The role of unusual pathogens in prostatitis syndrome

Škerk, Višnja; Krhen, Ivan; Schönwald, S; Čajić, Vjeran; Markovinović, Leo; Roglić, Srđan; Zekan, Šime; Andracevic, Arjana Tambic; Kružić, Vladimira

doi:10.1016/j.ijantimicag.2004.02.010

Cited by 73 publications

(61 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the diagnosis of prostatitis is often given for any unexplained symptoms that arise from prostate gland disorders, ranging from inflammation to infection to pelvic pain [2]. Pathogenic microorganisms are considered to be among the most important causes of this condition [4,5,6]. Microorganisms such as Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT) and nanobacteria have roles in chronic prostatitis [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Pathogenic microorganisms are considered to be among the most important causes of this condition [4,5,6]. Microorganisms such as Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT) and nanobacteria have roles in chronic prostatitis [5,6]. Presently, ordinary bacterial culture often does not reflect the true status of prostatitis pathogens.…”

Section: Introductionmentioning

confidence: 99%

“…Type III prostatitis (comprising type IIIa, inflammatory chronic pelvic pain syndrome, and type IIIb, noninflammatory chronic pelvic pain syndrome, according to the National Institutes of Health [NIH] Classification System for Prostatitis Syndromes, 1998) is the most common type of chronic prostatitis. It is extremely difficult to treat with conventional therapy, and its etiology remains unclear [5,6]. In order to properly explore the microbial species within the prostate of refractory chronic prostatitis patients, we utilized modern microbiological methods to detect microorganisms within expressed prostatic secretions (EPS) and compared them with those of normal adult male controls who had no sexual experience.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Atypical Microorganisms in Expressed Prostatic Secretion from Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Microbiological Results from a Case-Control Study

Xiao

Ren²,

Lv³

et al. 2013

Urol Int

View full text Add to dashboard Cite

Objectives: To investigate the microorganisms in expressed prostatic secretions (EPS) of both chronic prostatitis patients and normal young male adults and to determine which microorganisms are associated with the degree of intraprostatic inflammation. Methods: Specific polymerase chain reaction (PCR) technology was performed to confirm Neisseria gonorrhoeae, Mycobacterium tuberculosis, Mycoplasma and Chlamydia trachomatis as well as human papilloma virus (HPV), herpes simplex virus type 2 (HSV-2) and cytomegalovirus (CMV). Universal primer PCR technology was carried out to detect 16S bacteria rDNA, followed by cloning and sequencing of the entire 16S rDNA product. Results: The total number of bacteria and/or viruses detected by PCR assays was significantly associated with disease severity (p < 0.001). The white blood cell count and lecithin level was significantly correlated with the number of detected bacteria and/or viruses (p = 0.001 and p = 0.046, respectively). 17 bacterial isolates were identified from 14 EPS samples by 16S rDNA sequencing. Conclusions: Various microorganisms including Ureaplasma urealyticum, C. trachomatis, CMV, HPV and HSV-2 were identified in the EPS from patients with type III prostatitis. HPV infection may be associated with the degree of intraprostatic inflammation.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Atypical Microorganisms in Expressed Prostatic Secretion from Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Microbiological Results from a Case-Control Study

Xiao

Ren²,

Lv³

et al. 2013

Urol Int

View full text Add to dashboard Cite

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

“…Before each test, patients were required to cleanse thoroughly their hands and glans penis with an antiseptic soap. The samples were tested for the presence and load of traditional uropathogens (TUs; Pseudomonas aeruginosa, Klebsiella spp., Proteus spp., E. coli, other members of the Enterobacteriaceae family, Enterococcus faecalis, Staphylococcus aureus) [23] and 'unusual pathogens' (UPs; definition by Skerk et al [24]): Streptococcus spp., Haemophylus spp., Citrobacter spp., Coryneforms, Ureaplasma urealyticum, Mycoplasma spp., and others). When a patient showed at least a TU together with an UP in the context of a multiple infection localized at the prostatic level, he was considered positive for class II CBP and placed in the TU group.…”

Section: Study Design Inclusion Criteria and Diagnostic Proceduresmentioning

confidence: 99%

Semen analysis in chronic bacterial prostatitis: diagnostic and therapeutic implications

Magri¹,

Wagenlehner²,

Montanari³

et al. 2009

Asian J Androl

View full text Add to dashboard Cite

The significance and diagnostic value of semen analysis in chronic bacterial prostatitis has been extensively debated and remains controversial. To investigate the diagnostic relevance of semen culture in the bacteriological workup of prostatitis patients, we retrospectively analyzed a clinical database of 696 symptomatic patients. All patients were routinely subjected to a four-glass test, followed by semen culture and analysis. This allowed to dissect from the database three different diagnostic scenarios, and to compare the 'two-glass' pre-/post-massage test and the standard 'four-glass' test with a 'five-glass' test (four-glass plus post-VB3 semen culture). The 'five-glass' test showed 3.6-or 6.5-fold increases in relative sensitivity and lesser reductions (-13.2% or -14.7%) in relative specificity for traditional uropathogens (TUs) compared with the four-glass or two-glass test, respectively. The area under the ROC curve and Jouden's index were increased, whereas positive and negative likelihood ratios were lower than comparators, indicating that the 'five-glass' assay may be superior in confirming the negative outcome of both standard tests. The five-, four-, and two-glass tests detected TUs (Enterobacteriaceae, Enterococci, etc.) in 120, 33, and 20 patients and unusual pathogens (Streptococci, other Gram-positive species, Mycoplasmata, and others) in 130, 56, and 45 patients, respectively. When patients were subjected to pharmacological treatment, including a combination of a fluoroquinolone and a macrolide, no differences in eradication rates were observed between groups diagnosed with different tests, irrespective of pathogen category. Eradication was associated with long-term sign/symptom remission; no significant intergroup differences in sign/symptom scores were observed throughout a 24-month off-therapy follow-up period. In conclusion, our data support the usefulness of semen analysis in the diagnostic workup of prostatitis patients when this test is used to complement the four-glass Meares and Stamey test. Improvement of microbiological assays conveys important diagnostic and therapeutic implications.

show abstract

The role of unusual pathogens in prostatitis syndrome

Cited by 73 publications

References 8 publications

Atypical Microorganisms in Expressed Prostatic Secretion from Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Microbiological Results from a Case-Control Study

Atypical Microorganisms in Expressed Prostatic Secretion from Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Microbiological Results from a Case-Control Study

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

Semen analysis in chronic bacterial prostatitis: diagnostic and therapeutic implications

Contact Info

Product

Resources

About