Seminal microflora in chronic prostatitis patients

Authors: Silver Türk   Krista Lõivukene   Elve Raukas   Paul Korrovits   Margus Punab   Reet Mändar  

Chronic prostatitis is a frequent but poorly understood syndrome whose etiology is largely unknown. Traditional urinary tract pathogens (Enterobacteriaceae or Enterococcus) are found in only ten per cent of the patients. 

AIMS. Our aim was to find out associations between prostatitis and microorganisms beyond routine cultures – anaerobic bacteria, mycoplasmas and coryneform bacteria.

METHODS. Complex mic robiological investigations of semen were performed including quantitative cultures of full microflora, the Mycoplasma IST test (BioMerieux) and the PCR method.

RESULTS. In the semen of prostatitis patients abundant polymicrobial communities were found where microbial concentrations and the number of different species were much higher than in controls. Mycoplasmas were found more frequently in prostatitis patients compared with controls and some species were strongly associated with prostatitis – Ureaplasma par vum ja Mycoplasma genitalium. Of the coryneform bacteria, the Corynebacterium group G was detected more frequently in prostatitis patients than in controls. In addition, nine species of coryneforms were found at high concentrations  in prostatitis patients versus only four species in controls. Coryneform bacteria were frequently non-susceptible to fluoroquinolons which are frequently used in treatment of prostatitis; instead, they were highly susceptible to penicillins and TMP-SMX.

CONCLUSIONS. Most probably, chronic prostatitis has an important infectious component since these pat ients have abundant polymicrobial microbiocenoses containing both anaerobic and aerobic bacter ia. Coryneform bacter ia form a significant proportion of this microbiota and the Corynebacterium group G may be involved in the etiopathogenesis of prostatitis as one component of this microbiota. Some mycoplasma species, e.g. U. parvum and M. genitalium, may par ticipate in the etiology of chronic prostatitis.

Eesti Arst 2010; 89(2):83−94