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Yang Y, Shigemura K, Maeda K, Moriwaki M, Chen KC, Nakano Y, Fujisawa M. The harmful effects of overlooking acute bacterial prostatitis. Int J Urol 2024; 31:459-463. [PMID: 38239011 DOI: 10.1111/iju.15390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 12/26/2023] [Indexed: 05/05/2024]
Abstract
Prostatitis is a major urological disease affecting 25%-50% of men over their lifetime. However, prostatitis is often overlooked in nonurologic departments due to its sometimes indeterminate symptoms. In this review, we describe how to recognize and treat acute bacterial prostatitis, which manifests as a clinical problem in other departments as well as urology, to help prevent this disease from being overlooked. There are several possible negative effects of not recognizing acute bacterial prostatitis (ABP). First, initial treatment can fail. In the hyperacute phase, common antibiotics are often effective, but in rare cases, such antibiotics may not be effective. In addition, once ABP progresses to form a prostate abscess, potentially avoidable surgical interventions are often needed. A second issue is the transition to chronic prostatitis. If chronic bacterial prostatitis progresses, treatment requires long-term antibiotic administration and the response rate is not high. Some patients may have to deal with urinary tract infections for the rest of their lives. Finally, there is the problem of overlooking the underlying disease. ABP is rare in healthy adult men without underlying disease, including sexually transmitted diseases as well as benign prostatic hyperplasia, urinary stones, and malignant tumors, and may not be obvious. When examining patients with fever of unknown origin, it is necessary to exclude not only infectious diseases but also collagen diseases and malignant tumors. If there are any doubts, we recommend a rectal exam and consultation with a urologist.
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Affiliation(s)
- Youngmin Yang
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Katsumi Shigemura
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
- Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Koki Maeda
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Michika Moriwaki
- Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Kuan-Chou Chen
- Department of Urology, Taipei Medical University Shuang Ho Hospital, Taipei, Taiwan
| | - Yuzo Nakano
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Masato Fujisawa
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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Johri AV, Johri P, Hoyle N, Nadareishvili L, Pipia L, Nizharadze D. Case report: Successful treatment of recurrent E. coli infection with bacteriophage therapy for patient suffering from chronic bacterial prostatitis. Front Pharmacol 2023; 14:1243824. [PMID: 37790805 PMCID: PMC10544980 DOI: 10.3389/fphar.2023.1243824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023] Open
Abstract
Background: Chronic Bacterial Prostatitis (CBP) is inflammation of the prostate caused by bacterial infection. An estimated 8.2% of men have prostatitis, most commonly under the age of 50. Antibiotics often fail to treat CBP due to presence of bacterial biofilms and rising antibiotic resistance of pathogenic bacterial strains. The multidrug resistant (MDR) bacterial strains often implicated in cases of CBP include Extended Spectrum Beta Lactam resistant Escherichia coli, Vancomycin resistant Enterococci, Gram-positive bacterial strains like Staphylococci and Streptococci, Enterobacteriaceae like Klebsiella and Proteus, and Pseudomonas aeruginosa. CBP patients experience significant deterioration in quality of life, with impact on mental health comparable with patients of diabetes mellitus and chronic heart failure, leading patients to explore alternatives like phage therapy. Case presentation: We present the case of a patient diagnosed with and exhibiting typical symptoms of CBP. Tests of the prostatic and seminal fluids identified E. coli as the causative pathogen. The patient did not experience favourable long-term treatment outcomes despite repeated antibiotic courses administered over 5 years. This led him to seek phage therapy for treatment of his condition. Methods and outcome: The cultured strain of E. coli was tested against bacteriophage preparations developed by the Eliava Institute, Georgia. Preparations showing lytic activity against the strain were used for the patient's treatment at the Eliava Phage Therapy Center (EPTC). The patient underwent two courses of treatment with the EPTC. The first treatment course resulted in significant symptomatic improvement, followed by complete resolution of symptoms post the second course of phage therapy. Samples tested during treatment showed declining bacterial growth, corresponding with symptomatic improvement. Post-treatment cultures had no growth of pathogenic bacteria. Discussion: This case illustrates the efficacy of bacteriophages in treating CBP, a condition that is often resistant to antibiotic therapies. Antibiotics such as ofloxacin, Fosfomycin, trimethoprim, nitrofurantoin and ceftriaxone were administered in multiple courses over 5 years, but the infection recurred after each course. After two courses of phage therapy, the patient experienced long-term symptom resolution and substantial reduction in bacterial load. Increasing numbers of such cases globally warrant further research into the potential for bacteriophages for treating MDR and chronic infections.
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Affiliation(s)
| | | | - Naomi Hoyle
- Eliava Phage Therapy Center, Tbilisi, Georgia
- Skagit Regional Health, Mount Vernon, WA, United States
| | | | - Levan Pipia
- Eliava Phage Therapy Center, Tbilisi, Georgia
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Graziani A, Grande G, Martin M, Ferraioli G, Colonnello E, Iafrate M, Dal Moro F, Ferlin A. Chronic Prostatitis/Chronic Pain Pelvic Syndrome and Male Infertility. Life (Basel) 2023; 13:1700. [PMID: 37629557 PMCID: PMC10455764 DOI: 10.3390/life13081700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/29/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is defined as urologic pain or discomfort in the pelvic region, associated with urinary symptoms and/or sexual dysfunction, lasting for at least 3 of the previous 6 months. The rate of symptoms related to prostatitis has a mean prevalence of 8-8.2%. CP/CPPS is most frequent in men younger than 50 years, among whom it is the most common urologic diagnosis. In the last decades, many studies have been published on CP/CPPS and its association with male infertility. The pathophysiologic relation between CP/CPPS and male infertility involves several aspects, which are not well studied yet. A reduction in semen parameters has been demonstrated in patients with CP/CPPS, and several mechanisms have been proposed to represent putative pathophysiological links between CP/CPPS and infertility, including male accessory gland inflammation, metabolic syndrome, inflammatory bowel disease, HPV co-infection and autoimmunity. In light of this evidence, a multidisciplinary approach is advocated for patients with known CP/CPPS, and particular attention is needed for male patients of infertile couples in order to evaluate male accessory glands correctly. In addition, it is advisable that future studies dealing with the treatment of CP/CPPS take into consideration all the different pathophysiological aspects implicated.
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Affiliation(s)
- Andrea Graziani
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35122 Padova, Italy
| | - Giuseppe Grande
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35122 Padova, Italy
| | - Michel Martin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35122 Padova, Italy
| | - Giordana Ferraioli
- Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35122 Padova, Italy
| | - Elena Colonnello
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
- Chair of Endocrinology and Medical Sexology (ENDOSEX), University of Tor Vergata, 00133 Rome, Italy
| | - Massimo Iafrate
- Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35122 Padova, Italy
| | - Fabrizio Dal Moro
- Urology Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35122 Padova, Italy
| | - Alberto Ferlin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, 35122 Padova, Italy
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Bermudez M, Epstein SB, Guevara N, Pedraza L, Dahdouh M, Awad I. Prostatic Abscess Secondary to Staphylococcus haemolyticus and Escherichia coli: A Case Report. Cureus 2023; 15:e40406. [PMID: 37456390 PMCID: PMC10348605 DOI: 10.7759/cureus.40406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
A prostate abscess is a rare clinical entity with an incidence of 0.2%-0.5% in males. No case reports exist of Staphylococcus haemolyticus as an etiologic bacterial agent. We report a 59-year-old man with a past medical history of poorly controlled diabetes mellitus and benign prostatic hyperplasia who was hospitalized due to urosepsis and obstruction. A prostatic abscess was discovered and initially treated with intravenous vancomycin and ertapenem. Clinical improvement was apparent within two days following transrectal prostatic abscess drainage. Four weeks of intravenous antibiotics followed. Prostatic abscess cultures grew Staphylococcus haemolyticus and Escherichia coli following tube deployment. To the best of our knowledge, this is the first case reporting Staphylococcus haemolyticus as an organism in a prostate abscess. We regard this as another example of the rising incidence of gram-positive organisms in prostatic abscesses in the post-antibiotic era.
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Affiliation(s)
| | | | | | | | | | - Ihab Awad
- Urology, SBH Health System, New York, USA
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Characterisation and sequencing of the novel phage Abp95, which is effective against multi-genotypes of carbapenem-resistant Acinetobacter baumannii. Sci Rep 2023; 13:188. [PMID: 36604462 PMCID: PMC9813454 DOI: 10.1038/s41598-022-26696-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 12/19/2022] [Indexed: 01/06/2023] Open
Abstract
Acinetobacter baumannii has become one of the most challenging conditional pathogens in health facilities. It causes various infectious diseases in humans, such as wound or urinary tract infections and pneumonia. Phage therapy has been used as an alternative strategy for antibiotic-resistant A. baumannii infections and has been approved by several governments. Previously, we have reported two potential phage therapy candidates, Abp1 and Abp9, both of which are narrow-host-range phages. In the present study, we screened and isolated 22 A. baumannii bacteriophages from hospital sewage water and determined that Abp95 has a wide host range (29%; 58/200). The biological and genomic characteristics and anti-infection potential of Abp95 were also investigated. Abp95 belongs to the Myoviridae family, with a G+C content of 37.85% and a genome size of 43,176 bp. Its genome encodes 77 putative genes, none of which are virulence, lysogeny, or antibiotic resistance genes. Abp95 was found to accelerate wound healing in a diabetic mouse wound infection model by clearing local infections of multidrug-resistant A. baumannii. In conclusion, the lytic phage Abp95, which has a wide host range, demonstrates potential as a candidate for phage therapy against multiple sequence types of carbapenem-resistant A. baumannii.
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Lam JC, Lang R, Stokes W. How I manage bacterial prostatitis. Clin Microbiol Infect 2023; 29:32-37. [PMID: 35709903 DOI: 10.1016/j.cmi.2022.05.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Bacterial prostatitis is a highly prevalent infection responsible for significant morbidity among men. The diagnosis and treatment for bacterial prostatitis remains complicated. The difficulty in diagnosis is in part owing to the paucity of high-quality evidence that guides a clinician's interpretation of patients' history, physical examination, and laboratory findings. Treatment is challenging because of the few antimicrobials capable of prostate penetration, growing antimicrobial resistance limiting effective treatment options, and the high risk of recurrence. OBJECTIVES We aimed to provide a useful resource for clinicians in effectively diagnosing and managing acute bacterial prostatitis (ABP) and chronic bacterial prostatitis (CBP). SOURCES A PubMed literature search on prostatitis was performed with no restrictions on publication date. CONTENT The epidemiology, pathophysiology, diagnosis, and treatment for ABP and CBP are explored using a clinical vignette as relevant context. IMPLICATIONS Bacterial prostatitis can be diagnosed through a focused history and microbiological investigations. The Meares-Stamey 4-glass test or modified 2-glass test can help confirm the diagnosis if uncertainty exists. Typical uropathogens are common contributors to bacterial prostatitis but there is growing interest in exploring the role atypical and traditional non-pathogenic organisms may have. Fluoroquinolones remain first-line therapy, followed by trimethoprim-sulfamethoxazole (TMP-SMX) or doxycycline if the pathogen is susceptible. Fosfomycin has emerged as a repurposed and useful agent because of the increasing incidence of multidrug-resistant pathogens. Selection of appropriate antimicrobial regimens can be challenging and is dependent on the host, chronicity of symptoms, uropathogens' susceptibilities, antimicrobials' side effect profile, and the presence of prostatic abscesses or calcifications. ABP can typically be treated similar to other complicated urinary tract infections. However, CBP requires prolonged therapy, with a minimum of 4 weeks and up to 12 weeks of therapy.
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Affiliation(s)
- John C Lam
- Division of Infectious Diseases, Department of Medicine, University of California Los Angeles, Los Angeles, California, United States.
| | - Raynell Lang
- Division of Infectious Diseases, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - William Stokes
- Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
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Mahmud H, Keenan JD, Gonzales J, Schallhorn J, Chan M, Arnold B, Cavallino V, Lietman TM, Doan T, Seitzman GD. Ocular Rosacea microBiome Study (ORBS)-sub-microbial versus antibiotic dosing of doxycycline versus placebo in treatment of symptomatic ocular rosacea: study protocol for a parallel-arm randomized clinical trial. Trials 2022; 23:1033. [PMID: 36539810 PMCID: PMC9769060 DOI: 10.1186/s13063-022-06948-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Ocular rosacea is common and is often managed with long-term antibiotic treatment. Doxycycline is the most commonly selected antibiotic for the treatment of rosacea. As there is no established standard of care treatment dose for rosacea, prescribed doses of doxycycline vary widely. The FDA classifies 40 mg daily dose of doxycycline for ocular rosacea as sub-microbial in comparison to an antibiotic dose of 200 mg daily. However, this "sub-microbial" dose has never been evaluated in patients with ocular rosacea, and even the sub-microbial dose has potential to alter systemic mucosa flora. Here, we present a randomized controlled trial using RNA sequencing to fully characterize the impact of sub-microbial antibiotic dosing of doxycycline on antimicrobial resistance and bacterial composition of the ocular and gut flora. METHODS In a triple-masked parallel randomized control trial, patients with ocular rosacea will be randomized to three arms: a 40-mg dose of doxycycline, a 200-mg antibiotic dose of doxycycline, or placebo. Collected rectal and lower eyelid samples will be compared for frequency of antimicrobial resistance genetic determinants and microbiome diversity. A subjective ocular surface disease index survey and objective tear breakup time measurement will be determined. DISCUSSION These results will enhance our understanding of the overall systemic impact of long-term systemic sub-microbial antibiotic dosing for the treatment of chronic recurrent ocular inflammatory diseases. TRIAL REGISTRATION This trial was registered on ClinicalTrials.org (NCT05296837) on March 22, 2022.
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Affiliation(s)
- Hamidah Mahmud
- grid.266102.10000 0001 2297 6811San Francisco School of Medicine, University of California, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Francis I. Proctor Foundation, University of California, San Francisco, CA USA
| | - Jeremy D. Keenan
- grid.266102.10000 0001 2297 6811Francis I. Proctor Foundation, University of California, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Ophthalmology, University of California, San Francisco, CA USA
| | - John Gonzales
- grid.266102.10000 0001 2297 6811Francis I. Proctor Foundation, University of California, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Ophthalmology, University of California, San Francisco, CA USA
| | - Julie Schallhorn
- grid.266102.10000 0001 2297 6811Francis I. Proctor Foundation, University of California, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Ophthalmology, University of California, San Francisco, CA USA
| | - Matilda Chan
- grid.266102.10000 0001 2297 6811Francis I. Proctor Foundation, University of California, San Francisco, CA USA
| | - Benjamin Arnold
- grid.266102.10000 0001 2297 6811Francis I. Proctor Foundation, University of California, San Francisco, CA USA
| | - Victoria Cavallino
- grid.266102.10000 0001 2297 6811Francis I. Proctor Foundation, University of California, San Francisco, CA USA
| | - Thomas M. Lietman
- grid.266102.10000 0001 2297 6811Francis I. Proctor Foundation, University of California, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Ophthalmology, University of California, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Epidemiology and Biostatistics, University of California, San Francisco, CA USA
| | - Thuy Doan
- grid.266102.10000 0001 2297 6811Francis I. Proctor Foundation, University of California, San Francisco, CA USA
| | - Gerami D. Seitzman
- grid.266102.10000 0001 2297 6811Francis I. Proctor Foundation, University of California, San Francisco, CA USA ,grid.266102.10000 0001 2297 6811Department of Ophthalmology, University of California, San Francisco, CA USA
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Hu R, Yang Y, Song G, Zhao F, Chen S, Zhou Z, Zheng J, Shen W. In vivo targeting capacities of different nanoparticles to prostate tissues based on a mouse model of chronic bacterial prostatitis. Front Bioeng Biotechnol 2022; 10:1021385. [PMID: 36277385 PMCID: PMC9582453 DOI: 10.3389/fbioe.2022.1021385] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Chronic bacterial prostatitis usually occurs in men and seriously affects the quality of life of patients. The efficacy of chronic bacterial prostatitis treatment is limited by the difficulty for free drugs (e.g., antibiotics) to penetrate the prostate epithelium and target inflammatory tissues. The advent of nanotechnology offers the possibility to address this issue, such as the development of targeted nanoparticle delivery strategies that may overcome these important limitations. The physicochemical properties of nanoparticles, such as particle size, shape and surface modification ligands, determine their targeting effectiveness. In this study, nanoparticles with different physicochemical properties were prepared to explore and confirm their targeting capacities to inflammatory prostate tissues of chronic bacterial prostatitis, focusing on the effects of size and different modification ligands on the targeting performance. In vivo and ex vivo imaging results verified that folic acid-modified nanoparticles with a particle size of 180–190 nm via tail intravenous injection had the optimal targeting efficiency to prostate tissues. Our results provide an experimental basis and reference value for targeted therapy of prostate-related diseases with nanotechnology in the future.
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Affiliation(s)
| | | | | | | | | | | | - Jun Zheng
- *Correspondence: Jun Zheng, ; Wenhao Shen,
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Clinical Efficacy Analysis of Biofeedback Electrical Stimulation Combined with Doxycycline in the Treatment of Type IIIA Chronic Prostatitis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:7150204. [PMID: 36212975 PMCID: PMC9534622 DOI: 10.1155/2022/7150204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022]
Abstract
Purpose To analyse the clinical efficacy of biofeedback electrical stimulation combined with doxycycline in the treatment of type IIIA chronic prostatitis. Methods Eighty patients who met the diagnostic criteria of type IIIA chronic prostatitis in our hospital between February 2020 and February 2022 were selected and equally divided into the drug group and electrical stimulation group according to the random number table method. The drug group was treated with medication alone for 4 weeks; the electrostimulation group was treated with biofeedback electrostimulation on top of medication for 12 weeks. The expressed prostatic secretious (EPS) routine (lecithin bodies, white blood cells) and the maximum urinary flow rate (Qmax) and mean urinary flow rate (Qave) were measured before and after treatment in both groups, and the National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) was used to score the urinary symptom, pain or discomfort, and quality of life and determine the efficacy of the treatment in both groups. Results After treatment, the number of lecithin bodies and white blood cells in EPS improved significantly in both groups compared to before, and both the electrical stimulation group was better than the drug group (P < 0.05). After treatment, the Qmax and Qave were significantly higher in both groups than before, and both the electrical stimulation groups were higher than the drug group (P < 0.05). After treatment, the urinary symptom scores, pain or discomfort scores, quality of life scores, and total NIH-CPSI scores were significantly lower in both groups than before, and all were lower in the electrical stimulation group than in the drug group (P < 0.05). After treatment, the overall efficiency of patients in the electrical stimulation group was significantly higher than that of the drug group (P < 0.05). Conclusion Biofeedback electrical stimulation combined with doxycycline in the treatment of type IIIA chronic prostatitis can synergistically improve the patient's inflammation level, urinary dysfunction, relieve pelvic floor tension myalgia, and improve their quality of life, opening up new avenues for the rehabilitation of patients with type IIIA chronic prostatitis.
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Marquez-Algaba E, Burgos J, Almirante B. Pharmacotherapeutic interventions for the treatment of bacterial prostatitis. Expert Opin Pharmacother 2022; 23:1091-1101. [PMID: 35574695 DOI: 10.1080/14656566.2022.2077101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Bacterial prostatitis, acute or chronic, is one of the most prevalent urogenital infections in men. Its diagnosis requires the application of a careful methodology. Gram-negative bacilli are the most frequent causative agents, and in recent years, an increase in the frequency of multiresistant bacteria has been detected. The choice of the optimal antimicrobial treatment requires the selection of drugs with proven in vitro activity associated with good penetration into the prostatic tissue, especially in chronic forms of infection. AREAS COVERED The aim of this article is to summarize the current evidence regarding the pathogenesis, etiology, empirical and definitive antimicrobial therapy, and new pharmacotherapeutic interventions to improve the prognosis of bacterial acute or chronic prostatitis. EXPERT OPINION Bacterial prostatitis requires the application of an accurate diagnostic protocol to identify the causative agent and establish the optimal antimicrobial treatment. The structural and biochemical characteristics of prostatic tissue result in poor penetration of antimicrobials; therefore, in the choice of treatment, it is essential to select agents with proven antimicrobial activity and pharmacokinetic characteristics that ensure good and sustained concentrations in this area. Patients with chronic forms of infection require prolonged treatment, and relapses of the infectious process are frequent.
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Affiliation(s)
- Ester Marquez-Algaba
- Department of Infectious Diseases, Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Joaquin Burgos
- Department of Infectious Diseases, Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Red Española de Investigación en SIDA (RIS), Instituto de Salud Carlos III, Madrid, Spain
| | - Benito Almirante
- Department of Infectious Diseases, Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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11
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Wang D, Wang H. Cross‐sectional study on the etiological diagnosis of the patients with chronic prostatitis‐like symptoms by application of the urine‐prostate‐semen test. Health Sci Rep 2022; 5:e574. [PMID: 35387315 PMCID: PMC8973267 DOI: 10.1002/hsr2.574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 03/03/2022] [Accepted: 03/03/2022] [Indexed: 11/19/2022] Open
Abstract
Background and Aims The prostatic secretion was considered to be the most important and even only specimen in diagnosis and differential diagnosis of chronic prostatitis like symptoms, but little attention has been paid to other genital organ infections. A urine‐prostate‐semen test (U‐EPS‐S test) was used to investigate the microbial flora of internal genital organs in patients with chronic prostatitis‐like symptoms and their influence on the diagnosis and treatment of the patients. Materials and Methods We randomly selected the patients with chronic prostatitis‐like symptoms for this study and used a U‐EPS‐S test to collect urine, prostatic secretion, and semen specimens. The specimens were inoculated respectively into a suitable culture medium for bacteriological/fungal detection, and the number and distribution of colonies in each isolation culture were observed before and after the therapy. Results All of the specimens from the internal genital organs of these patients were shown as microbe‐positive isolation and the infection rate was 100%. Of these, prostatic secretion with microbe‐positive isolation was obtained in 66 cases (33%), semen with microbe‐positive isolation was obtained in 34 cases (17%), and both prostatic secretion and semen with microbe‐positive isolation were obtained in 100 cases (50%). In the isolates, Gram‐positive microbes were shown as the most common pathogens, accounting for 91.1%. In 200 patients, 95 patients were infected with one microbial species infection, of them 36 were prostatic secretion positive‐isolation (18%), 20 were semen sample positive‐isolation (10%), and 39 were positive‐isolation both prostatic secretion and semen samples (19.5%); 104 patients were infected with two microbial species, of them 30 were prostatic secretion positive‐isolation (15%), 14 were semen sample positive‐isolation (7%), and 60 were positive‐isolation both prostatic secretion and semen samples (30%); one patient was infected with three microbial species and them were isolated from the semen sample (0.5%). In the patients with chronic prostatitis‐like symptoms, the multiple microbial infection (MMI) was accounted for 53.5%, and the multiorgan infection (MOI) was accounted for 67%. Conclusions The U‐EPS‐S test is not only helpful to accurately identify the pathogens and contaminants in the culture isolates, but also the diagnosis and differential diagnosis and also evaluation of the treatment efficacy of the infection in different genital organs. In the patients with chronic prostatitis symptoms, Gram‐positive microbes were the most common causative agents, and MMI and MOI caused by resistant strains of different microbial species have a high incidence.
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Affiliation(s)
- Danni Wang
- Laboratory of Bacterial Pathogenesis, Department of Microbiology and Immunology, Institutes of Medical Sciences Shanghai Jiao Tong University School of Medicine Shanghai Shanghai China
| | - He Wang
- Department of Microbiology Guizhou Medical University Guiyang Guizhou China
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12
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Puerta Suárez J, Velázquez Rivera V, Morales M, Alvarez AM, Carvajal A, Cardona Maya WD. Chronic Prostatitis: Impact of Lifestyle, Infection, and Inflammation on Semen Parameters. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Chronic prostatitis is a widespread disease of the prostate affecting men’s sexual and reproductive health worldwide. Its leading causes are urogenital tract infections by microorganisms with a prostate tropism. This study aimed to evaluate semen parameters and the factors associated (lifestyle, urogenital infections, and inflammation) with the onset of chronic prostatitis symptoms. This case-control study included seventy-six donors: 30 volunteers with chronic prostatitis and 46 asymptomatic volunteers for urogenital infections as a control group. Sociodemographic, urinary symptoms, pain location, sexual and reproductive health and lifestyle-related variables were collected in a survey. Seminal quality, cytokine levels in semen and serum, and the presence of nineteen microorganisms in the urogenital tract were evaluated. Prostatitis was also associated with poor sperm morphology, more lipoperoxidation of the sperm membrane, and lower serum nitric oxide concentration. In addition, N. gonorrhoeae infection was detected more frequently in semen samples from volunteers with chronic prostatitis. Volunteers with chronic prostatitis report more frequently erectile dysfunction and premature ejaculation, anxiety, depression, and stress compared to the control group. Chronic prostate infections alter the microbiota from the genitourinary tract causing prostatitis, a disease that affects all life areas, including the familiar environment of patients. Chronic prostatitis affects seminal parameters, with a great impact on life quality and sexual and reproductive health. Despite being a relatively unexplored disease, much remains to be clarified regarding its diagnosis and treatment. Alterations in the genitourinary microbiota can favor sexually transmitted infections that produce chronic and systemic inflammation.
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Tsuboi I, Ogawa K, Wada K. Editorial Comment from Dr Tsuboi et al. to Does the microbiota spectrum of prostate secretion affect the clinical status of patients with chronic bacterial prostatitis? Int J Urol 2021; 28:1259-1260. [PMID: 34608679 DOI: 10.1111/iju.14711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ichiro Tsuboi
- Department of Urology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Kohei Ogawa
- Department of Urology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Koichiro Wada
- Department of Urology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
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Togo Y. Editorial Comment from Dr Togo to Does the microbiota spectrum of prostate secretion affect the clinical status of patients with chronic bacterial prostatitis? Int J Urol 2021; 28:1259. [PMID: 34535915 DOI: 10.1111/iju.14703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yoshikazu Togo
- Department of Urology, Kyowakai Medical Corporation Kyoritsu Hospital, Kawanishi, Hyogo, Japan
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Spectrum of Causative Pathogens and Resistance Rates to Antibacterial Agents in Bacterial Prostatitis. Diagnostics (Basel) 2021; 11:diagnostics11081333. [PMID: 34441267 PMCID: PMC8394067 DOI: 10.3390/diagnostics11081333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/05/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathogens of bacterial prostatitis in patients from Southern Europe, the Middle East, and Africa. Materials: 1027 isolates from cultures of urine or expressed prostatic secretion, post-massage urine or seminal fluid, or urethral samples were considered. Results: Escherichia coli (32%) and Enterococcus spp. (21%) were the most common isolates. Other Gram-negative, Gram-positive, and atypical pathogens accounted for 22%, 20%, and 5%, respectively. Resistance was <15% for piperacillin/tazobactam and carbapenems (both Gram-negative and -positive pathogens); <5% for glycopeptides against Gram-positive; 7%, 14%, and 20% for aminoglycosides, fosfomycin, and macrolides against Gram-negative pathogens, respectively; 10% for amoxicillin/clavulanate against Gram-positive pathogens; <20% for cephalosporins and fluoroquinolones against to Gram-negative pathogens (higher against Gram-positive pathogens); none for macrolides against atypical pathogens, but 20% and 27% for fluoroquinolones and tetracyclines. In West Africa, the resistance rates were generally higher, although the highest rates for ampicillin, cephalosporins, and fluoroquinolones were observed in the Gulf area. Lower rates were observed in Southeastern Europe. Conclusions: Resistance to antibiotics is a health problem requiring local health authorities to combat this phenomenon. Knowledge of the spectrum of pathogens and antibiotic resistance rates is crucial to assess local guidelines for the treatment of prostatitis.
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Johri AV, Johri P, Hoyle N, Pipia L, Nadareishvili L, Nizharadze D. Case Report: Chronic Bacterial Prostatitis Treated With Phage Therapy After Multiple Failed Antibiotic Treatments. Front Pharmacol 2021; 12:692614. [PMID: 34177601 PMCID: PMC8222915 DOI: 10.3389/fphar.2021.692614] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/24/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Chronic Bacterial Prostatitis (CBP) is an inflammatory condition caused by a persistent bacterial infection of the prostate gland and its surrounding areas in the male pelvic region. It is most common in men under 50 years of age. It is a long-lasting and debilitating condition that severely deteriorates the patient’s quality of life. Anatomical limitations and antimicrobial resistance limit the effectiveness of antibiotic treatment of CBP. Bacteriophage therapy is proposed as a promising alternative treatment of CBP and related infections. Bacteriophage therapy is the use of lytic bacterial viruses to treat bacterial infections. Many cases of CBP are complicated by infections caused by both nosocomial and community acquired multidrug resistant bacteria. Frequently encountered strains include Vancomycin resistant Enterococci, Extended Spectrum Beta Lactam resistant Escherichia coli, other gram-positive organisms such as Staphylococcus and Streptococcus, Enterobacteriaceae such as Klebsiella and Proteus, and Pseudomonas aeruginosa, among others. Case Presentation: We present a patient with the typical manifestations of CBP. The patient underwent multiple courses of antibiotic treatment without any long-term resolution of his symptoms. Testing of prostatic secretion and semen samples revealed pathogenic bacteria in each case, which collectively included members of the Staphylococcal species such as Methicillin resistant Staphylococcus aureus (MRSA) and Staphylococcus haemolyticus, Enterococcus faecalis, and Streptococcus mitis, among others. Methods and Outcome: Bacteriophage preparations from the Eliava Institute were used to treat the patient after establishing phage sensitivity to the pathogenic bacteria. Significant improvements in symptoms and re-testing of samples after bacteriophage treatment indicated a reduction in the bacterial load and resolution of the infection. Discussion: The patient saw significant improvement of symptoms, and positive dynamics in bacterial titers and ultrasound controls after phage therapy. The failure of antibiotic therapy and subsequent success of bacteriophage therapy in treating chronic bacterial prostatitis shows the effectiveness of bacteriophages in controlling chronic infections in areas of low vascularity and anatomical complexity. These cases also highlight the efficacy of phages in overcoming antibiotic-resistant infections as well as biofilm infections.
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Affiliation(s)
| | | | - Naomi Hoyle
- Eliava Phage Therapy Center, Tbilisi, Georgia
| | - Levan Pipia
- Eliava Phage Therapy Center, Tbilisi, Georgia
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Liu CP, Chen ZD, Ye ZY, He DY, Dang Y, Li ZW, Wang L, Ren M, Fan ZJ, Liu HX. Therapeutic Applications of Functional Nanomaterials for Prostatitis. Front Pharmacol 2021; 12:685465. [PMID: 34140892 PMCID: PMC8205439 DOI: 10.3389/fphar.2021.685465] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/10/2021] [Indexed: 01/02/2023] Open
Abstract
Prostatitis is a common disease in adult males, with characteristics of a poor treatment response and easy recurrence, which seriously affects the patient's quality of life. The prostate is located deep in the pelvic cavity, and thus a traditional infusion or other treatment methods are unable to easily act directly on the prostate, leading to poor therapeutic effects. Therefore, the development of new diagnostic and treatment strategies has become a research hotspot in the field of prostatitis treatment. In recent years, nanomaterials have been widely used in the diagnosis and treatment of various infectious diseases. Nanotechnology is a promising tool for 1) the accurate diagnosis of diseases; 2) improving the targeting of drug delivery systems; 3) intelligent, controlled drug release; and 4) multimode collaborative treatment, which is expected to be applied in the diagnosis and treatment of prostatitis. Nanotechnology is attracting attention in the diagnosis, prevention and treatment of prostatitis. However, as a new research area, systematic reviews on the application of nanomaterials in the diagnosis and treatment of prostatitis are still lacking. In this mini-review, we will highlight the treatment approaches for and challenges associated with prostatitis and describe the advantages of functional nanoparticles in improving treatment effectiveness and overcoming side effects.
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Affiliation(s)
- Chun-Ping Liu
- Department of Urology, Guangzhou Institute of Urology, Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zi-De Chen
- Department of Interventional Radiology, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, South China University of Technology, Guangzhou, China
| | - Zi-Yan Ye
- Department of Interventional Radiology, Cancer Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, South China University of Technology, Guangzhou, China
| | - Dong-Yue He
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yue Dang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhe-Wei Li
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, China
| | - Lei Wang
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Miao Ren
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhi-Jin Fan
- Guangdong Provincial People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Hong-Xing Liu
- Department of Urology, Guangzhou Institute of Urology, Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
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Liu CP, Chen ZD, Ye ZY, He DY, Dang Y, Li ZW, Wang L, Ren M, Fan ZJ, Liu HX. Therapeutic Applications of Functional Nanomaterials for Prostatitis. Front Pharmacol 2021. [DOI: 10.3389/fphar.2021.685465
expr 881861845 + 830625731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Prostatitis is a common disease in adult males, with characteristics of a poor treatment response and easy recurrence, which seriously affects the patient’s quality of life. The prostate is located deep in the pelvic cavity, and thus a traditional infusion or other treatment methods are unable to easily act directly on the prostate, leading to poor therapeutic effects. Therefore, the development of new diagnostic and treatment strategies has become a research hotspot in the field of prostatitis treatment. In recent years, nanomaterials have been widely used in the diagnosis and treatment of various infectious diseases. Nanotechnology is a promising tool for 1) the accurate diagnosis of diseases; 2) improving the targeting of drug delivery systems; 3) intelligent, controlled drug release; and 4) multimode collaborative treatment, which is expected to be applied in the diagnosis and treatment of prostatitis. Nanotechnology is attracting attention in the diagnosis, prevention and treatment of prostatitis. However, as a new research area, systematic reviews on the application of nanomaterials in the diagnosis and treatment of prostatitis are still lacking. In this mini-review, we will highlight the treatment approaches for and challenges associated with prostatitis and describe the advantages of functional nanoparticles in improving treatment effectiveness and overcoming side effects.
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Association of fluoroquinolones use with the risk of aortic aneurysm or aortic dissection: Facts and myths. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2021; 54:182-184. [PMID: 33775552 DOI: 10.1016/j.jmii.2021.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/06/2021] [Indexed: 01/21/2023]
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