Spectrum of Causative Pathogens and Resistance Rates to Antibacterial Agents in Bacterial Prostatitis.

Alberto Trinchieri,Soni Murdeshwar,Krishanu Das,Idrissa Sissoko,Ognyan Gatsev,Ivanka Gergova,Iliya Saltirov,Panagiotis Mourmouris,Khalid Mohammed Abdelrahman,Gianpaolo Perletti,Kamran Hassan Bhatti,Jibril O Bello,Vittorio Magri,Konstantinos Stamatiou,Nikos Mourmouras,Noor Buchholz

doi:10.3390/diagnostics11081333

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.

Highlights

Infection is microbiologically proven in approximately 10% of patients presenting with prostatitis-like symptoms [1]
Parenteral administration of high doses of broad-spectrum penicillins, third-generation cephalosporines, or fluoroquinolones is recommended in the acute phase, followed by an oral regimen with a susceptible antibiotic for at least four weeks [8]
Prostatic secretions expressed by prostate massage (EPS), urine evacuated after prostate massage (VB3), seminal fluid and urethral specimens were analyzed

Summary

Introduction

Infection is microbiologically proven in approximately 10% of patients presenting with prostatitis-like symptoms [1]. Acute prostatitis is characterized by urinary tract symptoms, pain, fever, malaise, and general symptoms. Patients present with features of sepsis requiring hospitalization [2]. Mid-stream urine culture yields a diagnosis in most cases. Escherichia coli is the most frequent pathogen in acute prostatitis. Other Enterobacteriacae may be causative, while Pseudomonas aeruginosa is less frequent, usually secondary to recent urological instrumentations. The rate of Gram-positive pathogens is approximately 5% [2]

Methods

Findings

Discussion

Conclusion