Chronic Bacterial Prostatitis Research Articles

Состояние микробиоты секрета предстательной железы у больных хроническим бактериальным простатитом до и после антибактериального лечения

Introduction. The effect of antibiotics on the microbiota of different organs is the subject of close attention and an urgent problem of modern medicine. The literature mainly contains works related to the effect of antibiotics on the intestinal microflora and some other organs other than the genitourinary organs. On the other hand, the microbiota of many organs, including the prostate, largely depends on the gut microbiota. Objective: to conduct a comparative analysis of the microbiota of prostate secretion (PS) in patients with chronic bacterial prostatitis (CBP) before and after antibacterial treatment. Material and methods. A prospective study of PS was conducted in 38 patients with CBP aged 25 to 50 years. The study of the microbiota of prostate secretion was carried out using cultural methods, real-time PCR and using a gas chromatograph of the Maestro mass spectrometer (Interlab LLC, Russia), by the methods of mass-spectrometry microbes markers (MSMM). Results. According to the statistical analysis of absolute indicators obtained from the MSMM data, a sharp decrease in the number of almost all groups of microorganisms (MO) has been established. At the same time, the level of the cocco-bacillary group decreased from 1,049.50 x cells/g to 142.00 x 105 cells/g, the level of anaerobes from 1,638.00 to 221.50, the level of actinobacteria from 197.00 to 40.00, the level of enterobacteria from 452.50 to 87.00, the level of gram-negative rods from 79.00 to 25.00, the level of fungi and yeast from 56.00 to 23.00, the level of viruses from 24.50 to 3.00x105 cells/g (p <0.0001; p = 0.0004; p = 0.0033; p = 0.0007; p <0.0001). In addition, there was a decrease in the level of resident MO, transient opportunistic, normally non-occurring MO and MO sum, as well as a decrease in the level of plasmologens and endotoxin sum (p <0.0001). When analyzing the relative value in the microbiome of individual MO, a decrease in the proportion of cocco-bacillar flora, actinobacteria, enterobacteria, viruses, transient and normally non-occurring microorganisms was noted, while the proportion of grams of negative rods increased by 48.4% (p = 0.0033), fungi and yeast by 74.4% (p<0.0001), anaerobes by 6.3% (p<0.0001), resident bacteria by 5.3% (p<0.0001). The decrease in the level of plasmologen reached 63.9% (p<0.0001), endotoxin 64.3% (p<0.0001). Conclusion. The analysis showed that antibiotics lead to a decrease in the level of absolute values in almost all microorganisms, regardless of belonging to different taxonomic groups, while the relative values in some groups increase and in others decrease. Keywords: microbiota, prostate secretion, gas chromatography-mass spectrometry, microorganisms.

Etiological diagnosis of prostatitis: current methods and ethical evaluation

The incidence of acute and chronic bacterial prostatitis in the juvenile and adult population is steadily increasing. This phenomenon is related to changing sexual habits. The clinical diagnosis of acute prostatitis is quite simple, both because of the characteristic symptomatology (fever with chills, sacral rachialgia, perineal pain) and the semeiological data of the rectal exploration. Prostate ultrasound may finally help to settle a doubt.

Resolution of Chronic Bacterial Prostatitis with Bacteriophage-antibiotic Therapy

Chronic bacterial prostatitis is a commonly diagnosed genitourinary infection that presents significant challenges both in diagnosis and treatment. In an upcoming era of antibiotic resistance, and limited therapeutic options it becomes imperative to revise current guidelines and to provide more effective treatment strategies. At the Eliava Phage Therapy Center (Tbilisi, Georgia) we utilize bacteriophage therapy as an alternative approach against chronic bacterial infections. Bacteriophages, viruses that target and lyse specific bacterial cells, can be used as a stand-alone treatment or in conjunction with antibiotics. We present a case report of a patient with prostatitis caused by Escherichia coli infection, who prior to addressing our clinic, has been receiving antibiotic therapy without any positive effect. Our approach of combined use of antibiotics and phages was successful not only in complete clinical improvement but also in total bacterial eradication. This outcome shows the potential of bacteriophage therapy as a valuable adjunct to conventional antibacterials in the management of prostatitis.

Pathogenicity factors and antibiotic resistance strains of <i>Enterococcus faecalis</i> isolated from prostate secretions in males with chronic bacterial prostatitis

Pathogenicity factors and antibiotic resistance strains of <i>Enterococcus faecalis</i> isolated from prostate secretions in males with chronic bacterial prostatitis

Fabrication and application of targeted ciprofloxacin nanocarriers for the treatment of chronic bacterial prostatitis

Pathogenic bacteria cause chronic bacterial prostatitis (CBP). CPB is characterized by urinary tract infection and persistence of pathogenic bacteria in prostatic secretion. Owing to poor blood supply to the prostate gland and limited drug penetration, CBP treatment is difficult. Transferosomes are ultradeformable vesicles for nanocarrier applications, which have become an important area of nanomedicine. Such carriers are specifically targeted to the pathological area to provide maximum therapeutic efficacy. It consists of a lipid bilayer soybean lecithin phosphatidylcholine (PC), an edge activator Tween 80 with various ratios, and a chloroform/methanol core. Depending on the lipophilicity of the active substance, it can be encapsulated within the core or among the lipid bilayer. Due to their exceptional flexibility, which enables them to squeeze themselves through narrow pores that are significantly smaller than their size, they can be a solution. One formulation (Cipro5 PEG) was selected for further in vitro analysis and was composed of phosphatidylcholine (PC), Tween 80, and polyethylene glycol-6 stearate (PEG-6 stearate) in a ratio of 3:3:1 in a chloroform/methanol mixture (1:2 v/v). In vitro, the results showed that PEGylated transferosomes had faster drug release, higher permeation, and increased bioavailability. The transferosomes were quantified with a particle size of 202.59 nm, a zeta potential of-49.38 mV, and a drug entrapment efficiency of 80.05%. The aim of this study was to investigate drug targeting. Therefore, Monoclonal antibody IgG was coupled with Cipro5 PEG, which has specificity and selectivity for conjugated nanoparticles. In vivo, a total of twenty-five adult Wistar rats were obtained and randomly divided into 5 groups, each of 5 rats at random: the control group, blank group, positive control group, Cipro 5PEG group, and Cipro 5PEG coupled with IgG antibody group. The cytokines levels (IL-1β, IL-8, and TNF-α) in the serum were detected by analysis kits. Compared with the control group, treatment with Cipro 5PEG coupled with the IgG antibody could significantly inhibit cytokines, according to histological analysis. Cipro 5PEG, coupled with the IgG antibody group, reduced prostate tissue inflammation. Hence, our results show a promising approach to delivering antibiotics for the targeted therapy of CBP.

Effectiveness of Wobenzym in combined therapy of chronic bacterial prostatitis. Results of systematic review and meta-analysis

A systematic review and meta-analysis of research data on the effectiveness of the drug Wobenzym in the treatment of chronic bacterial prostatitis was performed. The aim of this study to evaluate the effectiveness of Wobenzym in the complex therapy of chronic bacterial prostatitis. The analysis included randomized and non-randomized controlled studies of the effectiveness of Wobenzim in the complex therapy of chronic bacterial prostatitis. The search was carried out in the databases CENTRAL, PubMed, ICTRP, eLibrary, ClinicalTrials.gov., Google Scholar, CyberLeninka, search engines. The meta-analysis was conducted using the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Statistical heterogeneity was assessed using the Cochran test and visually when constructing forest plots. A random effects model and a fixed effect model were used. Works published over the entire period were analyzed, 712 publications were identified, of which 9 fully met the stated criteria, all studies were non-randomized controlled. The final analysis included the results of 1292 patients. According to the meta-analysis, it was possible to establish the superiority of complex therapy including Wobenzym compared to therapy without Wobenzym in all studied parameters: eradication of the pathogen, decrease in the number of points on the Quality of Life (QoL) scale, an increase in the linear speed of blood flow in the veins and peak systolic blood flow velocity in the arteries of the prostate gland, maximum urine flow rate, reduction in the number of points of the NIH-CPSI “Pain” subscale (difference 5 points) and NIH-CPSI “Quality of Life” subscale. The use of therapy including Wobenzym in patients with chronic prostatitis leads to a greater increase in the number of CD4+, CD8+ lymphocytes, phagocytic activity of lymphocytes, the level of complement CH-100 and immunoglobulins M, G, A. A systematic review/meta-analysis revealed an objective, statistically significant, positive effect of the drug Wobenzym in the complex therapy of patients with chronic bacterial prostatitis, which is associated with its pathogenetic orientation in relation to this group of patients.

The harmful effects of overlooking acute bacterial prostatitis.

Prostatitis is a major urological disease affecting 25%-50% of men over their lifetime. However, prostatitis is often overlooked in nonurologic departments due to its sometimes indeterminate symptoms. In this review, we describe how to recognize and treat acute bacterial prostatitis, which manifests as a clinical problem in other departments as well as urology, to help prevent this disease from being overlooked. There are several possible negative effects of not recognizing acute bacterial prostatitis (ABP). First, initial treatment can fail. In the hyperacute phase, common antibiotics are often effective, but in rare cases, such antibiotics may not be effective. In addition, once ABP progresses to form a prostate abscess, potentially avoidable surgical interventions are often needed. A second issue is the transition to chronic prostatitis. If chronic bacterial prostatitis progresses, treatment requires long-term antibiotic administration and the response rate is not high. Some patients may have to deal with urinary tract infections for the rest of their lives. Finally, there is the problem of overlooking the underlying disease. ABP is rare in healthy adult men without underlying disease, including sexually transmitted diseases as well as benign prostatic hyperplasia, urinary stones, and malignant tumors, and may not be obvious. When examining patients with fever of unknown origin, it is necessary to exclude not only infectious diseases but also collagen diseases and malignant tumors. If there are any doubts, we recommend a rectal exam and consultation with a urologist.

Quality of life of the patients with chronic prostatitis under the influence of complex balneopeloid and enzyme therapy with Longidase

BACKGROUND: In modern medicine, among the main indicators of the effectiveness of therapeutic measures, the quality of life of the patient is singled out, which allows determining the degree of recovery of physical and mental health after treatment of acute conditions.
 AIM: to evaluate the effectiveness of complex balneopeloid and enzyme therapy with longidase according to the monitoring of the quality of life of the patients suffering from chronic bacterial prostatitis.
 MATERIALS AND METHODS: There have been observed 54 patients with chronic prostatitis. They were divided into 2 groups by simple randomization: in the comparison group (n=26) the patients were prescribed exercise therapy, internal and external administration of mineral water of Zheleznovodsk type, peloidotherapy with silt sulfide mud topically, antibiotic therapy with ceftriaxone, phytomicroclysters; in the main group (n=28), the patients additionally underwent antibiotic and enzyme therapy by peripheral indirect lymphotropic therapy. The efficiency was assessed using validated Quality of Life questionnaires: Chronic Prostatitis Symptom Scale (NIH-CPS) and SF-36 General Health Questionnaire (Social Functioning-36).
 RESULTS: The analysis of the clinical effect of the new treatment technology revealed its advantage over the standardized therapy, which is proven by the monitoring of QoL indicators for 1 year after the spa treatment: recovery of QoL in the main group immediately after the treatment occurred by 59.7% (p 0.01), 6 months later ― by 72.7% (p 0.01), with a slight decrease in the rate in 12 months ― by 64.9% (p 0.01). The dynamics of physical and mental health indicators on the SF-36 scale was also observed with the same degree of confidence: compared with the baseline, the average improvement was 25.5% (p 0.01), 33.6% (p 0.01) and 27.3% (p 0.01) respectively. In the comparison group, the dynamics of indicators for all NIH-CPSI and SF-36 scales was also significant, but lower than similar indicators in the main group by 23–25% on average (p 0.01) and 12–15%, respectively.
 CONCLUSION: The results of the study indicate the high effectiveness of complex balneopeloid and lymphotropic therapy with the patients suffering from chronic prostatitis at the stage of spa treatment.

The Effect of Chronic Bacterial Prostatitis on Levels Antioxidant in Adult Men: A Meta-Analysis of Case-control Studies

Globally, adult males are frequently affected with chronic bacterial prostatitis (CBP), a prevalent urological illness. It is believed that the inflammatory reaction linked to CBP causes oxidative stress, which may change the impacted people's levels of enzyme antioxidants the Effect of Chronic Bacterial Prostatitis on Levels Enzymatic Antioxidant. From October - 2022 to August - 2023, examined 270 clinical samples from subjects males (adults). Two groups were divided: the first group consisted of 180 male patients. In contrast, the second group consisted of 90 healthy males (adults). Blood samples of (3-5) ml were collected from all participants and the levels of zinc, selenium, glutathione peroxidase GPx, superoxide dismutase SOD, and catalase CAT were measured. The results showed that the levels of zinc, selenium, GPx, SOD, and CAT in men with chronic bacterial prostatitis were significantly lower than those in the control group of patients who were visited after ethical treatment at AL-Sader Medical City in Najaf Governorate. Aspects approved by the Medical Ethics Committee of the Iraqi Ministry of Health. The aim of this meta-analysis is to statistically evaluate and in-depth examine the case-control studies conducted so far regarding the effects of CBP on the levels of enzymatic antioxidants in adult men.

Современные возможности лечения доброкачественной гиперплазии предстательной железы и симптомов нижних мочевыводящих путей: новые данные и опыт клинического применения гексанового экстракта плодов Serenoa repens

The article discusses the pharmacological properties and results concerning the clinical use of a medicinal herbal preparation — hexane extract of Serenoa repens (HESr) (creeping palm fruit). In recent years, quite a lot of research data has been accumulated indicating a multicomponent mechanism of drug action. It has been found to have antiandrogenic, antiproliferative and anti-inflammatory effects in the tissues of the prostate gland (pancreas). Studies have been published describing a new mechanism of action of HESr — antineurogenic, the implementation of which helps to reduce infravesical obstruction, leads to inhibition of α1-adrenergic, thromboxane-induced and cholinergic contraction of the pancreatic and detrusor smooth muscles, and also inhibits the growth of pancreatic stromal cells. At present, there is evidence proving the highest clinical efficacy level of the HESr (data from several meta-analyses). The listed effects and patterns of HESr are illustrated by clinical examples of prescribing this drug to patients with lower urinary tract symptoms and benign pancreatic hyperplasia. The safety of use in conditions of polypragmasy in a comorbid patient, the possibility of long-term use without the adverse events occurrence and ensuring a higher life quality while maintaining full sexual function are also particularly noted. KEYWORDS: lower urinary tract symptoms, benign prostatic hyperplasia, chronic bacterial prostatitis, hexane extract of Serenoa repens fruit, ejaculation, life quality. FOR CITATION: Amdiy R.E., Simanov R.N. Modern treatment options for benign prostatic hyperplasia and lower urinary tract symptoms: new data and clinical picture of the hexane extract of Serenoa repens fruit. Russian Medical Inquiry. 2024;8(4):228–234 (in Russ.). DOI: 10.32364/2587-6821-2024-8-4-7.

Surgical management of National Institutes of Health category II chronic bacterial prostatitis: a case series and scoping review of the literature.

National Institutes of Health (NIH) category II prostatitis refractory to antibiotic therapy can be challenging to treat. We present the outcomes from a case series of men who have undergone various surgical therapies to treat this condition. Additionally, we performed a scoping review of studies describing the characteristics and outcomes of patients surgically treated for chronic bacterial prostatitis (CBP). This is a single-center retrospective case series of adult patients at Cleveland Clinic Glickman Urological and Kidney Institute with refractory NIH category II prostatitis managed with surgical intervention. PubMed was queried and all resulting articles were analyzed for relevance and parallel study designs. Twelve subjects underwent endoscopic procedures. Two of 12 (16.7%) subjects had CBP recurrence with E. Coli at 12 and 60 months; both patients initially had prostatic stones. One patient with CBP recurrence developed a urethral stricture. Seven subjects were treated with nerve-sparing robotic radical prostatectomy of whom two had concomitant prostate cancer. Three subjects had prostate stones, two of which extended beyond the surgical capsule. E. coli was the isolated pathogen for six patients with two of these being multi-drug resistant (MDR) E. coli. One patient in this group experienced recurrent urinary tract infections (UTIs) despite the surgery. Scoping review of available articles consistently failed to mention definitive diagnosis of CBP with prostatic secretion cultures or even urine cultures prior to surgical intervention and no studies were found on the curative outcomes of surgical intervention. Our study provides one of the first single-center retrospective case series of patients with antibiotic refractory NIH category II CBP managed with surgical intervention. Overall, rate of cure between all surgical modalities was 84% (n=16). When disease is confined to the surgical capsule, endoscopic management is likely sufficient. Radical prostatectomy expectedly increased rates of postoperative erectile dysfunction and stress urinary incontinence compared to endoscopic intervention. However, in patients with disease beyond the capsule and/or concomitant prostate cancer, prior endoscopic treatment, or life-threatening UTI, radical prostatectomy may be justified.

SIgA-protease activity of microorganisms isolated from the prostate secretion

Our aim was to characterize the ability of bacteria from prostate secretions of different taxonomic affiliations to inactivate secretory IgA (sIgA). Materials and methods: We performed experiments with 122 isolates of eight types of microorganisms isolated from prostate secretions of the patients with chronic bacterial prostatitis (CBP) and healthy males. The bacterial spectrum of microbiota was studied by bacteriological techniques, the species identification of microorganisms was carried out by mass spectrometry. The sIgA-protease activity of microorganisms was determined by the enzyme immunoassay using the “IgA secretory – ELISA-BEST” kit. Results: A wide prevalence of sIgA-protease activity has been detected in the microorganisms of different types isolated from prostate secretions of patients with CBP and healthy males. E. faecalis was the most active producer of sIgA proteases. We revealed an intraspecific and interspecific variability of the levels of sIgA-protease activity among Staphylococci. The microorganisms isolated from CBP were shown to express a significantly more pronounced ability to inactivate sIgA compared to strains isolated from healthy men.

Prospects of oral fosfomycin for the treatment of chronic bacterial prostatitis

The most frequent causative agent of chronic bacterial prostatitis is Escherichia coli, however, in recent years, the proportion of other gram-negative and gram-positive microorganisms in the structure of pathogens has been increasing. There is not only an increase in the proportion of extended-spectrum β-lactamases producing Escherichia coli, which ensures the resistance of bacteria to penicillins, cephalosporins and aztreonam, but also carbapenemases producing strains. The tendency of increasing resistance of uropathogens to fluoroquinolones is noted. An alternative for the treatment of bacterial prostatitis may be fosfomycin, which is due to its high bioavailability when taken orally and the ability to reach high concentrations in the prostate.This review examines the mechanisms of action of fosfomycin, the features of its pharmacokinetics in the prostate gland, the antimicrobial spectrum and the mechanisms of resistance to fosfomycin of uropathogens. The results of oral fosfomycin for the treatment of chronic bacterial prostatitis are discussed.

Влияние препарата Простанорм® на персистентный потенциал микроорганизмов, выделенных при хроническом бактериальном простатите

Влияние препарата Простанорм® на персистентный потенциал микроорганизмов, выделенных при хроническом бактериальном простатите

Successful use of a phage endolysin for treatment of chronic pelvic pain syndrome/chronic bacterial prostatitis.

Chronic prostatitis (CP) is a common inflammatory condition of the prostate that is estimated to effect 2%-10% of the world's male population. It can manifest as perineal, suprapubic, or lower back pain and urinary symptoms occurring with either recurrent bacterial infection [chronic bacterial prostatitis (CBP)] or in the absence of evidence of bacterial infection [chronic pelvic pain syndrome (CPPS)]. Here, in the case of a 39 years-old CBP patient, we report the first successful use of a bacteriophage-derived muralytic enzyme (endolysin) to treat and resolve the disease. Bacteriological analysis of the patient's prostatic secretion and semen samples revealed a chronic Enterococcus faecalis prostate infection, supporting a diagnosis of CBP. The patient's E. faecalis strain was resistant to several antibiotics and developed resistance to others during the course of treatment. Previous treatment with multiple courses of antibiotics, bacteriophages, probiotics, and immunologic stimulation had failed to achieve long term eradication of the infection or lasting mitigation of the symptoms. A cloned endolysin gene, encoded by E. faecalis bacteriophage ϕEf11, was expressed, and the resulting gene product was purified to electrophoretic homogeneity. A seven-day course of treatment with the endolysin resulted in the elimination of the E. faecalis infection to below culturally detectable levels, and the abatement of symptoms to near normal levels. Furthermore, during the endolysin treatment, the patient experienced no untoward reactions. The present report demonstrates the effectiveness of an endolysin as a novel modality in managing a recalcitrant infection that could not be controlled by conventional antibiotic therapy.

Rapeseed Bee Pollen Alleviates Chronic Non-bacterial Prostatitis via Regulating Gut Microbiota.

Rapeseed bee pollen has been recognized as a critical treatment for chronic non bacterial prostatitis (CNP) and it also can modulate gut microbiota and improve gut health. This study aimed to explore the anti prostatitis effects of rapeseed bee pollen with or without wall disruption, and investigate the connection between this treatment and gut microbiota. Our results reveal that rapeseed bee pollen can effectively alleviate chronic non bacteria prostatitis via selectively regulating gut microbiota, with higher doses and wall disrupted pollen showing greater efficacy. Treatment with a high dose of wall disrupted rapeseed bee pollen (WDH, 1.26 g/kg body weight) respectively reduced prostate wet weight and prostate index by approximately 32% and 36%, similar to the control group. Moreover, WDH treatment significantly reduced (p<0.05) the expression of proinflammatory cytokines (IL-6, IL-8, IL-1β and TNF-α), as confirmed by immunofluorescence with laser scanning confocal microscope. Our results show that rapeseed bee pollen can inhibit pathogenic bacteria and enhance probiotics, particularly in the Firmicutes-to-Bacteroidetes(F/B) ratio and the abundance of Prevotella (genus). This is the first study to investigate the alleviation of rapeseed bee pollen on CNP through gut microbiota. Our results seem to provide a better understanding of developing rapeseed bee pollen as a complementary medicine. This article is protected by copyright. All rights reserved.

Fosfomycin: An old antibiotic and new perspectives. A review

Urinary tract infection (UTI) is one of the most common urological diseases and presents a problem for rational antibiotic therapy due to the growing antibiotic resistance. Fosfomycin is one of the older low molecular weight, broad-spectrum bactericidal antibiotics with activity against uropathogens, particularly Escherichia coli and others. Fosfomycin is administered as a single dose that achieves very high concentrations of the antibiotic in the urine and bladder, sufficient to eliminate most common uropathogens, including those with multidrug resistance (MDR). Many factors have contributed to the persistence of fosfomycin's antibacterial activity, including the use of a single dose, limited use for UTIs only, and very high and persistent urinary concentrations that rapidly kill bacteria, reducing the possibility of mutant selection. In addition to its antimicrobial properties, fosfomycin has an immunomodulatory effect by altering the function of lymphocytes, monocytes, and neutrophils. It affects the acute inflammatory cytokine response. New data have been obtained on the activity of fosfomycin against biofilms formed by uropathogens and against biofilm-associated bacterial strains with MDR. A new 2020 meta-analysis compared the efficacy of fosfomycin with equivalent antibiotics (β-lactams/cephalosporins, quinolones, sulfonamides, nitrofurantoin) in women in the broad categories of uncomplicated UTI or asymptomatic bacteriuria and found no difference in clinical and microbiological cure rates with comparison groups. A number of other studies in patients with UTIs with MDR or complicated course also showed a high sensitivity of uropathogens to fosfomycin and the effectiveness of treatment with multiple doses (2–3 doses with an interval of 48–72 hrs). Fosfomycin is being considered as a potentially useful antibiotic for the treatment of prostatitis. Current data indicate that sufficient concentrations in prostate tissue are achieved after a single dose of fosfomycin. Recent reviews in 2019 and 2022 present results of studies of fosfomycin for the prevention of infectious complications after transurethral prostate biopsy and in patients with chronic bacterial prostatitis whose pathogens are resistant to other antibiotics. Thus, the accumulation of new scientific data on the mechanisms of action and resistance of fosfomycin reveals more potential advantages of its practical application.

Solving the Problem of Treating Chronic Bacterial Prostatitis

Solving the Problem of Treating Chronic Bacterial Prostatitis

Bioprofiles of &lt;i&gt;Staphylococcus spp.&lt;/i&gt; isolated from prostate secretion in men with chronic bacterial prostatitis

Objective. To characterize pathogenic pheno- and genoprofiles of staphylococci of different species, isolated from the secretion of the prostate gland in male patients with chronic bacterial prostatitis.Materials and methods. The bacterial spectrum of microflora was studied by a bacteriological method; the species identification of microorganisms was carried out by mass spectrometry. Detection of genes determining pathogenicity factors was carried out by PCR. The biofilm-forming ability of staphylococci, as well as their anti-lysozyme, hemolytic, and adhesive activity, were determined by photometry.Results. Staphylococci were found to be dominant in the pathogen structure of chronic bacterial prostatitis. These microorganisms, regardless of their species, had a pronounced pathogenic potential. Specific features in the bioprofiles of cultures of different species were determined according to the severity of the studied biological properties. Thus, the hemolytic activity and biofilm-forming ability was significantly higher in S. aureus. Conversely, CNS strains were characterized by high anti-lysozyme activity. A significant difference was noted in the prevalence of genes that determine pathogenicity factors in the studied staphylococci of different species.Conclusion. The pathogenic bioprofile of staphylococci of various species isolated from patients with chronic bacterial prostatitis can be used as a criterion in the search and identification of the pathogen, as well as in the development of effective therapeutical approaches.

The Efficacy of Flogofilm® in the Treatment of Chronic Bacterial Prostatitis as an Adjuvant to Antibiotic Therapy: A Randomized Prospective Trial.

Bacterial prostatitis (BP) is a common prostatic infection characterized by a bimodal distribution in young and older men, with a prevalence between 5-10% among all cases of prostatitis and a high impact on quality of life. Although the management of bacterial prostatitis involves the use of appropriate spectrum antibiotics, which represent the first choice of treatment, a multimodal approach encompassing antibiotics and nutraceutical products in order to improve the efficacy of chosen antimicrobial regimen is often required. To evaluate the efficacy of Flogofilm® in association with fluoroquinolones in patients with chronic bacterial prostatitis (CBP). Patients diagnosed with prostatitis (positivity to Meares-Stamey Test and symptoms duration > 3 months) at the University of Naples "Federico II", Italy, from July 2021 to December 2021, were included in this study. All patients underwent bacterial cultures and trans-rectal ultrasounds. Patients were randomized into two groups (A and B) receiving antibiotic alone or an association of antibiotics plus Flogofilm® tablets containing Flogomicina® for one month, respectively. The NIH-CPSI and IPSS questionnaires were administered at baseline, four weeks, twelve and twenty-four weeks. A total of 96 (Group A = 47, Group B = 49) patients concluded the study protocol. The mean age was comparable, with a mean age of 34.62 ± 9.04 years for Group A and 35.29 ± 10.32 years for Group B (p = 0.755), and IPSS at the baseline was 8.28 ± 6.33 and 9.88 ± 6.89 (p = 0.256), respectively, while NIH-CPSI at baseline was 21.70 ± 4.38 and 21.67 ± 6.06 (p = 0.959), respectively. At 1, 3 and 6 months, the IPSS score was 6.45 ± 4.8 versus 4.31 ± 4.35 (p = 0.020), 5.32 ± 4.63 versus 3.20 ± 3.05 (p = 0.042) and 4.91 ± 4.47 versus 2.63 ± 3.28 (p = 0.005) for Groups A and B, respectively. Similarly, the NIH-CPSI total score at 1, 3 and 6 months was 16.15 ± 3.31 versus 13.10 ± 5.03 (p < 0.0001), 13.47 ± 3.07 versus 9.65 ± 4.23 (p < 0.0001) and 9.83 ± 2.53 versus 5.51 ± 2.84 (p < 0.0001), respectively. Flogofilm®, associated with fluoroquinolones, demonstrate a significant improvement in pain, urinary symptoms and quality of life in patients affected by chronic bacterial prostatitis in both IPSS and NIH-CPSI scores compared with fluoroquinolones alone.