Terai A, Ishitoya S, Mitsumori K, Ogawa O
Department of Urology, Faculty of Medicine, Kyoto University, Kyoto, Japan.
J Urol. 2000 Dec;164(6):1945-7.
To test the ascending urethral infection in the pathogenesis of acute bacterial prostatitis, we assessed the clonality of Escherichia coli strains isolated from urine and rectal swab of patients with acute bacterial prostatitis using molecular typing methods.
A total of 50 E. coli strains each isolated from urine and rectal swabs of 9 men with acute bacterial prostatitis at diagnosis were examined for 6 urovirulence determinant profiles and pulsed field gel electrophoresis patterns. In 1 case E. coli isolates from the rectal swab of the patient's wife were also examined at diagnosis and after 5 weeks.
The urovirulence profile and pulsed field gel electrophoresis demonstrated that causative E. coli was monoclonal in each case, and present in the rectal swab as a predominant (96% to 100%) fecal clone in 2 and a minority clone (2% to 8%) in 4. Furthermore, causative E. coli dominated in the rectal swab of the 1 patient's wife.
Our results are consistent with the ascending route of infection in acute bacterial prostatitis. However, causative E. coli might possibly originate from either intestinal reservoir of the host or household member. Owing to limitations of the cross-sectional design of this study, longitudinal studies are necessary to establish the ascending route of infection in this disease.
为了验证上行性尿道感染在急性细菌性前列腺炎发病机制中的作用，我们使用分子分型方法评估了从急性细菌性前列腺炎患者的尿液和直肠拭子中分离出的大肠杆菌菌株的克隆性。
对从9例诊断为急性细菌性前列腺炎的男性患者的尿液和直肠拭子中分别分离出的共50株大肠杆菌菌株进行了6种尿路毒力决定因子谱和脉冲场凝胶电泳图谱检测。在1例患者中，还对其妻子直肠拭子中的大肠杆菌分离株在诊断时及5周后进行了检测。
尿路毒力谱和脉冲场凝胶电泳表明，每例中的致病性大肠杆菌均为单克隆，在2例患者的直肠拭子中以主要（96%至100%）的粪便克隆形式存在，在4例患者中以少数克隆（2%至8%）形式存在。此外，致病性大肠杆菌在1例患者妻子的直肠拭子中占主导地位。
我们的结果与急性细菌性前列腺炎的上行感染途径一致。然而，致病性大肠杆菌可能源自宿主的肠道菌库或家庭成员。由于本研究横断面设计的局限性，需要进行纵向研究以确定该疾病的上行感染途径。
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