Characteristics of Acute Bacterial Prostatitis in Korean

Seung Chol Park

doi:10.14777/kjutii.2013.8.1.1

Journal List > Korean J Urogenit Tract Infect Inflamm > v.8(1) > 1059913

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Park: Characteristics of Acute Bacterial Prostatitis in Korean

Review

Korean J Urogenit Tract Infect Inflamm 2013;8(1):1-6.

Published online: 17 April 2013

DOI: https://doi.org/10.14777/kjutii.2013.8.1.1

Characteristics of Acute Bacterial Prostatitis in Korean

Seung Chol Park^1,²

¹Department of Urology, Wonkwang University School of Medicine and Hospital, Korea

²Institute of Wonkwang Medical Science, Iksan, Korea

Correspondence to: Seung Chol Park, Department of Urology, Wonkwang University School of Medicine and Hospital, 895, Muwang-ro, Iksan 570-711, Korea Tel: +82-63-859-1334, Fax: +82-63-842-1455 E-mail: sc.park@wonkwang.ac.kr No potential conflict of interest relevant to this article was reported.

Received 18 March 2013 Revised 8 April 2013 Accepted 8 April 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Prostatitis is the most common urological diagnosis in men younger than 50 years of age and the third most common urological diagnosis in men older than 50 years of age after two major prostatic diseases – benign prostatic hyperplasia and prostatic cancer. Acute bacterial prostatitis is a rare disease that accounts for about 5% of prostatitis cases but is relatively easy to diagnose due to its clinical symptoms. This disease constitutes a urological emergence, with obvious signs and symptoms of a urinary tract infection, including dysuria, and urinary frequency. With acute bacterial prostatitis, patients often present with intense suprapubic pain, urinary obstruction, fever, malaise, arthralgia, and myalgia. The most frequent bacteria responsible for causing acute bacterial prostatitis include Escherichia coli, Enterococcus, Proteus, Pseudomonas, Klebsiella, and Serratia. Antimicrobial treatment should be initiated immediately in patients presenting with acute bacterial prostatitis. Initially, parenteral administration of high doses of antibiotics, such as a broad-spectrum penicillin derivatives, a third-generation cephalosporin with or without an aminoglycoside, or a quinolone, are required until the fever and other signs and symptoms of infection subside. After initial improvement, an oral regimen, in particular quinolone, is appropriate and should be prescribed for at least 4 weeks.

Keywords: Prostatitis, Bactria, Symptom

REFERENCES

1. Roberts RO, Lieber MM, Rhodes T, Girman CJ, Bostwick DG, Jacobsen SJ. Prevalence of a physician-assigned diagnosis of prostatitis: the Olmsted County Study of Urinary Symptoms and Health Status Among Men. Urology. 1998; 51:578–84.

2. Collins MM, Meigs JB, Barry MJ, Walker Corkery E, Giovannucci E, Kawachi I. Prevalence and correlates of prostatitis in the health professionals followup study cohort. J Urol. 2002; 167:1363–6.

3. Krieger JN, Nyberg L Jr, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA. 1999; 282:236–7.

4. Neal DE Jr. Textbook of prostatitis. Nickel JC, editor. Acute bacterial prostatitis. 1st ed.Oxford: Isis Medical Media;1999.

5. Lee SJ, Lee DH, Park YY, Shim BS. A comparative study of clinical symptoms and treatment outcomes of acute bacterial prostatitis according to urine culture. Korean J Urol. 2011; 52:119–23.

6. Lee JY, Kim SJ, Ahn HS. The value of serum prostate-specific antigen in the diagnosis and followup of acute prostatitis. Korean J Urol. 2001; 42:800–3.

7. Ha US, Kim ME, Kim CS, Shim BS, Han CH, Lee SD, et al. Acute bacterial prostatitis in Korea: clinical outcome, including symptoms, management, microbiology and course of disease. Int J Antimicrob Agents. 2008; 31(Suppl 1):S96–101.

8. Yoon BI, Kim S, Han DS, Ha US, Lee SJ, Kim HW, et al. Acute bacterial prostatitis: how to prevent and manage chronic infection? J Infect Chemother. 2012; 18:444–50.

9. Lindert KA, Kabalin JN, Terris MK. Bacteremia and bacteriuria after transrectal ultrasound guided prostate biopsy. J Urol. 2000; 164:76–80.

10. Chiang IN, Chang SJ, Pu YS, Huang KH, Yu HJ, Huang CY. Major complications and associated risk factors of transrectal ultrasound guided prostate needle biopsy: a retrospective study of 1875 cases in taiwan. J Formos Med Assoc. 2007; 106:929–34.

11. Jeon SS, Woo SH, Hyun JH, Choi HY, Chai SE. Bisacodyl rectal preparation can decrease infectious complications of transrectal ultrasound-guided prostate biopsy. Urology. 2003; 62:461–6.

12. Kim SJ, Kim SI, Ahn HS, Choi JB, Kim YS, Kim SJ. Risk factors for acute prostatitis after transrectal biopsy of the prostate. Korean J Urol. 2010; 51:426–30.

13. Millan-Rodriguez F, Palou J, Bujons-Tur A, Musquera-Felip M, Sevilla-Cecilia C, Serrallach-Orejas M, et al. Acute bacterial prostatitis: two different sub-categories according to a previous manipulation of the lower urinary tract. World J Urol. 2006; 24:45–50.

14. Kim ME, Ha US, Cho YH. Prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in female outpatients in South Korea: a multicentre study in 2006. Int J Antimicrob Agents. 2008; 31(Suppl 1):S15–8.

15. Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Infectious Diseases Society of America (IDSA). Clin Infect Dis. 1999; 29:745–58.

16. Nickel JC. Prostatitis and related conditions, orchitis, and epididymitis. Wein AJ, Kaoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh urology. 10th ed.Philadelphia: Elsevier Saunders;2012. p. 327–56.

17. Roberts RO, Lieber MM, Bostwick DG, Jacobsen SJ. A review of clinical and pathological prostatitis syndromes. Urology. 1997; 49:809–21.

18. Hara N, Koike H, Ogino S, Okuizumi M, Kawaguchi M. Application of serum PSA to identify acute bacterial prostatitis in patients with fever of unknown origin or symptoms of acute pyelonephritis. Prostate. 2004; 60:282–8.

19. Schaeffer AJ, Wu SC, Tennenberg AM, Kahn JB. Treatment of chronic bacterial prostatitis with levofloxacin and ciprofloxacin lowers serum prostate specific antigen. J Urol. 2005; 174:161–4.

20. Santillo VM, Lowe FC. The management of chronic prostatitis in men with HIV. Curr Urol Rep. 2006; 7:313–9.

21. Horcajada JP, Vilana R, Moreno-Martinez A, Alvarez-Vijande R, Bru C, Bargallo X, et al. Transrectal prostatic ultrasonography in acute bacterial prostatitis: findings and clinical implications. Scand J Infect Dis. 2003; 35:114–20.

22. Benway BM, Moon TD. Bacterial prostatitis. Urol Clin North Am. 2008; 35:23–32.

23. Grabe B, Bjerklund-Johansen TE, Botto H, Cek M, Naber KG, Pickard RS, et al. Guidelines on urological infections. EAU Guideline Office. European Association of Urology Guidelines. Arnhem, The Netherlands: Drukkerij Gelderland;2012. p. 1–110.

24. Kravchick S, Cytron S, Agulansky L, Ben-Dor D. Acute prostatitis in middle-aged men: a prospective study. BJU Int. 2004; 93:93–6.

25. Ulleryd P, Sandberg T. Ciprofloxacin for 2 or 4 weeks in the treatment of febrile urinary tract infection in men: a randomized trial with a 1 year followup. Scand J Infect Dis. 2003; 35:34–9.

26. Wagenlehner FM, Naber KG. Therapy of prostatitis syndrome. Urologe A. 2001; 40:24–8.

27. Nickel JC. Alpha-blockers for the treatment of prostatitis-like syndromes. Rev Urol. 2006; 8(Suppl 4):S26–34.

28. Leport C, Rousseau F, Perronne C, Salmon D, Joerg A, Vilde JL. Bacterial prostatitis in patients infected with the human immunodeficiency virus. J Urol. 1989; 141:334–6.

29. Park SC, Lee JW, Rim JS. Prostatic abscess caused by community-acquired methicillin-resistant Staphylococcus aureus. Int J Urol. 2011; 18:536–8.

30. Chou YH, Tiu CM, Liu JY, Chen JD, Chiou HJ, Chiou SY, et al. Prostatic abscess: transrectal color Doppler ultrasonic diagnosis and minimally invasive therapeutic management. Ultrasound Med Biol. 2004; 30:719–24.

31. Gogus C, Ozden E, Karaboga R, Yagci C. The value of transrectal ultrasound guided needle aspiration in treatment of prostatic abscess. Eur J Radiol. 2004; 52:94–8.

32. Ludwig M, Schroeder-Printzen I, Schiefer HG, Weidner W. Diagnosis and therapeutic management of 18 patients with prostatic abscess. Urology. 1999; 53:340–5.

33. Varkarakis J, Sebe P, Pinggera GM, Bartsch G, Strasser H. Three-dimensional ultrasound guidance for percutaneous drainage of prostatic abscesses. Urology. 2004; 63:1017–20.

34. Lindstedt S, Lindstrom U, Ljunggren E, Wullt B, Grabe M. Single-dose antibiotic prophylaxis in core prostate biopsy: Impact of timing and identification of risk factors. Eur Urol. 2006; 50:832–7.

35. Carey JM, Korman HJ. Transrectal ultrasound guided biopsy of the prostate. Do enemas decrease clinically significant complications? J Urol. 2001; 166:82–5.

36. Gilad J, Borer A, Maimon N, Riesenberg K, Klein M, Schlaeffer F. Failure of ciprofloxacin prophylaxis for ultrasound guided transrectal prostatic biopsy in the era of multiresistant enterobacteriaceae. J Urol. 1999; 161:222.

37. Liss MA, Chang A, Santos R, Nakama-Peeples A, Peterson EM, Osann K, et al. Prevalence and significance of fluoroquinolone resistant Escherichia coli in patients undergoing transrectal ultrasound guided prostate needle biopsy. J Urol. 2011; 185:1283–8.

Fig. 1.

Treatment algorithm for acute bacterial prostatitis (adapted from Benway and Moon. Urol Clin North Am 2008;35:23-32).²²

Table 1.

Classification of prostatitis syndromes

Category	Name	Characteristic
I	Acute bacterial prostatitis	Acute bacterial infection Acute urinary tract infection
II	Chronic bacterial prostatitis	Persistent bacterial infection Recurrent urinary tract infections
III	Chronic prostatitis/chronic pelvic pain syndrome	Characteristic pelvic pains, urinary complaints and sexual dysfunction Absence of other urological disorders
IIIA	Inflammatory subtype	Leukocytes in the expressed prostatic fluid, post-prostate massage fluid or seminal fluid
IIIB	Non-inflammatory subtype	No inflammation in the expressed prostatic fluid, post-prostate massage fluid or seminal fluid
IV	Asymptomatic inflammatory	Asymptomatic patients with inflammatory infiltrates in prostate tissue or seminal fluid specimens evaluated for other indications

Table 2.

Microbial spectrum of patients with acute bacterial prostatitis in Korea

	Total (n=115)	With prior manipulation (n=39)	Without prior manipulation (n=76)	p-value
Escherichia coli	52.2% (60)	46.2% (18)	55.3% (42)	0.3546
Pseudomonas spp.	15.7% (18)	30.8% (12)	7.9% (6)	0.0014
Klebsiella spp.	9.6% (11)	10.3% (4)	9.2% (7)	0.8567
Enterobacter spp.	3.5% (4)	2.6% (1)	3.9% (3)
Streptococcus agalactiae	3.5% (4)	2.6% (1)	3.9% (3)
Serratia marcescens	1.7% (2)	2.6% (1)	1.3% (1)
Coagulase-negative staphylococcus	2.6% (3)	2.6% (1)	2.6% (2)
Enterococci	2.6% (3)	0% (0)	3.9% (3)
Mixed infection	4.3% (5)	7.7% (3)	2.6% (2)	0.2077
Others	4.3% (5)	2.6% (1)	5.3% (4)

Adapted from Ha et al. Int J Antimicrob Agents 2008;31 Suppl 1:S96-101.⁷

Table 3.

Antibiotics susceptibility (%) of pathogens isolated in patients with acute bacterial prostatitis in Korea

	Escherichia coli (n=60)	Other pathogens (n=55)	p-vlaue
Ampicillin	31.9	26.3	0.6822
Amplicillin/sulbactam	42.3	30.0	0.4975
Piperacillin/tazobactam	95.0	71.4	0.0157
First-generation cephalosporin	70.4	41.2	0.0293
Second-generation cephalosporin	91.9	53.9	0.0021
Third-generation cephalosporin	95.2	46.7	<0.0001
Fourth-generation cephalosporin	96.2	58.3	0.0030
Ciprofloxacin	76.2	68.4	0.5229
Ofloxacin	94.1	77.8	0.2147
Amikacin	98.3	78.6	0.0029
Gentamicin	90.5	65.0	0.0141
Tobramycin	91.4	66.7	0.0376
Imipenem	100.0	98.2	0.7882
TMP/SMA	71.4	60.0	0.4459

TMP: trimethoprim, SMA: sulfamethoxazole (adapted from Jeon et al. Urology 2003;62:461-6).¹¹

TOOLS

Similar articles