A severely symptomatic case of anaerobic chronic bacterial prostatitis successfully resolved with moxifloxacin therapy

Magri, Vittorio; Restelli, Antonella; Marras, Emanuela; Perletti, Gianpaolo

doi:10.1016/j.anaerobe.2009.10.008

Cited by 7 publications

(5 citation statements)

References 15 publications

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“…The uncircumcised glans penis has direct access to the prostate through the urethra 23 which is relatively anoxic. Although there is one report from 1988 linking anaerobes with prostate cancer 24 and one study demonstrating that antibiotics can clear them from the prostate 25 , most workers have until recently considered them as opportunists colonising necrotic tumour tissue rather than being considered as actual causative factors. Due to a long-held view that a “ Helicobacter -like” process could be involved in causation of prostate cancer 26 – 29 , this pilot study was undertaken to screen for aerobic and anaerobic bacteria by culturing small aliquots of urine samples obtained following a “mini-prostate massage” done for PCA3 testing.…”

Section: Introductionmentioning

confidence: 99%

Identification of low oxygen-tolerating bacteria in prostate secretions of cancer patients and discussion of possible aetiological significance

Bhudia

Ahmad

Akpenyi

et al. 2017

Sci Rep

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The microaerophylic organism Propionibacterium acnes has shown consistent association with prostate cancer (PC). Studies linking circumcision with reduced PC further support anaerobes involvement as circumcision reduces anaerobe colonisation on the glans penis. A 1988 study linked anaerobes with PC but considered them as opportunists in necrotic tumour. A hypothesis that a “Helicobacter-like” process causes PC justified this pilot study. Active surveillance patients were enrolled. Post-prostate massage urine samples were screened using the Matrix-Assisted Laser Desorption/Ionization Time-of-Flight (MALDI-TOF) technique for bacterial identification after culture in anaerobic and aerobic conditions. 8 out of 18 patients (41%) had either obligate anaerobic (n = 5) or microaerophilic (n = 4, one of whom also had anaerobes) organisms identified. None of 10 control samples contained obligate anaerobes. Although mean PSA was 63% higher in those with low oxygen tolerating bacteria, two high outliers resulted in this difference being non-significant. Given the substantially higher proportion of PC patients with organisms growing in a low concentration of oxygen when combined with previous studies compared to controls, the degree of significance was as high as smoking 5–9 cigarettes a day and needs further investigation. Translational research in trials combining Vitamin D and aspirin have begun as part of such investigation.

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Section: Introductionmentioning

confidence: 99%

Identification of low oxygen-tolerating bacteria in prostate secretions of cancer patients and discussion of possible aetiological significance

Bhudia

Ahmad

Akpenyi

et al. 2017

Sci Rep

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“…Besides traditional uropathogens (Escherichia coli, Klebsiella spp., Proteus spp., Pseudomonas aeruginosa, Enterococcus faecalis and Staphylococcus aureus), unusual pathogens (Chlamydia trachomatis, other Gram1/2 pathogens, Trichomonas vaginalis, Mycoplasmata and Mycobacteria) are reputed to play a causative role in CBP in some cases. 3,4 Anaerobic bacteria have been proposed to play a pathogenic role in CBP on the basis of studies that show (i) a significant association between the evidence of prostatic infection by anaerobes and the presence of markers of inflammation in prostatic secretions; (ii) a clinical cure or remission following eradication of anaerobic pathogens in patients showing signs and symptoms of CBP; [5][6][7] and (iii) the detection of anaerobes in a higher proportion of symptomatic chronic prostatitis/chronic pelvic pain syndrome patients compared to asymptomatic controls. 8 Owing to the introduction of fluoroquinolones as first-line antibacterial agents for CBP, higher eradication rates (70%-80%) have been reported, which have improved over the rates previously achieved by administration of cotrimoxazole (30%-65%).…”

Section: Introductionmentioning

confidence: 99%

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

Magri¹,

Montanari²,

Škerk³

et al. 2011

Asian J Androl

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We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category II chronic bacterial prostatitis (CBP). The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin (500 mg, thrice-weekly) with a once-daily 500-or 750-mg dose of ciprofloxacin (Cipro-500 or Cipro-750 cohort, respectively). Combined administration of azithromycin (1500 mg week 21 ) with ciprofloxacin at the rate of 750 mg day 21 for 4 weeks rather than at 500 mg day 21 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen (PSA) were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction (ED) at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.

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“…They are a common cause of anaerobic bacteremia [ 12 , 13 ]. They may also cause genitourinary tract infections, including chronic prostatitis, but to our knowledge have not yet been reported to cause an acute prostatic abscess [ 11 , 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

An Unusual Presentation of Prostatic Abscess due to Actinomyces turicensis and Peptostreptococcus

Barnes

Kaur

Augenbraun

2020

Cureus

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A severely symptomatic case of anaerobic chronic bacterial prostatitis successfully resolved with moxifloxacin therapy

Cited by 7 publications

References 15 publications

Identification of low oxygen-tolerating bacteria in prostate secretions of cancer patients and discussion of possible aetiological significance

Identification of low oxygen-tolerating bacteria in prostate secretions of cancer patients and discussion of possible aetiological significance

Fluoroquinolone–macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

An Unusual Presentation of Prostatic Abscess due to Actinomyces turicensis and Peptostreptococcus

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