Changing profile of prostatic abscess.

Area of Science:

• Urology
• Infectious Diseases
• Microbiology

Background:

• Prostatic abscess is a serious condition requiring timely diagnosis and treatment.
• Understanding trends in etiology, patient demographics, and antimicrobial resistance is crucial for effective management.

Purpose of the Study:

• To compare clinical presentations and treatment outcomes of prostatic abscess across two distinct time periods.
• To analyze changes in etiologies, co-morbid factors, and the impact of multidrug-resistant organisms.

Main Methods:

• Retrospective chart review of 48 patients diagnosed with prostatic abscess between 1991 and 2005.
• Division of the study period into two phases: Phase I (1991-1997) and Phase II (1998-2005).
• Analysis of patient demographics, clinical features, predisposing factors, imaging, bacteriology, antibiotic susceptibility, treatment, and outcomes.

Main Results:

• A significant decrease in mean patient age was observed from Phase I (59.22 yrs) to Phase II (49.14 yrs).
• Diabetes mellitus remained the most common co-morbid factor; however, an increase in younger patients (22-44 yrs) without co-morbidities was noted in Phase II.
• Emergence of multidrug-resistant organisms and rare infections, including HIV-associated tuberculous and cryptococcal prostatic abscesses, and melioidotic abscesses in Phase II.

Conclusions:

• Prostatic abscess incidence is rising in younger patients without co-morbidities.
• While the general bacteriological profile is stable, the emergence of multidrug-resistant organisms is a significant concern.
• A worrying trend of HIV-associated tuberculous prostatic abscesses and other rare pathogens necessitates updated treatment strategies.