H Kumon
Department of Urology, Okayama University Medical School, Okayama, Japan
The prostate is a unique organ from which human secretions may be obtained
relatively easily. The amount of these secretions is usually small but their contents are a good reflection of different clinical conditions or courses.
Using an indirect immunoperoxidase method or a solid phase ELISA
antigen- (causative bacteria-) specific antibody (BSA), response in prostatic fluid (EPS) was measured. Escherichia cold 0-14 was used as the universal strain for all cases where E. cold was isolated. In the other cases
individual bacteria isolated from each patient were used for the assay.
BSA responses were detected in all 21 cases of acute bacterial prostatitis. Even in the case where Enterococcus faecalis was isolated as the
etiological bacteria, remarkable elevation of IgG and IgA antibody titers in EPS was observed. On the other hand, in chronic prostatitis, BSA responses varied among the bacterial species isolated. Seventy-two strains
were isolated from 69 patients, with a significant increase of tenfold or more in the bacterial count in EPS when compared with the VB1 and VB2 specimens. BSA responses were detected in most cases of so-called high
virulent bacteria including E. coli, Klebsiella pneumoniae, and Staphylococcus aureus, while in a few limited cases of less virulent bacteria; the overall positive rate of BSA responses was only 27.8% (20/72).
The
measurement of BSA in EPS is helpful in detecting etiological agents in bacterial prostatitis, especially in chronic prostatitis with less virulent bacteria. It is also useful in evaluating the response to treatment and
differentiating mode of recurrence, re-infection, relapse, or chronic persistent infection (biofilm mode of infection), by monitoring BSA levels over a period of time. As a result, patients with prostate biofilm
infection have been successfully treated by TUR-P followed by a combination chemotherapy with fosfomycin and levofloxacin.
