Pathogen Detection and Diagnostic Scenarios in Chronic Prostatitis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Inclusion Criteria
2.2. Clinical Assessments
2.3. Microbiological Assessments
2.4. Statistical Analysis
3. Results
3.1. Baseline Clinical Assessments
3.2. General Microbiological Assessments
3.3. Traditional Uropathogens
3.3.1. Enterobacteriaceae
3.3.2. Enterococci
3.4. Sexually Transmitted Pathogens
3.5. Other Pathogens
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
CP | Chronic prostatitis |
CP/CPPS | Chronic prostatitis/chronic pelvic pain syndrome |
NIH-CPSI | NIH-Chronic Prostatitis Symptom Index |
PPMT | Pre- and post-massage test |
IPSS | International Prostate Symptom Score |
PSA | Prostate-specific antigen |
EPS | Expressed prostatic secretion |
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Test | 5-Glass | 4-Glass | 2-Glass | VB2-Semen | One-Way ANOVA | Tukey’s HSD Post Hoc Test |
---|---|---|---|---|---|---|
Mean age (±SD) | 46.51 ± 13.42 | 47.34 ± 14.55 | 47.42 ± 15.01 | 45.39 ± 12.96 | p = 0.06 | p > 0.05, all comparisons |
Mean PSA, ng/mL (±SD) | 2.50 ± 3.068 | 2.67 ± 3.47 | 2.58 ± 2.87 | 2.35 ± 2.75 | p = 0.42 | p > 0.05, all comparisons |
Mean Qmax, mL/S (±SD) | 16.19 ± 9.41 | 16.22 ± 10.15 | 16.09 ± 10.41 | 16.07 ± 8.67 | p = 0.99 | p > 0.05, all comparisons |
Post-void residual bladder urine, mL | 40.05 ± 55.11 | 42.38 ± 58.31 | 45.04 ± 59.37 | 38.73 ± 52.72 | p = 0.42 | p > 0.05, all comparisons |
NIH-CPSI total score (mean ± SD) | 21.83 ± 7.19 | 22.14 ± 6.98 | 22.56 ± 7.12 | 21.98 ± 7.27 | p = 0.55 | p > 0.05, all comparisons |
NIH pain score (mean ± SD) | 10.12 ± 5.48 | 10.13 ± 7.62 | 10.73 ± 9.59 | 10.10 ± 6.81 | p = 0.61 | p > 0.05, all comparisons |
NIH voiding symptom score (mean ± SD) | 4.61 ± 2.68 | 4.89 ± 2.61 | 5.05 ± 2.57 | 4.43 ± 2.71 | p = 0.047 | p > 0.05, for all comparisons, except: 2-glass vs. VB2-semen, p = 0.0081 |
NIH QoL impact score (mean ± SD) | 7.48 ± 2.71 | 7.68 ± 2.70 | 7.69 ± 2.63 | 7.60 ± 2.71 | p = 0.58 | p > 0.05, all comparisons |
IPSS (mean ± SD) | 11.93 ± 6.85 | 12.56 ± 6.81 | 13.56 ± 7.04 | 11.45 ± 7.02 | p = 0.0003 | p > 0.05, for all comparisons, except: 2-glass vs. VB2-semen, p = 0.0002 |
Pathogen Load, cfu/mL | EPS, % | VB3, % | Semen, % |
---|---|---|---|
103 | 43.62 | 32.58 | 30.29 |
104 | 29.53 | 17.98 | 23.72 |
105 | 20.81 | 26.22 | 30.93 |
106 | 6.04 | 23.22 | 15.06 |
Total | 100 | 100 | 100 |
Diagnostic Test | Significance of Difference Between Diagnostic Tests (Pearson’s χ2 or Fisher’s Exact Test) | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
5-Glass | 4-Glass | 2-Glass | VB2-S | 5G vs. 4G | 5G vs. 2G | 5G vs. VB2-S | 4G vs. 2G | 4G vs. VB2-S | 2G vs. VB2-S | |||||
Species | n | % | n | % | n | % | n | % | p | p | p | p | p | p |
Escherichia coli | 251 | 46.22 | 123 | 62.76 | 71 | 61.74 | 159 | 35.10 | 0.034 | 0.098 | 0.033 | 0.94 | 0.0002 | 0.0023 |
Enterococcus faecalis | 172 | 31.68 | 37 | 18.88 | 19 | 16.52 | 182 | 40.18 | 0.007 | 0.011 | 0.038 | 0.67 | <0.0001 | 0.0003 |
Proteus Myrabilis | 28 | 5.16 | 12 | 6.12 | 8 | 6.96 | 23 | 5.08 | 0.65 | 0.48 | 0.98 | 0.78 | 0.67 | 0.49 |
Klebsiella spp. | 22 | 4.05 | 3 | 1.53 | 3 | 2.61 | 22 | 4.86 | 0.11 | 0.59 | 0.51 | 0.67 | 0.046 | 0.44 |
Morganella Morganii | 22 | 4.05 | 6 | 3.06 | 5 | 4.35 | 19 | 4.19 | 0.52 | 0.80 | 0.86 | 0.54 | 0.46 | 0.99 |
Pseudomonas aeruginosa | 17 | 3.13 | 3 | 1.53 | 5 | 4.35 | 12 | 2.65 | 0.31 | 0.56 | 0.69 | 0.15 | 0.57 | 0.37 |
Staphylococcus aureus | 14 | 2.58 | 9 | 4.59 | 2 | 1.74 | 12 | 2.65 | 0.19 | 0.99 | 0.91 | 0.34 | 0.24 | 0.74 |
Citrobacter Koseri | 10 | 1.84 | 1 | 0.51 | 1 | 0.87 | 17 | 3.75 | 0.30 | 0.99 | 0.23 | 0.99 | 0.21 | 0.71 |
Enterobacter cloacae | 5 | 0.92 | 1 | 0.51 | 1 | 0.87 | 5 | 1.10 | 0.99 | 0.99 | 0.76 | 0.99 | 0.67 | 0.99 |
Enterococcus faecium | 2 | 0.37 | 1 | 0.51 | 0 | 0.00 | 2 | 0.44 | 0.99 | n.a. | 0.99 | n.a. | 0.99 | n.a. |
Total Gram-negative | 355 | 65.38 | 149 | 76.02 | 94 | 81.74 | 257 | 56.73 | 0.23 | 0.15 | 0.17 | 0.68 | 0.028 | 0.021 |
Total Gram-positive | 188 | 34.62 | 47 | 23.98 | 21 | 18.26 | 196 | 43.27 | 0.037 | 0.009 | 0.044 | 0.34 | 0.0006 | 0.0003 |
Total traditional uropathogens | 543 | 100 | 196 | 100 | 115 | 100 | 453 | 100 | ||||||
Traditional uropathogens/total tested population (n = 1047),% | 51.86 | 18.72 | 10.98 | 43.27 | ||||||||||
Ureaplasma urealyticum | 118 | 67.43 | 21 | 55.26 | 12 | 54.55 | 124 | 71.26 | 0.51 | 0.57 | 0.74 | 0.97 | 0.39 | 0.47 |
Chlamydia trachomatis | 40 | 22.86 | 16 | 42.11 | 7 | 31.82 | 36 | 20.69 | 0.074 | 0.47 | 0.69 | 0.59 | 0.039 | 0.35 |
Mycoplasma hominis | 10 | 5.71 | 0 | 0.00 | 3 | 13.64 | 9 | 5.17 | n.a. | 0.19 | 0.83 | n.a. | n.a. | 0.16 |
Neisseria gonorrheae | 4 | 2.29 | 1 | 2.63 | 0 | 0.00 | 2 | 1.15 | 0.99 | n.a. | 0.68 | n.a. | 0.45 | n.a. |
Candida spp. | 2 | 1.14 | 0 | 0.00 | 0 | 0.00 | 2 | 1.15 | n.a. | n.a. | 0.99 | n.a. | n.a. | n.a. |
Trichomonas Vaginalis | 1 | 0.57 | 0 | 0.00 | 0 | 0.00 | 1 | 0.57 | n.a. | n.a. | 0.99 | n.a. | n.a. | n.a. |
Total sexually transmitted pathogens | 175 | 100 | 38 | 100 | 22 | 100 | 174 | 100 | ||||||
Total ST pathogens/total tested population (n = 1047),% | 16.71 | 3.63 | 2.10 | 16.62 | ||||||||||
Streptococcus beta-haemolyticus Gr. B | 55 | 35.71 | 14 | 31.82 | 11 | 39.29 | 63 | 37.72 | 0.73 | 0.81 | 0.79 | 0.65 | 0.61 | 0.91 |
Haemophylus parainfluenzae | 32 | 20.78 | 5 | 11.36 | 5 | 17.86 | 38 | 22.75 | 0.23 | 0.99 | 0.73 | 0.51 | 0.21 | 0.81 |
Staphylococcus spp. (coagulase-negative) | 28 | 18.18 | 11 | 25.00 | 5 | 17.86 | 33 | 19.76 | 0.41 | 0.99 | 0.76 | 0.77 | 0.54 | 0.99 |
Corynebacterium seminale | 12 | 7.79 | 4 | 9.09 | 4 | 14.29 | 6 | 3.59 | 0.76 | 0.29 | 0.12 | 0.71 | 0.22 | 0.052 |
Streptococcus agalactiae | 9 | 5.84 | 9 | 20.45 | 2 | 7.14 | 3 | 1.80 | 0.018 | 0.68 | 0.081 | 0.31 | 0.0001 | 0.16 |
Gardnerella Vaginalis | 5 | 3.25 | 0 | 0.00 | 0 | 0.00 | 6 | 3.59 | n.a. | n.a. | 0.99 | n.a. | n.a. | n.a. |
Serratia mascescens | 4 | 2.60 | 0 | 0.00 | 0 | 0.00 | 4 | 2.40 | n.a. | n.a. | 0.99 | n.a. | n.a. | n.a. |
Peptostreptococcus spp. (AC) | 3 | 1.95 | 1 | 2.27 | 0 | 0.00 | 3 | 1.80 | 0.99 | n.a. | 0.99 | n.a. | 0.99 | n.a. |
Kocuria spp. | 2 | 1.30 | 0 | 0.00 | 1 | 3.57 | 6 | 3.59 | n.a. | 0.40 | 0.28 | n.a. | n.a. | 0.99 |
Actinomyces spp. | 2 | 1.30 | 0 | 0.00 | 0 | 0.00 | 2 | 1.20 | n.a. | n.a. | 0.99 | n.a. | n.a. | n.a. |
Clostridium spp. | 1 | 0.65 | 0 | 0.00 | 0 | 0.00 | 1 | 0.60 | n.a. | n.a. | 0.99 | n.a. | n.a. | n.a. |
Acinetobacter spp. | 1 | 0.65 | 0 | 0.00 | 0 | 0.00 | 2 | 1.20 | n.a. | n.a. | 0.99 | n.a. | n.a. | n.a. |
Total other pathogens | 154 | 100 | 44 | 100 | 28 | 100 | 167 | 100 | ||||||
Total other pathogens/total tested population (n = 1047),% | 14.71 | 4.20 | 2.67 | 15.95 | ||||||||||
Total pathogens detected, n | 872 | 278 | 165 | 794 | ||||||||||
Total pathogens detected/total tested population (n = 1047),% | 83.29 | 26.55 | 15.76 | 75.84 | <0.0001 | <0.0001 | 0.15 | <0.0001 | <0.0001 | <0.0001 | ||||
% Traditional uropathogens/total pathogens detected | 62.27 | 70.50 | 69.70 | 57.05 | 0.25 | 0.39 | 0.27 | 0.94 | 0.054 | 0.13 | ||||
% ST pathogens/total pathogens detected | 20.07 | 13.67 | 13.33 | 21.91 | 0.044 | 0.088 | 0.45 | 0.93 | 0.013 | 0.038 | ||||
% other pathogens/total pathogens detected | 17.66 | 15.83 | 16.97 | 21.03 | 0.55 | 0.85 | 0.15 | 0.78 | 0.12 | 0.33 | ||||
Total% | 100 | 100 | 100 | 100 |
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Magri, V.; Perletti, G.; Stamatiou, K. Pathogen Detection and Diagnostic Scenarios in Chronic Prostatitis. Diagnostics 2025, 15, 762. https://doi.org/10.3390/diagnostics15060762
Magri V, Perletti G, Stamatiou K. Pathogen Detection and Diagnostic Scenarios in Chronic Prostatitis. Diagnostics. 2025; 15(6):762. https://doi.org/10.3390/diagnostics15060762
Chicago/Turabian StyleMagri, Vittorio, Gianpaolo Perletti, and Konstantinos Stamatiou. 2025. "Pathogen Detection and Diagnostic Scenarios in Chronic Prostatitis" Diagnostics 15, no. 6: 762. https://doi.org/10.3390/diagnostics15060762
APA StyleMagri, V., Perletti, G., & Stamatiou, K. (2025). Pathogen Detection and Diagnostic Scenarios in Chronic Prostatitis. Diagnostics, 15(6), 762. https://doi.org/10.3390/diagnostics15060762