Login to Access Video or Poster Abstract: MP11-08
Sources of Funding: NIH NIDDK R01DK094898, R01DK108127

Introduction

Localization of traditional uropathogenic bacteria to the prostate has been reported in up to 8% of patients with CP/CPPS and in healthy controls. However, the frequency and significance of non-pathogenic bacteria have been highly variable.

Methods

We retrospectively reviewed prostate localization cultures done at our institution from 05/2010 to 11/2014 and the associated patient clinical information. Cultures were considered to be localized to the prostate if bacteria count was 1 log greater in the EPS or VB3 than that in the VB1 and VB2 (criteria 1), or 1 log greater than only that in the VB2 (criteria 2). Bacteria were analyzed for their ability to induce inflammation using THP1-Blue cells reporting NFkB expression.

Results

Using criteria 1, 14% (20 of 146) of patients with the diagnosis of CP/CPPS had localizing cultures all performed by (AJS). A total of 28 bacteria, all gram-positive, localized to their prostates. Using criteria 2, the localizing population included patients seen by other urologists and with 1 of 3 diagnoses: CP/CPPS (group 1, 37 patients), elevated PSA with no pelvic pain (group 2, 12 patients), and category II chronic bacterial prostatitis (CBP) or recurrent UTIs (group 3, 15 patients). Gram-positive bacteria comprised 100% of group 1 localizations, and 92% of group 2, while group 3 was 27% gram-negative. A high NFkB response was noted in 20%, 9%, and 42% of bacteria in groups 1, 2, and 3, respectively. While 100% of gram-negative organisms induced a high NFkB response, there was a subgroup of gram-positives (11% of E. faecalis, 13% of S. haemolyticus, 19% of S. epidermidis; 12 total) that also induced a high response. 100% and 83% of patients with bacteria in this subgroup reported pain and voiding complaints, respectively, compared to 66% and 69% of patients with low NFkB inducing gram-positive prostate bacteria.

Conclusions

Traditional gram-negative uropathogenic bacteria with high inflammatory response were prevalent among patients with CBP or UTIs. A subset of gram-positive bacteria from patients with CP/CPPS also showed a high inflammatory response and association with more pain and voiding complaints. A subset of traditional non-uropathogenic bacteria may contribute to inflammation and symptoms in patients with CP/CPPS.

Funding

NIH NIDDK R01DK094898, R01DK108127