From the Guidelines
The most common microorganism responsible for bacterial prostatitis is Enterobacterales, which includes a variety of species such as Escherichia coli (E. coli), Klebsiella, and Proteus. According to the European Association of Urology guidelines on urological infections, published in 2024 1, Enterobacterales are the primary pathogens in acute bacterial prostatitis (ABP). Some key points to consider when managing bacterial prostatitis include:
- The classification of bacterial prostatitis, which distinguishes between bacterial prostatitis with confirmed or suspected infection and chronic pelvic pain syndrome, as proposed by the National Institute of Diabetes, Digestive, and Kidney Diseases 1.
- The use of fluoroquinolone antibiotics, such as ciprofloxacin or levofloxacin, for the treatment of bacterial prostatitis, although the specific dosage and duration may vary depending on the severity and type of infection.
- The importance of considering the broader spectrum of species that may be involved in chronic bacterial prostatitis (CBP), which may include atypical microorganisms 1. It is essential to note that while E. coli is a common cause of bacterial prostatitis, the term Enterobacterales encompasses a broader range of species, and the specific microbiology may vary depending on the individual case and the type of prostatitis (acute or chronic) 1.
From the Research
Most Common Microorganism Responsible for Bacterial Prostatitis
- The most common organism associated with chronic bacterial prostatitis (CBP) is Escherichia coli 2, 3, 4, 5.
- Other organisms that have been documented to cause CBP include Klebsiella, Enterobacter, Proteus, Pseudomonas, and enterococci 2.
- E. coli is the causative organism in the majority of cases, with studies showing that it is responsible for the infection in 37 out of 106 patients in one study 5 and in all cases of chlamydial prostatitis in another study 6.
Prevalence of E. coli in CBP
- E. coli is the most common pathogen isolated in patients with CBP, with a prevalence of 37/106 (34.9%) in one study 5.
- Another study found that E. coli was the causative organism in 10 out of 16 patients (62.5%) with proven CBP 4.
- The high prevalence of E. coli in CBP highlights the importance of considering this organism when diagnosing and treating the condition.
Other Organisms Causing CBP
- Other organisms that can cause CBP include Gram-positive bacteria such as Enterococcus faecalis and Staphylococcus epidermidis 5.
- Klebsiella, Enterobacter, Proteus, and Pseudomonas are also potential causes of CBP, although they are less common than E. coli 2.
- The presence of these organisms highlights the importance of obtaining a microbiological diagnosis to guide treatment.