Nickel J Curtis, Stephens Alisa, Landis J Richard, Chen Jun, Mullins Chris, van Bokhoven Adrie, Lucia M Scott, Melton-Kreft Rachael, Ehrlich Garth D
Department of Urology, Queen's University, Kingston, Ontario, Canada.
Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
J Urol. 2015 Jul;194(1):127-35. doi: 10.1016/j.juro.2015.01.037. Epub 2015 Jan 14.
We used next-generation, state-of-the-art, culture independent methodology to survey urine microbiota of males with urologic chronic pelvic pain syndrome and control participants enrolled in the MAPP Network to investigate a possible microbial etiology.
Male patients with urologic chronic pelvic pain syndrome and matched controls were asked to provide initial, midstream and post-prostatic massage urine specimens. Specimens were analyzed with Ibis T-5000 Universal Biosensor technology to provide comprehensive identification of bacterial and select fungal species. Differences between urologic chronic pelvic pain syndrome and control study participants for the presence of species or species variation in a higher taxonomic grouping (genus) were evaluated using permutational multivariate analysis of variance and logistic regression.
Initial and midstream urine specimens were obtained from 110 (post-prostatic massage urine in 67) participants with urologic chronic pelvic pain syndrome and 115 (post-prostatic massage urine in 62) controls. Overall 78, 73 and 54 species (42, 39 and 27 genera) were detected in initial, midstream and post-prostatic massage urine specimens, respectively. Mean (SD) initial, midstream and post-prostatic massage urine species count per person was 1.62 (1.28), 1.38 (1.36) and 1.33 (1.24) for cases, and 1.75 (1.32), 1.23 (1.15) and 1.56 (0.97) for controls, respectively. Overall species and genus composition differed significantly between participants with urologic chronic pelvic pain syndrome and controls in initial stream urine (p=0.002 species level, p=0.004 genus level), with Burkholderia cenocepacia overrepresented in urologic chronic pelvic pain syndrome. No significant differences were observed at any level in midstream or post-prostatic massage urine samples.
Assessment of baseline culture-independent microbiological data from male subjects enrolled in the MAPP Network has identified overrepresentation of B. cenocepacia in urologic chronic pelvic pain syndrome. Future studies are planned to further evaluate microbiota associations with variable and changing urologic chronic pelvic pain syndrome symptom patterns.
我们采用新一代、最先进的非培养方法，对参与MAPP网络研究的患有泌尿系统慢性盆腔疼痛综合征的男性及对照者的尿液微生物群进行调查，以探究可能的微生物病因。
患有泌尿系统慢性盆腔疼痛综合征的男性患者及匹配的对照者被要求提供初始、中段及前列腺按摩后的尿液样本。采用Ibis T-5000通用生物传感器技术对样本进行分析，以全面鉴定细菌及选定的真菌种类。使用置换多变量方差分析和逻辑回归评估泌尿系统慢性盆腔疼痛综合征患者与对照研究参与者在更高分类学分组（属）中物种存在情况或物种差异。
从110名患有泌尿系统慢性盆腔疼痛综合征的参与者（67人提供了前列腺按摩后的尿液）和115名对照者（62人提供了前列腺按摩后的尿液）中获取了初始和中段尿液样本。初始、中段和前列腺按摩后的尿液样本中分别检测到78、73和54种（42、39和27属）。病例组每人初始、中段和前列腺按摩后尿液的平均（标准差）物种数分别为1.62（1.28）、1.38（1.36）和1.33（1.24），对照组分别为1.75（1.32）、1.23（1.15）和1.56（0.97）。泌尿系统慢性盆腔疼痛综合征患者与对照者在初始尿液中的总体物种和属组成存在显著差异（物种水平p=0.002，属水平p=0.004），在泌尿系统慢性盆腔疼痛综合征中洋葱伯克霍尔德菌的比例过高。在中段或前列腺按摩后的尿液样本中，在任何水平均未观察到显著差异。
对参与MAPP网络研究的男性受试者的基线非培养微生物学数据评估发现，洋葱伯克霍尔德菌在泌尿系统慢性盆腔疼痛综合征中比例过高。计划开展进一步研究，以进一步评估微生物群与泌尿系统慢性盆腔疼痛综合征症状模式变化之间的关联。
