Chronic bacterial prostatitis. Clinical and microbiological study of 332 cases

Abstract

Background and objective: Chronic bacterial prostatitis (CBP) is characterized by long-lasting symptoms, frequently associated with psychosomatic disorders. The objective of the study was to study PCB in our environment clinically and microbiologically.

Methods: Between January 2013 and December 2014 761 patients with suspected CBP were studied. Of these patients 332 (43.6%) underwent a complete microbiological study and the major clinical signs and symptoms were collected.

Results: Eighteen point four percent of patients were diagnosed microbiologically with CBP, Enterococcus faecalis being the main aetiologic agent (37.7%), followed by Escherichia coli (22.2%). Ninety-six point seven percent of the CBP had positive semen cultures, while only 22.9% had positive urine post-semen cultures. Data of sensitivity, specificity, positive predictive value and negative predictive value of semen were 96.7%, 95.9%, 84.3% and 99.3%, respectively and urine post-semen 22.9%, 99.3%, 87.5% and 85.1%, respectively. Testicular perineum pain (44.3%), ejaculatory discomfort (27.9%) and haemospermia (26.2%) were highlighted as the patients' main clinical manifestations.

Conclusions: Fractionated culture for the microbiological diagnosis of CBP could be simplified by the culture of urine pre-semen and semen, without the need for the culture of urine post-semen. The main aetiologic agent of CBP in our media was Enterococcus faecalis, followed by Escherichia coli.

Keywords: Chronic bacterial prostatitis; Cultivo; Culture; Microorganismos; Microorganisms; Orina; Prostatitis crónica bacteriana; Semen; Urine.

Fundamento y objetivos: La prostatitis crónica bacteriana (PCB) se caracteriza por una clínica de larga duración,frecuentemente asociada a trastornospsicosomáticos. El objetivodel estudio fue estudiar clínica y microbiológicamente la PCB en nuestro medio. Métodos: Entre enero de 2013 y diciembre de 2014 se estudiaron 761 pacientes con sospecha de PCB. De ellos, 332 (43,6%) fueron sometidos a un estudio microbiológico completo y se recogieron los principales signos y síntomas clínicos. Resultados: Un 18,4% de los pacientes fueron diagnosticados microbiológicamente de PCB, siendo Entero coccus faecalis el principal agente etiológico (37,7%), seguido de Escherichia coli (22,2%). El 96,7% de las PCB presentaron cultivos de semen positivos, mientras que tan solo un 22,95% tuvieron cultivos de orina postsemen positivos. Los datos de sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo del cultivo de semen fueron 96,7; 95,9; 84,3 y 99,3% respectivamente; y del cultivo de la orina postsemen 22,9; 99,3; 87,5 y 85,1% respectivamente. Destacaron el dolor perineotesticular (44,3%) de los pacientes, molestias eyaculatorias (27,9%) y la hemospermia (26,2%) como principales manifestaciones clínicas de los pacientes con estudio microbiológico significativo