Prostate Secretion Laboratory Inspection In Chronic Prostatitis Etiology Research

Objective:This research focusses on the routine examination and bacilliculture of the prostatic fluid from chronic prostatitis patients followed by antibiotic sensitivity testing and 16SrDNA gene examination of the bacteria involved in order to clarify the etiology and pathogenesis of chronic prostatitis an also assists in probing into the relationship between chronic prostatitis and pathogen detected which may act as an important factor in early diagnosis and treatment of the disease.Methods:(1) Semi quantitative White Blood Cell counting of total 218 samples was done.Comparison between WBC≥10/HPF and WBC<10/HPF, rate of bacteria detection by culture and PCR, Mycoplasma and Chlamydia detection rate, were done. Samples with WBC≥10 were stained to identify the different types of WBCs to catagorize the chronic prostatitis on this basis. For the microscopy of bacteria, the fluid was also stained by Gram stain and observed under oil immersion objective, and the positivity was compared with PCR findings.(2) Bacterial culture, Chlamydia culture, Mycoplasma culture and respective drug sensitivity test was done. The bacterial culture was done in blood agar plate, SS plate and L-type culture plate. Mycolpalsma and Chlamydiae in Xie Niaoren and Colloid Gold Law respectively.(3) PCR method was implementd to detect the bacterial 16Sr DNA gene and the result was compared with that of culture method.Results:(1) The comparison of results obtained by culture and PCR for both of the samples (WBC≥10/HPF and WBC<10/HPF) show no significant difference. The WBC number is seen to increase in bacterial infection, especially the neutrophils. The direct smear for bacterial microscopy results poorer positive findings than those by culture and PCR. But this method is more convenient for those needing quick diagnosis especially in the out patient department.(2) Out of the total 218 cases,122 samples were found to have single pathogen involved in infection and 1 case had multiple infections. Seventy six samples were found to be positive in both L- type culture and ordinary culture and 3 cases were positive only in L- type culture. Mycoplasma and Chlamydia positivity were seen in 46 samples. The coagulase negative Staphylococcus showed intermediate sensitivty to Vancomycin and relatively more sensitve to anibiotics like rifampin, gentamicin, clindamyin etc. Staphylococcus aureus was susceptible to rifampin, gentamicin, chloramphenicol and doxycycline. Escherichia coli was more sensitive to amikacin, fosfomycin, meropenem, piperacillin, cephalosporins(cefoperazone, cefotaxime, cetazidime, cefuroxime), quinolones (ciprofloxacin, levofloxacin,) nitrofurantoin etc.(3) In PCR results ou of 218 samples,124 were positive for 16SrDNA gene. All these 124 were also positive for bacterial culture are responsible for bacterial prostatitis. Out of 93 culture positive bacteria,79(84.9%) were PCR positive. The comparison of culture and PCR shows that the difference has statistical significance (P<0.05), the sensitivity of PCR is higher than that of culture.Conclusions:(1) In type II prostatitis, WBC count does not necessarily increase but still has prostatitis symptom. So patients whose WBC counts are normal are also suggested to do tests for the possible micro-organism in order to rule out the type IIIB prostatitis.(2) The bacterial prostatitis occurs with elevation of WBC count,especially neutrophils.(3) The direct microscopy for bacteria is suitable for the patients who need urgent diagnosis or who are in the outpatient department.(4) The bacterial infection is one of the primary causes of prostatitis. The bacteria commonly involved are enterobacteriaceae family coagulase positive as well as negative staphylococcus etc. Mycoplasma and Chlmydia are also important pathogens causing prostatitis.(5) The PCR examination of 16SrDNA gene may enhance the sensitivity of bacterial prostatitis diagnosis.