Dokaz bakterije Mycoplasma genitalium u muškaraca sa sindromom kroničnog prostatitisa: prevalencija, dijagnostički kriteriji te rutinski probir Detection of Mycoplasma genitalium in men with chronic prostatitis syndrome: prevalence, diagnostic criteria and population-based screening

摘要

In the study, there were 91 patients with chronic prostatitis symptoms and 26 asymptomatic men enrolled, all treated at the Outpatient department for urogenital infections and sexually transmitted diseases of the University hospital for infectious diseases “Dr. Fran Mihaljević” in the period February 1 to August 1, 2010. After initial patient history, every patient filled out the Croatian translation of the NIH chronic prostatitis symptom index (NIH-CPSI), followed by a clinical examination. Urethral swabs were performed and selective collection of urine and expressed prostatic secretion (EPS) samples by the Meares-Stamey 4-glass test followed. Finally, an ultrasound examination of the pelvis was performed. The number of leukocytes, gram-positive and gram-negative bacteria in urine and EPS was determined in 1 ml samples, and a finding of ≥10 leukocytes in EPS or VB 3 signified an inflammatory nature of the disease. Urethral swabs were analyzed for M. genitalium, C. trachomatis, M. hominis, and U. urealyticum. EPS and VB 3 were analyzed for the presence of M. genitalium, C. trachomatis, M. hominis, U. urealyticum, and T. vaginalis; while all three urine and EPS samples were cultured to identify gram-positive and gram-negative bacteria. An infectious etiology of the chronic prostatitis syndrome was confirmed in 16 patients (17%), while only in one (1%) was there a confirmed inflammatory nature of the disease, ie. an inflammatory case of the chronic pelvic pain syndrome by T. vaginalis was determined. M. genitalium was not proven in any of the urethral, EPS or VB 3 samples of the patients with symptoms or signs of chronic prostatitis syndrome, by any of the three modern diagnostic methods (a standardized PCR method with a MgPa target gene of the main adhesion protein; a PCR method for 16S rRNA; and a real-time PCR also for 16S rRNA). Also, there were no positive findings in the control group. As M. genitalium, in this study, was not proven in any of the subjects, we conclude that routine sampling for M. genitalium within the chronic prostatitis syndrome, at this time, is not warranted, but the problem should be further investigated in a larger number of patients.