Nagy Vincent, Kubej Dušan
Department of Urology, P.J. Šafárik University, Medical Faculty and L. Pasteur University Hospital, SNP 1, Košice, Slovak Republic. vincent.nagy @ upjs.sk
Urol Int. 2012;89(4):445-50. doi: 10.1159/000342653. Epub 2012 Oct 18.
To assess the current microbiological profile and sensitivity to antibiotics in patients with acute bacterial prostatitis (ABP).
In the period 2003-2010, we treated 192 ABP patients, aged from 18 to 85 years (average 56.3 years). We performed a biochemical examination including a microbiological urine examination. After admission, we immediately began the empirical antibacterial treatment.
The clinical picture was dominated by pain, prostate enlargement and failure of micturition in 185 (96.4%) patients; 14 (7.3%) patients had acute urinary retention where epicystostomy was necessary. Fever occurred in 177 (92.2%) patients and Escherichia coli was the most frequent etiological agent detected in 103 (53.7%) patients followed by Pseudomonas aeruginosa and Klebsiella species. In 16 (8.3%) patients we found 2 bacteriological strains. Sterile urine was found in 65 (33.8%) patients. Fluoroquinolones, aminoglycosides and cephalosporins were used most frequently. 147 (76.6%) patients were treated according to the microbiological results. Overview of resistance shows an increase in resistance to fluoroquinolones. In 14 (7.3%) patients there was progression to urosepsis.
Clinicians should consider local drug-resistance patterns when choosing antibiotics and should adjust the therapy on the basis of bacterial cultures and local sensitivity to antibiotics.
评估急性细菌性前列腺炎（ABP）患者当前的微生物学特征及对抗生素的敏感性。
在2003年至2010年期间，我们治疗了192例ABP患者，年龄在18至85岁之间（平均56.3岁）。我们进行了包括微生物学尿液检查在内的生化检查。入院后，我们立即开始经验性抗菌治疗。
185例（96.4%）患者的临床表现以疼痛、前列腺肿大和排尿困难为主；14例（7.3%）患者发生急性尿潴留，需要进行膀胱造瘘术。177例（92.2%）患者出现发热，103例（53.7%）患者中检测到的最常见病原体是大肠埃希菌，其次是铜绿假单胞菌和克雷伯菌属。在16例（8.3%）患者中我们发现了2种细菌菌株。65例（33.8%）患者尿液无菌。氟喹诺酮类、氨基糖苷类和头孢菌素类药物使用最为频繁。147例（76.6%）患者根据微生物学结果进行治疗。耐药性概述显示对氟喹诺酮类药物的耐药性增加。14例（7.3%）患者病情进展为尿脓毒症。
临床医生在选择抗生素时应考虑当地的耐药模式，并应根据细菌培养和当地对抗生素的敏感性调整治疗方案。
