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Evaluation of a needle disinfectant technique to reduce infection-related hospitalization following transrectal prostate biopsy

BJU International Aug 18, 2017

Auffenberg GB, et al. – This observational analysis intended to evaluate if a needle disinfectant technique during transrectal prostate biopsy is correlated with lower rates of infection–related hospitalization. The results of this study displayed that hospitalizations for infectious complications were less common when the procedure included a needle disinfection technique. Nevertheless, after adjusting for potential confounders the impact of needle disinfection was not statistically significant. Prospective assessment is needed to determine whether this step serves a scalable and effective method to minimize infectious complications.

Methods
  • Researchers carried out a retrospective analysis of all transrectal prostate biopsies across the Michigan Urological Surgery Improvement Collaborative (MUSIC) from January 2012 through March 2015.
  • Thereafter, natural variation in technique allowed us to assess for differences in infection-related hospitalizations based on whether or not a needle disinfectant technique was utilized.
  • The disinfectant technique was an intra-procedural step to cleanse the biopsy needle with antibacterial solution after each core was sampled (i.e., 10% formalin or 70% isopropyl alcohol).
  • They compared the rate of infection-related hospitalizations within 30 days of biopsy after grouping biopsies according to whether or not the procedure included a needle disinfectant step.
  • Generalized estimating equation (GEE) models were fit to adjust for potential confounders.

Results
  • They conducted 17,954 biopsies with 5,321 (29.6%) including a disinfectant technique during the evaluated period.
  • As per the data, the obtained rate of infection-related hospitalization was lower when a disinfectant technique was utilized at biopsy (0.60% vs. 0.90% without disinfectant technique, p=0.04).
  • It was showed that the adjusted hospitalization rate in the disinfectant group was 0.85% (vs. 1.12%), (adjusted OR 0.76, 95% CI 0.50 -1.15, p= 0.19) after accounting for differences between groups.
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