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Objectives: To determine, in a prospective, multicentre setting, the prevalence of fluoroquinolone‐resistant (FQ‐R) and extended‐spectrum β‐lactamase (ESBL)‐producing Escherichia coli (E. coli) strains in men undergoing transrectal ultrasonography‐guided prostate biopsy (TRUS‐Bx) in Finland; and to survey the associated risk factors for having the previously mentioned strains. Patients and Methods: This is a substudy of the trial investigating the role of magnetic resonance imaging (MRI) in prostate cancer diagnosis (Improved Prostate Cancer Diagnosis – Combination of Magnetic Resonance Imaging Targeted Biopsies and Biomarkers Multi‐institutional Study [multi‐IMPROD], NCT02241122). In all, 359 patients from four study centres were recruited to this prospective study. After having signed the informed consent form, these men with suspicion of prostate cancer completed a detailed questionnaire on their medical, smoking, and travelling history, as well as their recent use of antibiotics. After the bi‐parametric MRI scan, TRUS‐Bx was taken and a rectal swab sample was collected and cultured for determining the antimicrobial susceptibility profile of E. coli strains. The potential risk factors for having FQ‐R or third‐generation cephalosporin‐resistant (3GC‐R) E. coli strains were analysed using univariate and multivariate logistic regression analysis. Results: The percentage of FQ‐R and 3GC‐R E. coli strains amongst the study population was 13% and 8%, respectively. Amongst patients having E. coli strains, the rate of FQ‐R and 3GC‐R strains was 14% and 8%, respectively. Of the 3GC‐R E. coli strains, 62% proved to be ESBL‐producers and 88% were also FQ‐R. In multivariate analysis, international travel during the preceding year significantly increased the risk of having a FQ‐R E. coli strain (odds ratio [OR] 3.592, P = 0.001) and, unexpectedly, use of antibiotics during the previous year significantly decreased this risk (OR 0.442, P = 0.035). No significant risk factors for having 3GC‐R E. coli were identified. Conclusion: The occurrence of intestinal FQ‐R and/or 3GC‐R (potentially ESBL‐producing) E. coli strains in men undergoing TRUS‐Bx in Finland is notable. The finding is consistent with the global increase in antimicrobial resistance. International travel appears to be an indisputable risk factor for having intestinal FQ‐R E. coli strains. The contemporary antimicrobial resistance situation should be taken into account in the care of post‐TRUS‐Bx infections. [ABSTRACT FROM AUTHOR]

Background: Older men (aged ≥75 years) with high risk, non-metastatic prostate cancer (PCa) are increasingly treated with curative therapy (surgery or radiotherapy). However, it is unclear if curative therapy prolongs life and improves health-related quality of life (HRQoL) in this age group compared to conservative therapy, which has evolved considerably during the last decade., Study Design: The Scandinavian Prostate Cancer Group (SPCG) 19/Norwegian Get-Randomized Research Group-Prostate (GRand-P) is a randomised, two-armed, controlled, multicentre, phase III trial carried out at study centres in Norway, Denmark, Finland, and Sweden., Endpoints: The primary endpoints are overall survival and HRQoL (burden of disease scale, European Organisation for the Research and Treatment of Cancer [EORTC] Elderly Cancer patients). Secondary endpoints are PCa-specific survival, metastasis-free survival, role-functioning scale (EORTC quality of life questionnaire 30-item core), urinary irritative/obstructive scale (26-item Expanded Prostate Cancer Index Composite [EPIC-26]), bowel scale (EPIC-26), intervention-free survival, PCa morbidity, use of secondary and tertiary systemic therapies, mean quality-adjusted life-years (QALYs), and mean total healthcare costs., Patients and Methods: A total of 980 men (aged ≥75 years) with non-metastatic, high-risk PCa will initially be screened with Geriatric 8 (G8) health status screening tool and Mini-COG© brief cognitive test. Participants identified by G8 as 'fit' or 'frail' will be randomised (ratio 1:1) to either immediate curative therapy (radiotherapy or prostatectomy) or conservative therapy (endocrine therapy or observation). Participants who are unable or unwilling to participate in randomisation will be enrolled in a separate observation group. Randomised patients will be followed for 10 years., Trial Registration: Ethics approval has been granted in Norway (457593), Denmark (H-22051998), Finland (R23043) and Sweden (Dnr 2023-05296-01). The trial is registered on Clinicaltrials.org (NCT05448547)., (© 2024 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.)