Prokaryotic DNA sequences in patients with chronic idiopathic prostatitis

Area of Science:

• Urology
• Microbiology
• Molecular Diagnostics

Background:

• Chronic prostatitis affects many men, with unknown causes in over 90% of cases.
• Traditional diagnostic methods often fail to identify causative agents in refractory prostatitis.

Purpose of the Study:

• To investigate the presence of microorganisms in chronic prostatitis patients unresponsive to standard antimicrobial therapy using molecular techniques.
• To explore the association between detected microorganisms and prostate inflammation.

Main Methods:

• Utilized Polymerase Chain Reaction (PCR) assays for specific pathogens (Mycoplasma genitalium, Chlamydia trachomatis, Trichomonas vaginalis) and broad-spectrum targets (tetracycline resistance genes, 16S rRNA).
• Analyzed expressed prostatic secretions for leukocyte counts.
• Employed direct sequencing and repetitive cloning for 16S rRNA analysis.

Main Results:

• Specific PCR detected known pathogens in 8% of patients.
• Broad-spectrum PCR identified tetracycline resistance genes in 25% and 16S rRNA in 77% of subjects.
• 16S rRNA detection was significantly associated with higher leukocyte counts in prostatic secretions (P < 0.001).
• Identified novel 16S rRNA sequences distinct from common flora, suggesting unculturable microorganisms.

Conclusions:

• The prostate can harbor microorganisms undetectable by conventional culture methods.
• These novel microorganisms may contribute to chronic prostatitis and inflammation.
• Molecular methods are crucial for identifying culture-resistant pathogens in chronic prostatitis.