Objective: To explore the risk factors, pathogenic bacteria distribution and drug resistance of systematic transrectal ultrasound-guided prostate biopsy (TRUS-Bx), 329 cases of TRUS-Bx were collected, retrospectively, in the Second Affiliated Hospital, Army Military Medical University, from April 2017 to October 2019.
Methods: A total of 329 cases were all qualified and grouped into the SIRS group (25 cases) and the non-SIRS group (304 cases). Of all the cases, incidence and risk factors of systemic inflammatory response syndrome (SIRS) were analyzed. Urine and blood samples of patients with SIRS after TRUS-Bx were also collected for bacterial culture and drug sensitivity test.
Results: Multivariate logistic regression analysis showed that BMI ≥ 25 kg/m² (OR = 1.66, 95% CI = 1.34– 2.12, P < 0.001), history of diabetes (OR = 5.48, 95% CI = 1.53– 19.68, P = 0.008), urinary infection before operation (OR = 9.19, 95% CI = 2.92– 20.93, P < 0.001) and erythrocyte sedimentation (ESR) ≥ 20 mm/h (OR = 1.04, 95% CI = 1.01– 1.08, P = 0.039) were independent risk factors of SIRS after TURS-PB.
Conclusion: The incidence of SIRS and urinary sepsis was 7.59% and 2.13%, respectively, and major pathogens of SIRS after TRUS-Bx were Escherichia coli  (58.33%), Klebsiella pneumoniae  (12.5%) and Pseudomonas aeruginosa  (12.5%). Imipenem, meropenem, tigecycline, piperacillin/tazobactam, teicoplanin, vancomycin, amikacin and cefoperazone/sulbactam had a very strong inhibitory effect to those pathogenic bacteria (sensitivity 85.72%∼ 100%). Levofloxacin, ciprofloxacin, gentamicin, penicillin G, compound neonomine and second-generation cephalosporins showed less but also worked as a good inhibitor to pathogenic bacteria (42.86%∼ 80.95%).
Keywords: systematic transrectal ultrasound-guided prostate biopsy, systemic inflammatory response syndrome, prostate cancer, risk factors infection, pathogens