Acute bacterial prostatitis (ABP) is one of main infective disease in urology with various symptoms. Occurrence of complications can be minimized by appropriate treatment. We studied whether any changes in antimicrobial resistance of hospitalized ABP patients as time passed.
The study was based on retrospective study. From 2004 to 2007 as past period and 2014 to 2017 as recent period defined. Patient's ages, length of admission days, intensive care, urinalysis, strains, and resistance to antibiotics were investigated in hospitalized patients with ABP and compared between the two periods.
Fifty patients of past period and 72 patients of recent period with ABP were admitted. The mean age was increased 55.5±13.2 years to 62.0±15.3 years. The infection route was mostly community-acquired. Prostate biopsy-related was decreased 7 to 1. The mean of hospital days were 7.9±4.2 days to 6.9±3.4 days. Intensive care were 5 to 7. Average length of stay intensive care was 4.2±1.3 days to 4.1±1.4 days. Urine cultures showed no significant difference from the previous studies in strains. Extended spectrum beta-lactamases producing bacteria increased 4.3% to 25.0%, and third generation cephalosporin resistance was increased 13.0% to 40.9%. Fluoroquinolone was no significant change 26.1% to 27.3%. Aminoglycosides were identified in 4.3% to 6.8% and carbapenem in 4.3% to 2.3%.
The mean age of hospitalized patients with ABP increased. Antimicrobial resistance did not change to fluoroquinolone, but extended spectrum beta-lactamases producing bacteria showed increased resistance to third-generation cephalosporin. Therefore, attention should be paid to the use of empirical antibiotics.
Differences between two periods of clinical manifestation in acute bacterial prostatitis patients
| Parameter | Past period (2004–2007, n=50) | Recent period (2014–2017, n=72) | Total (n=122) | p-value |
|---|---|---|---|---|
| Mean age (y) | 55.5±13.2 | 62.0±15.3 | 59.3±14.8 | 0.016 |
| Hypertension | 12 (24.0) | 26 (36.1) | 38 (31.1) | 0.421 |
| Diabetes mellitus | 4 (8.0) | 12 (16.7) | 16 (13.1) | 0.719 |
| Cerebrovascular accident | 2 (4.0) | 5 (6.9) | 7 (5.7) | 0.138 |
| Infection route | ||||
| Community | 42 (84.0) | 67 (93.1) | 109 (89.3) | 0.140 |
| Hospital | 1 (2.0) | 4 (5.6) | 5 (4.1) | 0.406 |
| Urologic manipulation | 1 (2.0) |
1 (1.4) |
– | |
| Prostate biopsy | 7 (14.0) | 1 (1.4) | 8 (6.6) | 0.008 |
| Hospitalization period (d) | 7.9±4.2 | 6.9±3.4 | 7.3±3.8 | 0.146 |
| Intensive care unit treatment | ||||
| Number | 5 (10.0) | 7 (9.7) | 12 (9.8) | >0.999 |
| Period (d) | 4.2±1.3 | 4.1±1.4 | 4.2±1.3 | 0.943 |
Values are presented as mean±standard deviation or number (%). -: not available.
)Cystoscopy,
transurethral resection of the prostate.
Results of the detected microbial species and resistances
| Parameter | Past period (2004–2007) | Recent period (2014–2017) | Total | p-value |
|---|---|---|---|---|
| Species | ||||
| No growth | 27 | 28 | 55 | |
| Growth | 23 | 44 | 67 | |
| Escherichia coli | 18 (78.3) | 26 (59.1) | 44 (65.7) | 0.176 |
| Klebsiella pneumoniae | 3 (13.0) | 4 (9.1) | 7 (10.4) | 0.684 |
| Pseudomonas aeruginosa | 1 (4.3) | 2 (4.5) | 3 (4.5) | >0.999 |
| Enterococcus | 1 (4.3) | 3 (6.8) | 4 (6.0) | >0.999 |
| Etc. |
0 | 9 (20.5) | 9 (13.4) | |
| Resistance to antibiotics | ||||
| Fluoroquinolones | 6 (26.1) | 12 (27.3) | 18 (26.9) | >0.999 |
| Aminoglycosides | 1 (4.3) | 3 (6.8) | 4 (6.0) | >0.999 |
| Third generation cephalosporins | 3 (13.0) | 18 (40.9) | 21 (31.3) | 0.026 |
| Carbapenems | 1 (4.3) | 1 (2.3) | 2 (3.0) | >0.999 |
| ESBL positive | 1 (4.3) | 11 (25.0) | 12 (17.9) | 0.045 |
Values are presented as number only or number (%).
ESBL: extended-spectrum beta lactamases.
)Proteus mirabilis, Staphylococcus aureus, and Streptococcus.