Korean J Urogenit Tract Infect Inflamm.  2014 Apr;9(1):21-26. 10.14777/kjutii.2014.9.1.21.

Chronic Bacterial Prostatitis

Affiliations
  • 1Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. tigerhj@dreamwiz.com

Abstract

Men with prostatitis-like symptoms who had uropathogenic bacteria localized to the prostate gland by elaborate collection and culturing techniques were diagnosed with chronic bacterial prostatitis. Chronic bacterial prostatitis is characterized by prolonged or recurrent symptoms and relapsing bacteriuria. Chronic bacterial prostatitis is caused mainly by Gram-negative uropathogens. For treatment, fluoroquinolones are considered the drug of choice because of their favorable pharmacokinetic properties and antimicrobial spectrum, with the best evidence supporting ciprofloxacin and levofloxacin. Despite conduct of intensive investigations, our knowledge regarding the diagnostic ability to differentiate bacterial from nonbacterial prostatitis, the relevance of nontraditional uropathogens, and the relationship between uropathogens localized to the prostate and recurrent urinary tract infection is still limited. In this paper, we reviewed the new concepts associated with chronic bacterial prostatitis and explored the evolution of our understanding of the etiology, diagnosis, and treatment of this significant urologic disease.

Keyword

Prostatitis; Etiology; Therapeutics

MeSH Terms

Bacteria
Bacteriuria
Ciprofloxacin
Diagnosis
Fluoroquinolones
Humans
Levofloxacin
Male
Prostate
Prostatitis*
Urinary Tract Infections
Urologic Diseases
Ciprofloxacin
Fluoroquinolones

Reference

1. Woo YN. Prostatitis. Korean J Urol. 1994; 35:575–85.
2. Krieger JN, Riley DE, Cheah PY, Liong ML, Yuen KH. Epidemiology of prostatitis: new evidence for a world-wide problem. World J Urol. 2003; 21:70–4.
3. Millán-Rodríguez F, Palou J, Bujons-Tur A, Musquera-Felip M, Sevilla-Cecilia C, Serrallach-Orejas M, et al. Acute bacterial prostatitis: two different sub-categories according to a previous manipulation of the lower urinary tract. World J Urol. 2006; 24:45–50.
Article
4. Nickel JC, Downey J, Hunter D, Clark J. Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. J Urol. 2001; 165:842–5.
Article
5. The Korean Society of Infectious Diseases; The Korean Society for Chemotherapy; Korean Association of Urogenital Tract Infection and Inflammation; The Korean Society of Clinical Microbiology. Clinical guideline for the diagnosis and treatment of urinary tract infections: asymptomatic bacteriuria, uncomplicated & complicated urinary tract infections, bacterial prostatitis. Infect Chemother. 2011; 43:1–25.
6. Nickel JC, Moon T. Chronic bacterial prostatitis: an evolving clinical enigma. Urology. 2005; 66:2–8.
Article
7. Terai A, Ishitoya S, Mitsumori K, Ogawa O. Molecular epide-miological evidence for ascending urethral infection in acute bacterial prostatitis. J Urol. 2000; 164:1945–7.
Article
8. Kirby RS, Lowe D, Bultitude MI, Shuttleworth KE. Intra-prostatic urinary reflux: an aetiological factor in abacterial prostatitis. Br J Urol. 1982; 54:729–31.
Article
9. Lobel B, Rodriguez A. Chronic prostatitis: what we know, what we do not know, and what we should do! World J Urol. 2003; 21:57–63.
10. Guo H, Xu YM, Ye ZQ, Yu JH, Fu Q, Sa YL, et al. Heat-shock protein 70 expression in the seminal plasma of patients with chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome. Prostate Cancer Prostatic Dis. 2010; 13:338–42.
Article
11. Cho YH, Lee SJ, Lee JY, Kim SW, Lee CB, Lee WY, et al. Antibacterial effect of intraprostatic zinc injection in a rat model of chronic bacterial prostatitis. Int J Antimicrob Agents. 2002; 19:576–82.
Article
12. Kim SI, Yim SH, Sohn DW, Lee SJ, Ha US, Han CH, et al. Preventive effect on inflammation and anti-inflammatory and anti-microbial effects of garlic extract in a rat model of chronic bacterial prostatitis. Korean J Urol. 2009; 50:602–8.
Article
13. Yoon BI, Ha US, Sohn DW, Lee SJ, Kim HW, Han CH, et al. Anti-inflammatory and antimicrobial effects of nanocatechin in a chronic bacterial prostatitis rat model. J Infect Chemother. 2011; 17:189–94.
Article
14. Han CH, Yang CH, Sohn DW, Kim SW, Kang SH, Cho YH. Synergistic effect between lycopene and ciprofloxacin on a chronic bacterial prostatitis rat model. Int J Antimicrob Agents. 2008; 31(Suppl 1):S102–7.
Article
15. Nickel JC, Costerton JW. Coagulase-negative staphylococcus in chronic prostatitis. J Urol. 1992; 147:398–400. discussion 400-1.
Article
16. Ha US, Kim ME, Kim CS, Shim BS, Han CH, Lee SD, et al. Acute bacterial prostatitis in Korea: clinical outcome, including symptoms, management, microbiology and course of disease. Int J Antimicrob Agents. 2008; 31(Suppl 1):S96–101.
Article
17. Ruiz J, Simon K, Horcajada JP, Velasco M, Barranco M, Roig G, et al. Differences in virulence factors among clinical isolates of Escherichia coli causing cystitis and pyelonephritis in women and prostatitis in men. J Clin Microbiol. 2002; 40:4445–9.
18. Johnson JR, Kuskowski MA, Gajewski A, Soto S, Horcajada JP, Jimenez de Anta MT, et al. Extended virulence genotypes and phylogenetic background of Escherichia coli isolates from patients with cystitis, pyelonephritis, or prostatitis. J Infect Dis. 2005; 191:46–50.
19. Nickel JC, Costerton JW. Bacterial localization in antibiotic-refractory chronic bacterial prostatitis. Prostate. 1993; 23:107–14.
Article
20. Nickel JC, Costerton JW, McLean RJ, Olson M. Bacterial biofilms: influence on the pathogenesis, diagnosis and treatment of urinary tract infections. J Antimicrob Chemother. 1994; 33(Suppl A):31–41.
Article
21. Soto SM, Smithson A, Martinez JA, Horcajada JP, Mensa J, Vila J. Biofilm formation in uropathogenic Escherichia coli strains: relationship with prostatitis, urovirulence factors and antimicrobial resistance. J Urol. 2007; 177:365–8.
Article
22. Mazzoli S. Biofilms in chronic bacterial prostatitis (NIH-II) and in prostatic calcifications. FEMS Immunol Med Microbiol. 2010; 59:337–44.
Article
23. Bundrick W, Heron SP, Ray P, Schiff WM, Tennenberg AM, Wiesinger BA, et al. Levofloxacin versus ciprofloxacin in the treatment of chronic bacterial prostatitis: a randomized double-blind multicenter study. Urology. 2003; 62:537–41.
Article
24. Nickel JC, Alexander RB, Schaeffer AJ, Landis JR, Knauss JS, Propert KJ. Chronic Prostatitis Collaborative Research Network Study Group. Leukocytes and bacteria in men with chronic prostatitis/chronic pelvic pain syndrome compared to asymptomatic controls. J Urol. 2003; 170:818–22.
Article
25. Nickel JC, Xiang J. Clinical significance of nontraditional bacterial uropathogens in the management of chronic prostatitis. J Urol. 2008; 179:1391–5.
Article
26. Krieger JN, Ross SO, Limaye AP, Riley DE. Inconsistent localization of gram-positive bacteria to prostate-specific specimens from patients with chronic prostatitis. Urology. 2005; 66:721–5.
Article
27. Shurbaji MS, Gupta PK, Myers J. Immunohistochemical demonstration of Chlamydial antigens in association with prostatitis. Mod Pathol. 1988; 1:348–51.
28. Ohkawa M, Yamaguchi K, Tokunaga S, Nakashima T, Fujita S. Ureaplasma urealyticum in the urogenital tract of patients with chronic prostatitis or related symptomatology. Br J Urol. 1993; 72:918–21.
29. Potts JM, Sharma R, Pasqualotto F, Nelson D, Hall G, Agarwal A. Association of ureaplasma urealyticum with abnormal reactive oxygen species levels and absence of leukocytospermia. J Urol. 2000; 163:1775–8.
Article
30. Krieger JN, Riley DE. Prostatitis: what is the role of infection. Int J Antimicrob Agents. 2002; 19:475–9.
Article
31. Weidner W, Diemer T, Huwe P, Rainer H, Ludwig M. The role of Chlamydia trachomatis in prostatitis. Int J Antimicrob Agents. 2002; 19:466–70.
Article
32. Goto T, Nakame Y, Nishida M, Ohi Y. Bacterial biofilms and catheters in experimental urinary tract infection. Int J Antimicrob Agents. 1999; 11:227–31. discussion 237-9.
Article
33. Lipsky BA, Byren I, Hoey CT. Treatment of bacterial prostatitis. Clin Infect Dis. 2010; 50:1641–52.
Article
34. Naber KG, Roscher K, Botto H, Schaefer V. Oral levofloxacin 500 mg once daily in the treatment of chronic bacterial prostatitis. Int J Antimicrob Agents. 2008; 32:145–53.
35. Naber KG. European Lomefloxacin Prostatitis Study Group. Lomefloxacin versus ciprofloxacin in the treatment of chronic bacterial prostatitis. Int J Antimicrob Agents. 2002; 20:18–27.
Article
36. Skerk V, Schönwald S, Krhen I, Markovinović L, Barsić B, Mareković I; I, et al. Comparative analysis of azithromycin and clarithromycin efficacy and tolerability in the treatment of chronic prostatitis caused by Chlamydia trachomatis. J Chemother. 2002; 14:384–9.
37. Skerk V, Schönwald S, Krhen I, Banaszak A, Begovac J, Strugar J, et al. Comparative analysis of azithromycin and ciprofloxacin in the treatment of chronic prostatitis caused by Chlamydia trachomatis. Int J Antimicrob Agents. 2003; 21:457–62.
Article
38. Skerk V, Krhen I, Lisić M, Begovac J, Roglić S, Skerk V, et al. Comparative randomized pilot study of azithromycin and doxycycline efficacy in the treatment of prostate infection caused by Chlamydia trachomatis. Int J Antimicrob Agents. 2004; 24:188–91.
39. Kolumbić Lakos A, Skerk V, Maleković G, Dujnić Spoljarević T; T, Kovacic D, Pasini M, et al. A switch therapy protocol with intravenous azithromycin and ciprofloxacin combination for severe, relapsing chronic bacterial prostatitis: a prospective non-comparative pilot study. J Chemother. 2011; 23:350–3.
40. Lee G. Ciprofloxacin resistance in Enterococcus faecalis strains isolated from male patients with complicated urinary tract infection. Korean J Urol. 2013; 54:388–93.
41. Lee SJ, Lee KS, Jeong SJ, Lee SE, Cho YH. In-vitro activity of tosufloxacin compared with levofloxacin and ofloxacin against uropathogens, isolated from acute uncomplicated cystitis in female outpatients. Infect Chemother. 2007; 39:202–7.
42. Yoon BI, Kim S, Han DS, Ha US, Lee SJ, Kim HW, et al. Acute bacterial prostatitis: how to prevent and manage chronic infection? J Infect Chemother. 2012; 18:444–50.
Article
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