[Ecology and fluoroquinolon resistance profiles in febrile urinary tract infections (FUTI) after prostate needle biopsy: A retrospective study in 466 biopsies]. / Écologie et résistances aux fluoroquinolones dans les complications infectieuses urinaires fébriles (CIUF) après biopsies de prostate : étude rétrospective portant sur 466 biopsies.

OBJECTIVE: The biopsies of prostate are the reference examination to assert the diagnosis of prostate cancer. Even if the urinary infectious complications are rare thanks to the systematic oral antibiotic prophylaxis, they may still be serious. The SPILF (Society of Infectious Pathology and French language) published in 2014, an important increase of the resistances in fluoroquinolones for Escherichia coli (3 to 25%), whereas this is the most bacterium frequently found in the urinary infections (70-80%). The objectives of this study were to estimate the indicence of the febrile urinary tract infections after prostate needle biopsy and to define the ecology and the profile of E. coli's resistance. METHODS: A total of 466 transrectal ultrasound-guided needle prostate biopsy were included in the study from 2012 to 2015. All the patients were taken care according to the recommendations of the AFU (Ouzzane et al., 2011). We estimated, for all the inclusive patients, if they had presented a clinic sign of urinary infection like fever or burning which suggestive of an urinary infection, and having a urines and blood culture, in the next 30 days the realization of the medical exam. RESULTS: Among 466 realized biopsies, seven patients developed a febril urinary tract infection (1.5%) [prostatitis (n=6), orchitis (n=1)]. Five infections to E. coli were identified; two were resistant for fluoroquinolones (40%). No germ was able to be identified for two patients. CONCLUSION: The infectious complications post-biopsy of prostate are rare (1.5%). E. coli is the germ most frequently identified with 40% of resistance with fluoroquinolones. LEVEL OF EVIDENCE: 4.

[Cardiovascular risk associated with urolithiasis]. / Risque cardiovasculaire chez les lithiasiques.

OBJECTIVE: Urolithiasis appears to be associated with several cardiovascular risk factors (excess salt and animal proteins, hypertension, metabolic syndrome) and, more recently, the development of stroke. The authors describe the frequency of cardiovascular risk factors and cardiovascular events before and after management of urolithiasis. METHOD: The authors retrospectively collected data from patients born before 1956 and managed surgically or instrumentally for urolithiasis in our establishment in 1994 concerning the frequency of cardiovascular risk factors and the incidence of acute coronary syndrome, stroke or acute lower limb ischaemia before or after treatment of urolithiasis. RESULTS: Data were obtained for 33 patients, revealing 12 events including five previous events (four cases of acute coronary syndrome, one ischaemic stroke) and seven subsequent events (five cases of acute coronary syndrome with one death, one ischaemic stroke, one case of acute lower limb ischaemia) an average of 5.7 years after management. These 33 patients had an average of more than two risk factors. CONCLUSION: This retrospective study based on a small sample size demonstrated a high frequency of risk factors and cardiovascular events. This correlation needs to be studied in more detail. Urolithiasis could constitute an indirect cardiovascular risk factor dependent on "classical" risk factors, suggesting the need for integrated management of stone patients, in the same way as for patients with erectile dysfunction.