Spermioculture enriched with BHI-OXOID in the diagnosis of chronic bacterial prostatitis: a prospective comparative study
Objectives: The objective of the study was to compare the Meares Stamey test, the gold standard for diagnosis of prostate infections, with a microbiological Protocol conducted by the University of the studies of Campania "Luigi Vanvitelli", in patients diagnosed with chronic prostatitis ( NIH type II).
Materials and Methods
Materials and methods: We enrolled patients with chronic prostatitis, defined by a NIH-CPSI score ≥ 10 and a symptom duration ≥ 6 months. The patients performed a Meares-Stamey test collection of the first voided samples (10 ml) of the first morning urine (VB1), a midstream (10 ml) (VB2), of prostatic secretions after prostatic massage (EPS) and further 10 ml of post-massage urine (VB3). The review concluded with the collection of semen during the following days (1-3). Each patient has practiced exams with 3 days of abstinence from sexual intercourse and at least 10 days prior to antibiotic treatments. The samples obtained, a part of them were insemenzati in common culture media, for the detection of pathogenic. The seminal fluid, was experimented in standard culture media, while a rate of pellet was enriched with "brain heart infusion" (BHI-OXOID).
Results: 30 patients were enrolled in the study. 4 were negative (14%) and 26 are positive in the survey results (86%). Of these, the Meares-Stamey test was positive in 4 patients (15%), which showed as much positivity to spermioculture BHI-OXOID, 22 patients were positive only to spermioculture BHI-OXOID (85%). 6 of the 26 positive patients (23%) reported positivity to both the classical spermioculture both to that performed by prior enrichment. The remaining 20 patients (77%) reported positive only enriched semen with BHI-OXOID according to the applied protocol.
The pathogen most frequently isolated was E. faecalis (13 pc), followed by E. Coli (7), P. aeruginosa (3), K. pneumoniae (3), S. Aureus ,, S. Mitis, C.Koserii , H. parainfluenzae, M. morganii, S. marcescens (1).
Discussion: the protocol used may represent a real breakthrough in the diagnosis of prostatitis. It is also important to emphasize that many of these infections are from pathogenic biofilm manufacturers and thus unlikely to be isolated. With this method it is thus possible to isolate the entire sessile bacteria of the same biofilm.
Conclusions: The present study showed that the semen culture is enriched with BHI-OXOID land can be considered a useful tool for the diagnosis of chronic bacterial prostatitis; Moreover, such a microbiological technique may allow you to relocate patients with chronic prostatitis belonging to Group III in Group II, by changing treatment strategies. Being able to have a more specific framework is an absolutely important, because in these patients very often the treatments do not lead you to a real advantage, especially on quality of life (as extremely relevant, also assessed the outcome of the two places questionnaires) . It should also be borne in mind that very often these drugs with systemic effects, sometimes side. In this way, therefore, one of the characteristics is the ability to promote a significant reduction about the assumption of non-targeted drugs.
Keywords: Chronic Prostatitis – Semen – Meares Stamey – BHI-OXOID
Vittorio Picone1, Enza Mallardo2, Davide Arcaniolo1, Carmelo Quattrone1, Raffaele Balsamo1, Marco Terribile1, Marco Stizzo1, Celeste Manfredi1, Maria Rosaria Iovene2 and Marco De Sio1
1 Unità di Urologia – Università degli Studi della Campania “L.Vanvitelli”
2 U.O. di Batteriologia clinica – Università degli Studi della Campania “L.Vanvitelli”