Association of Warmer Weather and Infectious Complications Following Transrectal Ultrasound-Guided Prostate Biopsy

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.

Keywords: infection; prostate; seasonality; sepsis; temperature; transrectal; weather.

Figure 1

The distribution of seasonal infectious complications rates and temperatures in the continuous 5 year time period in Kaohsiung, Taiwan. The column represents the seasonal rate of infectious complications after a transrectal ultrasound-guided prostate biopsy (black column: urinary tract infection; gray column: sepsis; white column: positive culture finding). The line represents the average monthly temperature during the season (black solid line: average temperature; dense dotted line: lowest temperature; loose dotted line: highest temperature).