Bartoletti Riccardo, Cai Tommaso, Nesi Gabriella, Albanese Sara, Meacci Francesca, Mazzoli Sandra, Naber Kurt
Department of Clinical Care Medicine and Surgery, Urology Unit Santa Maria Annunziata Hospital, University of Florence, Florence, Italy.
World J Urol. 2014 Jun;32(3):737-42. doi: 10.1007/s00345-013-1145-9. Epub 2013 Aug 6.
We aim to evaluate the role of biofilm-producing bacteria in the clinical response to antibiotic therapy among patients affected by chronic bacterial prostatitis (CBP).
All patients attending our centre from January to December 2008 due to prostatitis-like symptoms with a positive Meares-Stamey test were enroled. The clinical symptoms were assessed according to the NIH-CPSI, and the bacterial strains isolated from the patients enroled were identified and tested for antibiotic sensitivity using cards of the Vitek II semi-automated System for Microbiology (BioMerieux). Quantitative bacterial slime production was assessed by the Christensen microwell assay. All patients were treated with fluoroquinolones for 4 weeks and reevaluated clinically and microbiologically after 3 months.
One hundred and sixteen patients were enroled, and 150 bacterial strains were isolated from all patients. About 85 % of these strains were strong or moderate biofilm producers. Patients with strong or moderate biofilm-producing bacteria had a higher NIH-CPSI symptom score than those without biofilm-producing bacteria (mean 17.6 ± 5.6 vs. 14.1 ± 3.3; p = 0.0009). At the follow-up, 68 patients (58.6 %) had negative microbiological tests, but only 11 (9.48 %) reported a reduction in NIH-CPSI score. Improvement of symptoms was found statistically significantly less frequent in patients with biofilm-producing bacteria than in those without (p = 0.03). Ultrastructural analysis showed cellular forms in active replication with aberrant morphology of unknown cause and confirmed strong slime production with consistent bacterial stratification.
In our CBP population, biofilm-producing bacteria were commonly found and had a significant negative impact on the clinical response to antibiotic therapy.
我们旨在评估产生物膜细菌在慢性细菌性前列腺炎（CBP）患者抗生素治疗临床反应中的作用。
纳入2008年1月至12月因前列腺炎样症状且Meares-Stamey试验呈阳性而到我们中心就诊的所有患者。根据美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）评估临床症状，使用Vitek II微生物半自动系统（生物梅里埃公司）的卡片对纳入患者分离出的细菌菌株进行鉴定和抗生素敏感性测试。通过克里斯滕森微孔试验评估细菌黏液的定量产生。所有患者接受氟喹诺酮治疗4周，并在3个月后进行临床和微生物学重新评估。
共纳入116例患者，从所有患者中分离出150株细菌菌株。其中约85%的菌株为强或中度生物膜产生菌。有强或中度产生物膜细菌的患者NIH-CPSI症状评分高于无产生物膜细菌的患者（平均17.6±5.6 vs. 14.1±3.3；p = 0.0009）。随访时，68例患者（58.6%）微生物学检测呈阴性，但只有11例（9.48%）报告NIH-CPSI评分降低。有产生物膜细菌的患者症状改善在统计学上显著低于无产生物膜细菌的患者（p = 0.03）。超微结构分析显示细胞处于活跃复制状态，形态异常原因不明，并证实有强烈的黏液产生和一致的细菌分层。
在我们的CBP患者群体中，常见产生物膜细菌，且其对抗生素治疗的临床反应有显著负面影响。
