomella LG. Prostate biopsy : techniques and imaging. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, Editors. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia: Elsevier; 2020. p.3490-504.