Riley D E, Berger R E, Miner D C, Krieger J N
Department of Urology, School of Medicine, University of Washington, Seattle 98195, USA.
J Clin Microbiol. 1998 Jun;36(6):1646-52. doi: 10.1128/JCM.36.6.1646-1652.1998.
Treatment of chronic prostatitis/chronic pelvic pain syndrome is often empirical because clinical culture methods fail to detect prostate-associated pathogens in >90% of patients. Previously, we tested a variety of specific-microorganism PCRs and began a DNA sequence study after we found that 77% of prostatitis patients were PCR positive for prokaryotic rRNA-encoding DNA sequences (rDNAs) despite negative cultures using optimal techniques. In the present study, 36 rDNA clones from 23 rDNA-positive patients were sequenced. This study represents more than twice the total rDNA sequence and more than twice the number of patients in the previous study. The increased number of patients and clones sequenced allowed enhanced phylogenetic analyses and refinements in our view of rDNA species inhabiting the prostate. A continuum of related rDNAs that might be arbitrarily described as two major groups of rDNAs and several minor groups was found. Sequences termed Pros A, identified in 8 (35%) of 23 rDNA-positive patients, grouped with Aeromonas spp. in phylogenetic studies. Sequences termed Pros B, identified in 17 (74%) of 23 rDNA-positive patients, were distinct from previously reported sequences, although all were >90% similar to known gram-negative bacteria. Of the nine patients for whom multiple rDNAs were sequenced, six had biopsy specimens containing rDNAs from more than one species. Four (17%) patients had rDNAs different from those of the Pros A and Pros B groups. Of these four, one patient had rDNA similar to that of Flavobacterium spp., another had rDNA similar to that of Pseudomonas testosteroni, and two patients had rDNAs <70% similar to known rDNAs. These findings suggest that the prostate can harbor bacteria undetectable by traditional approaches. Most of these diverse sequences are not reported in environments outside the prostate. The sequence similarities suggest adaptation of limited groups of bacteria to the microenvironment of the prostate. Further studies may elucidate the relationship of prostate-associated bacteria to chronic prostatitis/chronic pelvic pain syndrome.
慢性前列腺炎/慢性盆腔疼痛综合征的治疗通常是经验性的，因为临床培养方法在90%以上的患者中未能检测出与前列腺相关的病原体。此前，我们测试了多种特定微生物的聚合酶链反应（PCR），在发现尽管采用了最佳技术进行培养结果为阴性，但77%的前列腺炎患者的原核生物核糖体RNA编码DNA序列（rDNA）的PCR检测呈阳性后，我们开展了一项DNA序列研究。在本研究中，对来自23名rDNA阳性患者的36个rDNA克隆进行了测序。这项研究的rDNA序列总数是之前研究的两倍多，患者数量也是之前研究的两倍多。患者和测序克隆数量的增加使得系统发育分析得到加强，并且让我们对栖息在前列腺中的rDNA种类有了更精确的认识。发现了一系列相关的rDNA，它们可以被任意地描述为两个主要的rDNA组和几个次要的rDNA组。在23名rDNA阳性患者中的8名（35%）中鉴定出的序列被称为Pros A，在系统发育研究中与气单胞菌属归为一组。在23名rDNA阳性患者中的17名（74%）中鉴定出的序列被称为Pros B，它们与先前报道的序列不同，尽管所有序列与已知革兰氏阴性菌的相似度均>90%。在对多个rDNA进行测序的9名患者中，有6名患者的活检标本中含有来自不止一个物种的rDNA。4名（17%）患者的rDNA与Pros A组和Pros B组的不同。在这4名患者中，1名患者的rDNA与黄杆菌属的相似，另1名患者的rDNA与睾丸酮假单胞菌的相似，还有2名患者的rDNA与已知rDNA的相似度<70%。这些发现表明前列腺可能藏有传统方法无法检测到的细菌。这些不同的序列大多数在前列腺以外的环境中未被报道。序列的相似性表明有限的细菌群体适应了前列腺的微环境。进一步的研究可能会阐明与前列腺相关的细菌与慢性前列腺炎/慢性盆腔疼痛综合征之间的关系。
