Aetiological Diagnosis of the U-EPS-S Test in Patients with Chronic Prostatitis-Like Symptoms

Abstract

Background: Prostate examination is considered to be most important in the diagnosis and differential diagnosis of patients with chronic prostatitis-like symptoms, and little attention has been given to other genital organ examinations for these patients. We speculate that this may be an important factor affecting the treatment effect of chronic prostatitis. Methods: We randomly selected 200 patients with chronic prostatitis-like symptoms from the clinic services of hospitals in China for this study and used a urine-prostate-semen test (U-EPS-S test) to collect urine, prostatic secretion and semen specimens. The specimens were inoculated into a suitable medium culture for bacteriological/fungal localization detection, and the number and distribution of colonies in each isolation culture were observed. The gene assay by PCR was used to further identify the Chlamydia and the species of Neisseria and Candida. Findings: All of these patients had an infection of the internal genital organs, and the infection rate was 100%. Of these, prostatic secretion-positive isolation cultures were obtained in 66 cases (33%), semen-positive isolation cultures were obtained in 34 cases (17%), and prostatic secretion- and semen-positive isolation cultures were obtained in 100 cases (50%). In these patients, gram-positive microbes were the most common pathogens, accounting for 91.1%. Positive isolation cultures of more than two kinds of microbes occurred in 107 cases, and multiple microbial infections (MMIs) accounted for 53.5%. Positive isolation cultures of semen and both prostatic secretions and semen occurred in 134 cases, and multi-organ infections (MOIs) accounted for 67%. Interpretations: In patients with chronic prostatitis symptoms, there was a high incidence of MMI and MOI caused by resistant strains of different microbial species, and gram-positive microbes were the most common causative agents. Neglecting semen sample collection and posttherapy pathogen redetection are important factors leading to missed diagnosis and misdiagnosis of patients and thus treatment failure. Funding: This study was supported by the Science and Technology Department of Guizhou Province of China (SY[2001]3045) and Health Department of Guizhou Province of China (gzwkj2009-1-028) and State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention (2011SKLID302). Declaration of Interest: We declare no competing interests. Ethical Approval: This protocol was evaluated and approved by the ethics committee of Guizhou Medical University.