Chronic Abacterial Prostatitis: Emergence of Sexually Transmitted Microorganisms Detected by Molecular Diagnosis

S Mazzoli, A Salvi, C Romeo, l Ramacciotti

STD Center, Santa Maria Annunziata Hospital, SHA of Florence, Florence, Italy

Chronic prostatitis represents one of the emerging infective problems in young male adults of our area in Italy. Mean age in these patients is confirmed around 30-31 years. Due to early advent of symptoms and the fact that symptoms persist for years, considering the relative young age of these patients and additionally the fact that no common bacteria, fungi, or mycoplasmata were found by conventional culture methods in semen or /and prostatic secretions, we started to look for other micro-organisms, difficult to culture, that the patient could acquire in young age, probably together with the beginning of sexual activity.

With the introduction in Italy of molecular diagnostic methods to detect bacterial and viral DNA (PCR), we started to search systematically STDs agents such as Chlamydia trachomatis (Ct), Neisseria gonhorroeae (Ng) (Roche Molecular System USA), and, later in 1998, Human Papilloma Virus (HPV) (Diatech-ltaly, Alphagenics Diaco Biotecnology ltaly, Bioline Diagnostics-ltaly, Cytic USA) in chronic prostatitis patients" biological fluids. Out of 820 chronic abacterial prostatitis patients screened for Ct and Ng DNA in semen in the last 2 years, 15.7% (129 patients) tested positive; prevalence rate for single micro-organism was 7.80% and 7.92%, respectively. None of them tested positive in urethra. Out of the 114 patients screened for presence of HPV DNA in semen, 30.70 % were positive. The co-infection rate for Ct/HPV was 51.4% and for Ng/HPV it was 34.2; 82.35% of Chlamydia t. and/or Gonococcus DNApositive patients were co-infected by HPV, either low or high risk HPV strains. Gonococcai and Chlamydial co-infection rate was 9.3%, but it seems to be underestimated if we consider the 40.2 % Western blot confirmed specific anti Chlamydia t. secretory IgA positives in semen.

Detecting DNA, we proved microorganism presence in 20% (165/820) abacterial prostatitis patients. The high co- infection rate between these STDs agents emphasises about common risk factors strictly connected with infections by these microorganisms early, probably at the start of sexual activity.