Microbiology, Antibiotic Resistance, and Risk Factors Associated with Infectious Complications in Patients Undergoing Transrectal Prostate Biopsy.

Purpose: Urinary tract infections (UTI) are a potentially fatal complication in men undergoing transrectal prostate biopsy (TRPB). Antibiotic prophylaxis is indicated for every patient and recommendations are vastly empiric or based on older epidemiological data. Adequate antibiotic stewardship tailored to local data is essential to reduce the incidence of MDR bacteria. The aim of this study is to investigate the microbiology in our population and to identify risk factors associated with infectious complications after prostate biopsy. Methods: A retrospective analysis of prospectively collected data from 531 patients undergoing a TRPB biopsy at a tertiary care center in Mexico City between 2017-2023 was performed. Baseline characteristics, clinica and microbiological data were compared between patients with and without protoperative UTIs. Biniary logistic regression was used to identify risk factors for infectious compliations. Results: Of the 531 patients, 44 (8.3%) developed UTIs, with 9 (1.7%) requiring hospitalization due to sepsis. Significant risk factors included Diabetes Mellitus (DM), dyslipidemia, and previous abdominal radiotherapy. DM was the only independent risk factor (OR 2.82, CI 95% 1.48-5.39). E. coli was the most common isolate (85.7%), with high antibiotic resistance. Conclusions: Postoperative UTIs were observed in 8.3% of patients, with DM being the sole independent risk factor. High antibiotic resistance rates in E. coli isolates suggest a need for alternative prophylactic strategies.