Shoskes D A, Shahed A R
Division of Urology, Harbor-UCLA Medical Center, Torrance, California 90509, USA.
Tech Urol. 2000 Sep;6(3):240-2.
Some men with chronic pelvic pain syndrome (CPPS) have evidence of bacteria in their prostatic fluid (expressed prostatic secretions [EPS]) detected by 16S rRNA techniques. In this study, we correlate presence of bacterial signal with response to therapy.
EPS and first voided urine (VB1) from 47 men with CPPS were analyzed by polymerase chain reaction (PCR) for bacterial signal using universal primers specific for bacterial 16S rRNA. Signal was considered positive if found only in the EPS sample, or if at least 10x stronger in the EPS than in VB1. All patients were treated with antibiotic therapy.
Thirty-three patients were category IIIa (nonbacterial prostatitis) and 14 were category IIIb (prostatodynia). Seventeen of the 33 category IIIa patients had positive localizing cultures for gram-positive bacteria. However, a positive bacterial signal was detected in 23 EPS samples by 16S rRNA PCR. This signal was found in 14 of 17 culture-positive patients, 7 of 16 of the remaining category IIIa patients, and 2 of 14 of category IIIb patients. No patient with negative bacterial signal improved with antibiotic therapy (negative predictive value 100%). Thirteen patients with positive bacterial signal improved with antibiotic therapy.
In men with category III chronic prostatitis/CPPS, bacterial signal detected by PCR can help predict response to antimicrobial therapy.
一些患有慢性盆腔疼痛综合征（CPPS）的男性，其前列腺液（前列腺按摩液[EPS]）中通过16S rRNA技术检测到有细菌存在的证据。在本研究中，我们将细菌信号的存在与治疗反应相关联。
对47例CPPS男性患者的EPS和首次晨尿（VB1）进行聚合酶链反应（PCR）分析，使用针对细菌16S rRNA的通用引物检测细菌信号。若仅在EPS样本中发现信号，或EPS中的信号强度至少比VB1强10倍，则该信号被视为阳性。所有患者均接受抗生素治疗。
33例患者为Ⅲa类（非细菌性前列腺炎），14例为Ⅲb类（前列腺痛）。33例Ⅲa类患者中有17例革兰氏阳性菌定位培养呈阳性。然而，通过16S rRNA PCR在23份EPS样本中检测到阳性细菌信号。在17例培养阳性患者中的14例、其余Ⅲa类患者中的16例中的7例以及Ⅲb类患者中的14例中的2例中发现了该信号。细菌信号阴性的患者接受抗生素治疗后均无改善（阴性预测值为100%）。13例细菌信号阳性的患者接受抗生素治疗后有所改善。
在Ⅲ类慢性前列腺炎/CPPS男性患者中，PCR检测到的细菌信号有助于预测对抗菌治疗的反应。
