Evaluation of the bacterial flora of the prostate using a 16s rRNA gene based polymerase chain reaction
Evaluation of the bacterial flora of the prostate using a 16s rRNA gene based polymerase chain reaction
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DOI：
10.1016/s0022-5347(05)67987-6
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发表时间：
2000-01-01
影响因子：
6.6
通讯作者：
Schaeffer, AJ
中科院分区：
文献类型：
--
作者：
Hochreiter, WW;Duncan, JL;Schaeffer, AJ
目的：细菌在慢性盆腔疼痛综合征（非细菌性前列腺炎和前列腺痛）中的作用是有争议的，难以评估，因为前列腺的细菌植物群没有很好的定义。聚合酶链反应（PCR）是一种高度敏感的细菌检测方法。它以高置信度确认组织的无菌性，并检测可能代表病原体的少量微生物因子。我们进行PCR以确定假定健康男性和接受简单或根治性前列腺切除术的患者前列腺的细菌定植。我们分析了来自18名器官捐献者的28份前列腺样本，这些器官捐献者的前列腺组织是在器官取出时在无菌手术条件下获得的，14份无菌手术前列腺标本，来自7名接受前列腺癌根治性前列腺切除术的患者，这些患者既往接受过经直肠活检，6份无菌手术前列腺标本来自2例因良性前列腺增生（BPH）接受单纯前列腺切除术的男性的手术标本，其中1例留置导管数周。对于PCR，我们使用2套引物检测细菌16 S rRNA基因序列。正常前列腺组织在体外接种已知数量的大肠杆菌被用来评估PCR.Results的敏感性：只有3的28个器官供体样本有组织学迹象的最小炎症和所有其他样本似乎是正常的，没有证据表明炎症反应。所有这些样本均为PCR阴性。在几个PCR对照反应中，前列腺组织与已知数量的E.大肠杆菌的检测表明，高灵敏度的测定，允许检测少至6个细菌的存在下，25毫克。前列腺组织在14例根治性直肠癌切除术标本中发现了局灶性和不均匀分布的炎症和感染。在前列腺癌和BPH组中，炎症与阳性PCR结果有很强的相关性。11例前列腺标本中3例无炎症，9例有炎症，PCR均阳性。在我们的研究中，在表面健康的男性前列腺组织中的阴性PCR反应使得在前列腺中存在正常细菌植物群的可能性极小。根治性前列腺切除术标本中细菌和/或炎症的存在被认为是一个局部过程。单纯性和根治性前列腺切除术标本中炎症和阳性PCR结果之间的一致性表明，细菌可能经常在组织学炎症性前列腺炎中发挥作用。
Purpose: The role of bacteria in the chronic pelvic pain syndrome (nonbacterial prostatitis and prostatodynia) is controversial and difficult to assess because the bacterial flora of the prostate is not well defined. Polymerase chain reaction (PCR) is a highly sensitive molecular method of bacterial detection. It confirms the sterility of tissue with a high level of confidence and detects small numbers of microbial agents that may represent pathogens. We performed PCR to determine bacterial colonization of the prostate in presumably healthy men and in those undergoing simple or radical prostatectomy.Materials and Methods: We analyzed 28 prostate samples from 18 organ donors from whom prostate tissue was obtained under sterile surgical conditions at organ withdrawal, 14 sterile surgical prostate specimens from 7 patients undergoing radical prostatectomy for prostate cancer who previously underwent transrectal biopsy and 6 sterile surgical specimens from 2 men who underwent simple prostatectomy for benign prostatic hyperplasia (BPH), including 1 with an indwelling catheter for several weeks. For PCR we used 2 sets of primers to detect bacterial 16S rRNA gene sequences. Normal prostate tissue seeded in vitro with known numbers of Escherichia coli was used to assess the sensitivity of PCR.Results: Only 3 of the 28 organ donor samples had histological signs of minimal inflammation and all other samples appeared to be normal without evidence of inflammatory reaction. All of these samples were PCR negative. Of several PCR control reactions the mixture of prostate tissue seeded with known numbers of E. coli demonstrated the high sensitivity of the assay, allowing the detection of as few as 6 bacteria in the presence of 25 mg. of prostate tissue. A focal and heterogeneous distribution of inflammation and infection was noted in the 14 radical prostatectomy specimens. In the prostate cancer and BPH groups there was a strong association of inflammation with positive PCR findings. Of 11 samples 3 without but all 9 with inflammation were PCR positive.Conclusions: PCR is a highly sensitive method for detecting bacteria in the prostate. In our study negative PCR reactions in the prostate tissue of apparently healthy men made the presence of normal bacterial flora in the prostate extremely unlikely. The presence of bacteria and/or inflammation in radical prostatectomy specimens was found to be a localized process. Concordance between inflammation and positive PCR results in simple and radical prostatectomy specimens suggests that bacteria may frequently have a role in histologically inflammatory prostatitis.