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The impact of biofilm-producing bacteria on chronic bacterial prostatitis treatment: results from a longitudinal cohort study

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Abstract

Purpose

We aim to evaluate the role of biofilm-producing bacteria in the clinical response to antibiotic therapy among patients affected by chronic bacterial prostatitis (CBP).

Methods

All patients attending our centre from January to December 2008 due to prostatitis-like symptoms with a positive Meares–Stamey test were enroled. The clinical symptoms were assessed according to the NIH-CPSI, and the bacterial strains isolated from the patients enroled were identified and tested for antibiotic sensitivity using cards of the Vitek II semi-automated System for Microbiology (BioMerieux). Quantitative bacterial slime production was assessed by the Christensen microwell assay. All patients were treated with fluoroquinolones for 4 weeks and reevaluated clinically and microbiologically after 3 months.

Results

One hundred and sixteen patients were enroled, and 150 bacterial strains were isolated from all patients. About 85 % of these strains were strong or moderate biofilm producers. Patients with strong or moderate biofilm-producing bacteria had a higher NIH-CPSI symptom score than those without biofilm-producing bacteria (mean 17.6 ± 5.6 vs. 14.1 ± 3.3; p = 0.0009). At the follow-up, 68 patients (58.6 %) had negative microbiological tests, but only 11 (9.48 %) reported a reduction in NIH-CPSI score. Improvement of symptoms was found statistically significantly less frequent in patients with biofilm-producing bacteria than in those without (p = 0.03). Ultrastructural analysis showed cellular forms in active replication with aberrant morphology of unknown cause and confirmed strong slime production with consistent bacterial stratification.

Conclusion

In our CBP population, biofilm-producing bacteria were commonly found and had a significant negative impact on the clinical response to antibiotic therapy.

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Acknowledgments

We are grateful to all participating centre’s members for their assistance and to Professor John Denton (Department of Modern Philology, University of Florence) for manuscript language revision.

Conflict of interest

Sanofi-Aventis Italia has provided technical support and funding. No author, however, has financial or commercial conflict of interests.

Author information

Authors and Affiliations

  1. Department of Clinical Care Medicine and Surgery, Urology Unit Santa Maria Annunziata Hospital, University of Florence, Florence, Italy

    Riccardo Bartoletti

  2. Department of Urology, Santa Chiara Regional Hospital, Largo Medaglie d’Oro, 9, 38123, Trento, Italy

    Tommaso Cai

  3. Department of Pathology, University of Florence, Florence, Italy

    Gabriella Nesi

  4. STD and Microbiology Center, Santa Maria Annunziata Hospital, Azienda Sanitaria Firenze, Florence, Italy

    Sara Albanese, Francesca Meacci & Sandra Mazzoli

  5. Department of Urology, Technical University of Munich, Munich, Germany

    Kurt Naber

Authors
  1. Riccardo Bartoletti
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  2. Tommaso Cai
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  3. Gabriella Nesi
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  4. Sara Albanese
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  5. Francesca Meacci
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  6. Sandra Mazzoli
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  7. Kurt Naber
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Corresponding author

Correspondence to Tommaso Cai.

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Bartoletti, R., Cai, T., Nesi, G. et al. The impact of biofilm-producing bacteria on chronic bacterial prostatitis treatment: results from a longitudinal cohort study. World J Urol 32, 737–742 (2014). https://doi.org/10.1007/s00345-013-1145-9

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  • DOI: https://doi.org/10.1007/s00345-013-1145-9

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