Microbiological etiology of bacterial prostatitis in general hospital and primary care clinic in Korea

Purpose: The National Institutes of Health classification of prostatitis reported the proportion of chronic bacterial prostatitis, especially category II, at 3% to 10%. Because of the polymerase chain reaction (PCR) diagnosis technique, chronic prostatitis syndrome (CPS) with a known bacterial origin has increased recently. In this study, we evaluated the proportion of chronic bacterial prostatitis in a general hospital and a primary care clinic (PCC) in addition to the distribution of the microorganism in chronic bacterial prostatitis in Korea. Methods: Two hundred and ninety-three patients were enrolled in this study. One hundred and five patients in the general hospital and 188 patients in the PCC were enrolled in the study. Using a questionnaire, all patients were checked for symptoms of urinalysis, expressed prostate secretion (EPS), EPS or V3 culture and PCR of EPS or VB3 for Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genetalia, and Trichomatis vaginalis. Results: In routine EPS or VB3 culture, 12 of 105 patients (11.4%) in the general hospital showed positive culture, but 77 of 188 patients (40.9%) in the PCC showed a positive culture. Escherichia coli, Streptococcus faecalis, Staphylococcus epidermidis, Staphylococcus hemolyticus, Staphylococcus aureus, and Pseudomonas were isolated in routine culture. In the PCR diagnosis, 37 of 105 patients (35.2%) in the general hospital were PCR positive, and 65 of 188 patients (34.5%) in the PCC were PCR positive. In the general hospital, C. trachomatis was the most common (49%), followed by U. urealyticum (24%), M. genetalia (16%), M. hominis (10%), and T. vaginalis (2%). In the PCC, U. urealyticum was the most common (45%), followed by C. trachomatis (34%), M. hominis (13%), M. genetalia (7%) and T. vaginalis (1%). The proportions of chronic bacterial prostatitis were 46.6% (49/105) and 67.5% (127/188) in the general hospital and PCC, respectively. Conclusions: The total portion of chronic bacterial prostatitis was 59.3% (174/293). Culture-positive patients in the PCC were significantly higher than in the general hospital, but the number of PCR positive patients in the PCC was the same as in the general hospital.