Abstract
The seasonal and meteorological factors in predicting infections after urological interventions have not been systematically evaluated. This study aimed to determine the seasonality and the effects of the weather on the risk and severity of infectious complications (IC) after a transrectal ultrasound-guided prostate biopsy (TRUS-Bx). Using retrospectively collected data at the tertiary care hospital in Taiwan, we investigated the seasonal and meteorological differences in IC after TRUS-Bx. The IC included urinary tract infection (UTI), sepsis, and a positive culture finding (PCF). The severity was assessed on the basis of the Common Terminology Criteria for Adverse Events grading system. The prevalences of the infectious complications (UTI, sepsis, PCF and grade ≥ 3 IC) were significantly higher in the summer than in the winter. Monthly temperature and average humidity were significant factors for IC. After adjusting the demographic factors, multivariate regression revealed that UTI, sepsis, PCF, and grade ≥ 3 IC increased by 12.1%, 16.2%, 21.3%, and 18.6% for every 1 °C increase in the monthly average temperature, respectively (UTI: p = 0.010; sepsis: p = 0.046; PCF: p = 0.037; grade ≥ 3 IC: p = 0.021). In conclusion, the development and severity of IC after TRUS-Bx had significant seasonality. These were dose-dependently associated with warmer weather. Infectious signs after TRUS-Bx should be monitored more closely and actively during warm weather.
Highlights
Transrectal ultrasound-guided prostate biopsy (TRUS-Bx), a standard procedure used to diagnose prostate cancer, is one of the most commonly performed urologic procedures, with more than one million prostate biopsies performed annually among Medicare beneficiaries [1]
Compared to previous studies that focused on patients’ demographic risk factors, such as a previous history of prostatitis, preexisting diabetes, and the development of antimicrobial resistance, for infectious complications [5], we focused on the seasonality and meteorological variables affecting these complications after adjusting for the possible demographic variables
Our analysis revealed that all the infectious complications (UTI, sepsis, and positive culture finding (PCF)) occurred more significantly in the summer when compared with winter
Summary
Transrectal ultrasound-guided prostate biopsy (TRUS-Bx), a standard procedure used to diagnose prostate cancer, is one of the most commonly performed urologic procedures, with more than one million prostate biopsies performed annually among Medicare beneficiaries [1]. Infection is the most common and serious complication of prostate biopsy. The reported rates of infectious complications range from 0.1% to 7.0%, while the sepsis and hospitalizations rates range from 0.3% to 3.1% [2] and 0.6% to 4.1%, respectively [3]. There has been a reported increase in the incidence of hospitalizations and fatal sepsis after prostate biopsy [4]. Risk factors for developing infectious complications after TRUS-Bx include a previous history of prostatitis, diabetes, and the development of antimicrobial resistance [5]. Seasonality has been reported for certain bacterial [6,7], viral [8], and even parasitic infections [9]. For the several infections showing a seasonal pattern in their incidence, the variations have been associated with weather changes, such as temperature, humidity, rainfall, or wind [6,7,10]. It is likely that the weather is related to the infectious complications after TRUS-Bx
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