Bacterial Infection in Prostatodynia

Lowentritt, Joshua E.; Kawahara, Kazuya; Human, Liset G.; Domingue, Gerald J.

doi:10.1016/s0022-5347(01)66870-8

Cited by 18 publications

(9 citation statements)

References 13 publications

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“…A large study of 597 prostatitis patients indicated that nearly one-third were diagnosed with prostatodynia, which is a significant fraction of the urological population (10). The recent literature suggests that the condition referred to as chronic idiopathic (nonbacterial) prostatitis may actually have an infectious etiology (18,32,38,53). Some patients relate the onset of their symptoms to sexual activity-sometimes associated with acute urethritis (7)-while others have indicated no relationship with sexual activity.…”

Section: Definition Of a Problemmentioning

confidence: 99%

“…Gram-positive bacteria, particularly the cocci, remain controversial as possible etiologic agents. Recently, coagulase-negative staphylococcal species and coryneforms have been found in segmented specimens (including prostatic secretions) and are postulated to play a role in chronic idiopathic prostatitis (38,53). It is generally agreed that Enterococcus faecalis can cause chronic bacterial prostatitis and related recurrent enterococcal bacteriuria.…”

Section: Common Bacterial Etiologic Agentsmentioning

confidence: 99%

“…It is generally agreed that Enterococcus faecalis can cause chronic bacterial prostatitis and related recurrent enterococcal bacteriuria. Although many published reports have indicated that gram-positive bacteria other than enterococci rarely cause bacterial prostatitis (43), emerging molecular data and special culture results suggest that these organisms and other less well known bacteria may well be true pathogens in the poorly understood condition referred to as chronic idiopathic prostatitis (18,32,38,53,60).…”

Section: Common Bacterial Etiologic Agentsmentioning

confidence: 99%

“…Recent studies suggest that the etiology of chronic idiopathic prostatitis may be of bacterial origin (18,22). Three types of provocative data have demonstrated the presence of bacteria in prostatic specimens (tissue and secretions) that were negative by traditional clinical microbiologic tests: (i) bacterial gene sequences encoding 16S rRNA and tetracycline resistance (tetM-tetO-tetS) were present in prostatic tissue (32); (ii) culture findings indicated that coagulase-negative staphylococci were the most common isolates in patients with prostatodynia (chronic idiopathic prostatitis) (38,53); and (iii) culture of difficult-to-grow coryneforms in EPS and direct microscopic observation of these pleomorphic bacteria in EPS thought to be negative by routine culture were reported (18,60).…”

Section: Chronic Idiopathic Prostatitismentioning

confidence: 99%

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Prostatitis

Domingue

Hellstrom²

1998

Clin Microbiol Rev

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SUMMARY The laboratory diagnosis of acute bacterial prostatitis is straightforward and easily accomplished in clinical laboratories. Chronic bacterial prostatitis, and especially chronic idiopathic prostatitis (most often referred to as abacterial prostatitis), presents a real challenge to the clinician and clinical microbiologist. Clinically, the diagnosis of chronic idiopathic prostatitis is differentiated from that of acute prostatitis by a lack of prostatic inflammation and no “significant” (controversial) leukocytes or bacteria in the expressed prostatic secretions. Despite these diagnostic criteria, the etiology of chronic idiopathic prostatitis is unknown. While this review covers the entire spectrum of microbially caused acute prostatitis (including common and uncommon bacteria, viruses, fungi, and parasites) and microbially associated chronic prostatitis, a special focus has been given to chronic idiopathic prostatitis. The idiopathic syndrome is commonly diagnosed in men but is poorly treated. Recent data convincingly suggests a possible bacterial etiology for the condition. Provocative molecular studies have been published reporting the presence of 16S rRNA bacterial sequences in prostate biopsy tissue that is negative for ordinary bacteria by routine culture in men with chronic idiopathic prostatitis. Additionally, special culture methods have indicated that difficult-to-culture coryneforms and coagulase-negative staphylococci are present in expressed prostatic secretions found to be negative by routine culture techniques. Treatment failures are not uncommon in chronic prostatitis. Literature reports suggest that antimicrobial treatment failures in chronic idiopathic prostatitis caused by organisms producing extracellular slime might result from the virulent properties of coagulase-negative staphylococci or other bacteria. While it is difficult to definitively extrapolate from animal models, antibiotic pharmokinetic studies with a murine model have suggested that treatment failures in chronic prostatitis are probably a result of the local microenvironment surrounding the persistent focal and well-protected small bacterial biofilms buried within the prostate gland. These conclusions support the molecular and culture data implicating bacteria as a cause of chronic idiopathic prostatitis.

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Section: Definition Of a Problemmentioning

confidence: 99%

Section: Common Bacterial Etiologic Agentsmentioning

confidence: 99%

Section: Common Bacterial Etiologic Agentsmentioning

confidence: 99%

Section: Chronic Idiopathic Prostatitismentioning

confidence: 99%

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Prostatitis

Domingue

Hellstrom²

1998

Clin Microbiol Rev

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“…No other differences were found. Lowentritt et al [30] also performed a case-control study of 22 patients and 16 controls. Nine patients with CPPS and six controls had positive cultures.…”

Section: Control Populationsmentioning

confidence: 99%

Microbiology of the Prostate

Lee

2000

Curr Urol Rep

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Prostatitis is a common genitourinary disease in men. The National Institutes of Health has defined four types of prostatitis. The bacteriology of acute and chronic bacterial prostatitis is well understood. Causative organisms can be isolated by four-glass urine cultures. Chronic pelvic pain syndrome (CPPS; chronic abacterial prostatitis) is an enigma; whether there is a microbiologic cause for this condition is unknown. Researchers have postulated that CPPS may be an infectious disease of the prostate. This article reviews current literature regarding the microbiology of the prostate in CPPS.

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