Prostatitis --Comparison of a mollicute-specific PCR, a ureaplasma-specific PCR, and a RAPD protocol

Third International Chronic Prostatitis Network

Comparison of a mollicute-specific PCR, a ureaplasma-specific PCR, and a RAPD protocol for detection of ureaplasma urealyticum in men with chronic prostatitis

J. Dimitrakov, J. Tchitalov, T. Zlatanov, D. Dikov, J.S. Jensen, W. Weidner
Justus-Liebig University, Urology Clinic, Giessen, Germany; Higher Medical Institute, Departments of Urology and Pathology, Plovdiv, Bulgaria; Mycoplasma Laboratory, Statens Seruminstitut, Copenhagen, Denmark

Background

The results from human and animal inoculation studies and observations on immunocompromised patients provide substantial evidence that ureaplasmas are a cause of non-chlamydial non-gonococcal urethritis and prostatitis in men and controlled antibiotic and sero-logical studies lend some support to this contention. However, the proportion of patients with ureaplasma-induced prostatitis is unknown; the occurrence of urethral ureaplasmas in healthy men suggest that the organism may persist after causing asymptomatic untreated disease and/or that only certain serovars are pathogenic or that predisposing factors such as lack of mucosal immunity exist in those who develop the disease.

Material & Interest

We evaluated one hundred category IIIA chronic abac-terial prostatitis patients (median age 25, range 18-40) and one hundred asymptomatic age-matched controls. Patients were assigned to category III A if they met the diagnostic criteria for isolation, quantitative determi- nation, and localization of Ureaplasma urealyticum to the prostate as detailed by Weidner et al (1988). Urethral and expressed prostatic secretion (EPS) and/or post-prostatic massage urine (PPMU) samples were evaluated using Mollicute-specific PCR, Ureaplasma-specific PCR and the recently proposed PCR protocol for species identification and subtyping of Ureaplasma parvum and Ureaplasma urealyticum (Gilbert GL et al, 2000) and published RAPD protocols.

Conclusions

The results from our study show that Ureaplasma parvum is instrumental in the pathogenesis of a subgroup of category IIIA chronic prostatitis patients. RAPD results show that mba serovars 3/14 and 1 are most frequently implicated in prostatic inflammation and they are different from the urethral serovars. We therefore propose an algorithm for the diagnosis of Ureaplasma-associated prostatitis.

Supported by a grant to Dr. J. Dimitrakov from the Prostatitis Foundation of America

Results

Patients/Methods	Sample site	Mollicute-specific PCR	Ureaplasma-specific PCR	Ureaplasma-parvum	Ureaplasma-urealyticum

Patients	Urethra	25	22	10	12
	EPS/PPMU	32	35	29	6
Controls	Urethra	21	17	7	10
	EPS/PPMU	25	20	3	17

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