The state of the microflora of prostate secretions in healthy individuals and in acute bacterial prostatitis

Relevance. Acute bacterial prostatitis is one of the urgent problems in urology. According to the data presented in the literature, the number of men who have been diagnosed with this disease ranges from 10 to 40 %. At the same time, the main etiological factor in the development of this pathology is most often assigned to the bacterial microflora. However, most of the works are devoted to the study of the microflora in chronic prostatitis, and the state of the microflora in acute bacterial prostatitis remains insufficient. The aim of the study is to evaluate the state of prostate secretion microflora in a comparative aspect in healthy individuals and in patients with acute bacterial prostatitis. Materials and Methods. The study included a comparative analysis of microbiological cultures in prostate secretion of 30 people. All examined were divided into two groups: the first included 15 people without established urological pathology, the second - 15 people with an established diagnosis of acute bacterial prostatitis. Results and Discussion. As a result of the study, it was found that when sowing prostate secretion in persons without established pathology, the absence of microorganism growth was not observed in 60 % of observations, while in 40 % of cases, microorganisms growth was obtained. In the group of examined without established urological pathology, the growth of microorganisms of the following was noted: Escherichia coli - in 58 % of observations; Staphylococcus epidermidis - in 10 % of observations; Staphylococcus warnerii - in 6 % cases and Enterobacter spp. - in 26 %. At the same time, the number of detected microorganisms did not exceed 104 CFU/ml. At the same time, the presence of microbial associations was not recorded. In patients with acute bacterial prostatitis, the sterile prostate secret was 13,3 %, and in 86,7 % of people, microflora growth was obtained. Most often, in the group examined with acute bacterial prostatitis, Escherichia coli was obtained - in 45 % of the observations; Klebsiella spp. - in 23 % cases and Proteus spp. - in 19 %. Less often Staphylococcus epidermidis - in 8 % of observations; Enterobacter spp. - 3,2 %. Serratia spp. - 1,1 % and Staphylococcus warnerii - in 0,7 % cases were the least obtained. At the same time, 86 % of observations in this group revealed microbial associations. Conclusion . Comparison of the state of microflora of prostate secretions in healthy individuals and patients with acute bacterial prostatitis revealed that in patients with acute bacterial prostatitis, the absence of inoculated microflora in prostate secretions was 3 times less than in healthy individuals (13.3 % and 40 %, respectively.), and Escherichia coli was the most common microorganism in the group of patients with acute bacterial prostatitis.

Risk Factors for Relapse in Acute Bacterial Prostatitis: the Impact of Antibiotic Regimens

In the manuscript, we report a large series of acute bacterial prostatitis cases and describe data about the etiology, antibiotic resistance rate, and outcome, specially focused on the risk factors for relapse. We found high rates of resistance to the most frequently used antibiotics and a high relapse rate in patients whose treatment was not adjusted according to their microbiological susceptibility.

A Case Report of Acute Prostatitis Secondary to Use of P-valve Condom Catheter During Cave Diving

Introduction: Acute bacterial prostatitis is characterized by acute inflammation of the prostate gland accompanied by the presence of pain and other urinary tract or systemic symptoms. Prostatitis is a relatively common disease of the urinary tract in men, However, this case reports a man diagnosed with acute bacterial prostatitis with an unusual presentation, as well as an unusual pathogen and a unique mechanism of colonization. Case Report: A 52-year-old male with no past medical history presented to our facility for right-sided buttock pain associated with dysuria, diarrhea, and perianal burning. The patient was diagnosed with sepsis secondary to acute bacterial prostatitis, and the pathogen identified in his urine was Aeromonas hydrophila/A. caviae. His disease process was later recognized as a complication of the use of a P-valve condom catheter while freshwater cave diving. Conclusion: This is the first documented case of prostatitis as a result of the use of a P-valve condom catheter while diving. Furthermore, the pathogen identified is of particular interest as there are very few documented cases of urosepsis secondary to Aeromonas hydrophila or A. caviae.

Post colonoscopic acute bacterial prostatitis: a case report

Colonoscopy is a common procedure for diagnosing a wide range of conditions and symptoms affecting the large bowel. Research has shown that the examination itself may induce transient bacterial infections. Specifically acute bacterial prostatitis (ABP) has little mention in medical literature as a recognized complication of this procedure. Here we discuss a 37 year old male presenting with symptoms suggesting lower urinary tract infection after having undergone colonoscopy followed by recurrent episodic haematuria and lower urinary tract symptoms (LUTS). Physicians and endoscopists should be aware of the risk of acute bacterial prostatitis as a potential complication of colonoscopy in order to minimize misdiagnosis as well as the complications associated with the delayed treatment of it. In addition male patients and the immunocompromised should be fully counselled regarding this risk prior to undertaking this procedure.

The immune system fails to mount a protective response to Gram-positive or Gram-negative bacterial prostatitis

Bacterial prostatitis affects 1% of men, with increased incidence in the elderly. It is defined by the frequency and urgency to urinate, localized pain, and positive bacterial cultures in expressed seminal fluids. Acute bacterial prostatitis frequently progresses to chronicity, which is marked by recurrent acute episodes interspersed with asymptomatic periods of variable duration. Up to 80% of bacterial prostatitis cases are caused by Gram-negative uropathogenic E. coli (UPEC) or Gram-positive E. faecalis. Antibiotic treatment is standard of care, however, global dissemination of antimicrobial resistant uropathogens threatens efficacy of therapy. Thus, development of non-antibiotic-based approaches to treat bacterial prostatitis is a priority. One challenge is that the immune response to infection in the prostate is incompletely understood. We used a mouse model of transurethral bacterial instillation to study the immune response to UPEC or E. faecalis prostate infection. Both uropathogens exhibited tropism for the prostate over the bladder early post-infection. UPEC infection induced greater proinflammatory cytokine expression and neutrophil and monocyte infiltration compared to E. faecalis infection. Following challenge infection, cytokine responses and myeloid cell infiltration were largely comparable to primary infection. Characteristic of memory responses, more lymphoid cells infiltrating the prostate in the second infection compared to the primary infection. Unexpectedly, however, bacterial burden in prostates challenged with either UPEC or E. faecalis was equal or greater than in primary infection, despite that an adaptive response to UPEC infection was evident in the bladder of the same animals. Thus, an immune response to primary infection is initiated, however it does not protect against reinfection. Our findings support the idea that chronic or recurrent prostatitis develops in the absence of efficacious immunity to infection. A greater understanding of the mechanisms underlying this observation may point to actionable targets for immunotherapy.

Septic Shock with Chlamydia Pneumoniae Secondary to Prostatic Abscess: A Rare Case Report

Prostatic abscesses are a rare clinical entity in current practice due to the widespread use of antibiotics. Management usually imposes a challenge to urologists that is due to the difficult diagnosis, as it may mimic other diseases of the lower urinary tract and the lack of guidelines for treatment. Prostate abscess (PA) usually develops in immunocompromised patients, including diabetic and HIV patients, as a consequence of acute bacterial prostatitis. The reason for the lack of guidelines as regards PA is that most of the published data in the literature are case reports due to the declining incidence of the disease today. We presented a male patient who was not foreknown with pathological or personal antecedents or a promiscuous lifestyle. He was hospitalized in the urology section with subfebrility and lumbar pain. His general condition changed rapidly within the span of a few hours, the patient entering septic shock without an etiology or a determined infection. After careful serial investigations, hemocultures (atypical germs) for IgM antibodies Chlamydia Pneumoniae were found in the serological complement fixation (cf) test. The patient responded well to empirically initiated antibiotic treatment upon admission to Intensive Care. Due to a favorable evolution, the patient was declared clinically healthy upon discharge. This was a rare case in medical literature of septic shock of initially unspecified etiology but which, upon thorough investigations and urological reevaluation, revealed a prostatic abscess with Chlamydia Pneumoniae, exteriorized through the urethra and highlighted through positive hemocultures only.

Prostatitis/chronic pelvic pain syndrome in men

This chapter, ‘Prostatitis or chronic pelvic pain syndrome in men’, provides the reader with a comprehensive overview of these syndromes. There are separate sections for acute bacterial prostatitis, chronic bacterial prostatitis, and chronic prostatitis/chronic pelvic pain syndrome (CPPS). The Chronic Prostatitis Symptom Index (from National Institutes of Health) is included as a potentially useful tool in the assessment of men presenting with CPPS. Rarer causes of prostatitis are also outlined including granulomatous prostatitis (TB), parasites, viruses, and mycoses. The potential role of sexually transmitted pathogens is also included. HIV is mentioned as a risk for abscess formation in men presenting with bacterial prostatitis.