title: Clinical and microbiological characteristics of spontaneous acute prostatitis and transrectal prostate biopsy-related acute prostatitis: Is transrectal prostate biopsy-related acute prostatitis a distinct acute prostatitis category?
abstract: OBJECTIVE
  This study aimed to compare the clinical and microbiological characteristics between acute bacterial prostatitis and transrectal biopsy-related acute prostatitis.
  
  
  METHODS
  We retrospectively reviewed the records of 135 patients hospitalized for acute prostatitis in three urological centers between 2004 and 2013. Acute bacterial prostatitis was diagnosed according to typical symptoms, findings of physical examination, and laboratory test results. Clinical variables, laboratory test results, and anti-microbial susceptibility results were reviewed. Patients were classified into the spontaneous acute prostatitis group (S-ABP) or biopsy-related acute prostatitis (Bx-ABP) for comparison of their clinical, laboratory, and microbiological findings.
  
  
  RESULTS
  The mean age of all patients was 61.7 ± 12.9 years. Compared with S-ABP patients, Bx-ABP patients were significantly older, had larger prostate volumes, higher PSA values, higher peak fever temperatures, and higher incidence of septicemia and antibiotic-resistant bacteria. Overall, of the 135 patients, 57.8% had positive bacterial urine and/or blood cultures. Bx-ABP patients had a higher incidence of bacterial (urine and/or blood) positive cultures compared to S-ABP patients (66.7% versus 55.6%). Escherichia coli was the predominant organism in both groups, but it was more common in Bx-ABP (88.9%) than in S-ABP (66.7%). Extended spectrum beta-lactamase -producing bacteria accounted for 64.7% of culture-positive patients in the Bx-ABP group compared to 13.3% in the S-ABP group.
  
  
  CONCLUSIONS
  Bx-ABP patients showed a higher incidence of septicemia and antibiotic-resistant bacteria than S-ABP patients. These results have important implications for the management and antimicrobial treatment of Bx-ABP, which may well deserve to be considered a distinct prostatitis category.
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Mi Mi
authors.initials: MM
authors.lastname: Oh
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Bae
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: dgmoon@korea.ac.kr.
authors.forename: Du Geon
authors.initials: du G
authors.lastname: Moon
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy / Q000379:methods; D004926:Escherichia coli / Q000187:drug effects; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000187:drug effects / Q000382:microbiology* / Q000473:pathology*; D011472:Prostatitis / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute prostatitis; Extended spectrum beta-lactamase; Transrectal prostate biopsy