Aetiology of chronic prostatitis

Škerk, Višnja; Schönwald, S; Krhen, Ivan; Markovinović, Leo; Beus, Antun; Kuzmanović, Nataša-Šterk; Kružić, Vladimira; Vince, Adriana

doi:10.1016/s0924-8579(02)00087-0

Cited by 60 publications

(49 citation statements)

References 12 publications

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“…The aetiological organisms of prostatitis syndrome suggested as important in the literature include C. trachomatis, U. urealyticum, M. hominis and T. vaginalis [5][6][7][8][9]. C. trachomatis may originate in the prostate in an unknown percentage of patients with prostatitis syndrome [10,11].…”

Section: Discussionmentioning

confidence: 99%

The role of unusual pathogens in prostatitis syndrome

Škerk

Krhen

Schönwald

et al. 2004

International Journal of Antimicrobial Agents

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Section: Discussionmentioning

confidence: 99%

The role of unusual pathogens in prostatitis syndrome

Škerk

Krhen

Schönwald

et al. 2004

International Journal of Antimicrobial Agents

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“…In a study on chronic idiopathic prostatitis, T. vaginalis was identiWed by culture in expressed prostatic secretions or urine in 19% of the cases [6]. In contrast, examination of prostatic tissue from men with chronic idiopathic prostatitis by others revealed the presence of T. vaginalis in only 2% of cases by PCR [7] and even below by culture [8].…”

Section: Introductionmentioning

confidence: 99%

High detection rate of Trichomonas vaginalis in benign hyperplastic prostatic tissue

Mitteregger

Aberle²,

Makristathis

et al. 2011

Med Microbiol Immunol

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While Trichomonas vaginalis, a protozoan parasite, is a well-investigated pathogen in the female population, there is little awareness of its significance in the male uro-genital tract. The presence of T. vaginalis in the prostate gland has only been scarcely investigated and has never been attested in conditions other than clinical prostatitis. Still, by some authors, this organ is regarded as ecologic niche for T. vaginalis. Since normal prostate tissue of sufficient quality is hard to come by, we investigated samples from 86 patients (mean age 68.7 ± 7.6 years) suffering from benign prostatic hyperplasia (BPH), a medical condition currently ranked as noninfectious, but characterized by chronic inflammatory tissue infiltrates of unknown etiology. Applying two different PCR protocols and sequence analysis of the respective amplicons, we detected T. vaginalis DNA in 29/86 (34%) BPH tissue samples, whereas in only 2/86 (2.3%) cases T. vaginalis grew in culture. Detection of T. vaginalis DNA correlated significantly (P < 0.01) with elevated peripheral blood monocytic cell counts, appearing along with protozoan infections. Given the unexpected high prevalence of T. vaginalis in BPH tissue of a nonselected, elderly study population from Austria, further epidemiological studies have to confirm this finding. Potential interactions of T. vaginalis in its prostatic habitat may be investigated with respect to their possible contribution to the inflammatory pathogenesis of BPH, since inflammatory cytokines have been shown to sustain prostatic hyperplastic growth.

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“…vaginalis is found on every continent and within every culture with highest occurrences in South and South East Asia, sub-Saharan Africa and amongst the under-privileged [3]. Approximately 50% of infections present with non-typical symptoms ranging from vaginitis, cervicitis and vulvitis in women, to urethritis, prostatitis and pruritis in men [12,13]. Neonatal ocular and respiratory infections have also been described in neonates of infected mothers [14,15].…”

Section: Introductionmentioning

confidence: 99%

Drug resistance in the sexually transmitted protozoan Trichomonas vaginalis

et al. 2003

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Trichomoniasis is the most common, sexually transmitted infection. It is caused by the flagellated protozoan parasite Trichomonas vaginalis. Symptoms include vaginitis and infections have been associated with preterm delivery, low birth weight and increased infant mortality, as well as predisposing to HIV/AIDS and cervical cancer. Trichomoniasis has the highest prevalence and incidence of any sexually transmitted infection. The 5-nitroimidazole drugs, of which metronidazole is the most prescribed, are the only approved, effective drugs to treat trichomoniasis. Resistance against metronidazole is frequently reported and cross-resistance among the family of 5-nitroimidazole drugs is common, leaving no alternative for treatment, with some cases remaining unresolved. The mechanism of metronidazole resistance in T. vaginalis from treatment failures is not well understood, unlike resistance which is developed in the laboratory under increasing metronidazole pressure. In the latter situation, hydrogenosomal function which is involved in activation of the prodrug, metronidazole, is down-regulated. Reversion to sensitivity is incomplete after removal of drug pressure in the highly resistant parasites while clinically resistant strains, so far analysed, maintain their resistance levels in the absence of drug pressure. Although anaerobic resistance has been regarded as a laboratory induced phenomenon, it clearly has been demonstrated in clinical isolates. Pursuit of both approaches will allow dissection of the underlying mechanisms. Many alternative drugs and treatments have been tested in vivo in cases of refractory trichomoniasis, as well as in vitro with some successes including the broad spectrum anti-parasitic drug nitazoxanide. Drug resistance incidence in T. vaginalis appears to be on the increase and improved surveillance of treatment failures is urged.

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Aetiology of chronic prostatitis

Cited by 60 publications

References 12 publications

The role of unusual pathogens in prostatitis syndrome

The role of unusual pathogens in prostatitis syndrome

High detection rate of Trichomonas vaginalis in benign hyperplastic prostatic tissue

Drug resistance in the sexually transmitted protozoan Trichomonas vaginalis

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