Etiología microbiana de la prostatitis crónica bacteriana: revisión sistemática / Microbial etiology of bacterial chronic prostatitis: systematic review

Objectives: The importance of Gram-positive microorganisms and atypical bacteria in chronic bacterial prostatitis (CBP) has recently been described. For this reason, this study analyzes the etiology of CBP, as well as the evolution of antibiotic resistance through a systematic review. Material and methods: A systematic review of studies obtained through the MEDLINE (PubMed) database, related to the etiology and antibiotic resistance profile of CBP, published up July 1, 2021. Results: The most frequent isolated microorganisms that we have found in publications are Enterococcus faecalis (46.90%), Staphylococcus spp. (22.30%), Escherichia coli (15.09%) and atypical bacteria (6.04%). Conclusions: CBP is undergoing and unprecedented change of paradigm. Gram-positive bacteria and atypical bacteria are the main pathogens involved in the aetiology of this entity. This forces us to rethink the therapeutic strategy used, since it is necessary to use antibiotics that assume the etiological change and the profile of antibiotic resistance described. (AU)

Objetivos: Recientemente se ha descrito la importancia de los microorganismos grampositivos y de las bacterias atípicas en la prostatitis crónica bacteriana (PCB). Por ello, en este estudio se analiza la etiología de la PCB, así como la evolución de la resistencia antibiótica a través de una revisión sistemática. Material y métodos: Se ha realizado una revisión sistemática de estudios obtenidos a través de la base de datos MEDLINE (PubMed), relacionados con la etiología y el perfil de resistencia antibiótica de la PCB, publicados con anterioridad al 1 de julio de 2021. Resultados: Los principales microorganismos aislados en los estudios incluidos en la revisión fueron Enterococcus faecalis (46,90%), Staphylococcus spp. (22,30%), Escherichia coli (15,09%) y bacterias atípicas (6,04%). Conclusiones: La PCB está experimentando un cambio de paradigma, ya que las bacterias grampositivas y las atípicas se erigen como los principales agentes causales de esta entidad. Esto obliga a replantear la estrategia terapéutica utilizada, pues es necesario utilizar antibióticos que asuman el viraje etiológico y el perfil de resistencias antibióticas descrito. (AU)

[Etiology of urinary tract infections in our health area and susceptibility profile of the most common uropathogens.] / Etiología de las infecciones urinarias en nuestra área sanitaria y perfil de sensibilidad de los uropatógenos más frecuentes.

BACKGROUND AND OBJECTIVE: Adequate empirical treatment should be established for treatment urinary tract infections, considering the prevalence of the most frequent microorganisms in each geographic area and their susceptibility to different antibiotics. The objective of the study is to analyze the epidemiology of UTIs in our Health Area as well as to understand the antibiotic susceptibility of the most prevalent isolated microorganisms to guide empirical treatment. The objective was to establish a reasoned system for recommending ITU empirical therapy, based on the microorganisms causing episodes assisted in a Regional Hospital, knowing their antibiotic susceptibility. PATIENTS AND METHODS: A descriptive-retrospective study was carried out based on the results of 12,204 urine cultures of the year 2018. The overall empirical activity of the antibiotics tested was calculated, differentiating between episodes of the community and of in patients, adults and children. RESULTS: Escherichia coli was the most frequently isolated microorganism in all studied groups. The following microorganisms in frequency, in adults, were Enterococcus faecalis, Klebsiella pneumoniae and yeasts (8%). In the group of children these were Enterococcus faecalis and Proteus mirabilis. There was no difference in the activity of antibiotics against Escherichia coli, in adults or in children, of the community or in patients, with sensitivityto fosfomycin and nitrofuranto in greater than 96%; at imipenem and piperacillin-tazobactam greater than 94% and third generation cephalosporins greater than 90%. However, the overall empirical activity, without distinction by microorganism, was for fosfomycin 77.96-80.60% in adults and 92.73-94.50% in children; to prevent 77.70-78.74% in adults and 92.36-91.28% in children; for piperacillin-tazobactam of 77.57-80.03% in adults and 89.09-94.04% in children; and for cefotaxime of 53.28-54.76% in adults and 68.73-74.77% in children. CONCLUSIONS: Fosfomycin, piperacillin-tazobactam or imipenem were the best option for empirical treatment without covering all episodes in adults. Each Center must establish a reasoned profile of empirical treatment of the infection, which should also take into account risk factors for a microorganism and clinical severity.

ANTECEDENTES Y OBJETIVO: Se debe establecer un tratamiento empírico adecuado que acabe con la mayor parte de las infecciones del tracto urinario (ITU), teniendo en cuenta la prevalencia de los microorganismos más frecuentes en cada área geográfica y la sensibilidad de estos a los distintos antibióticos. El objetivo del estudio es analizar la epidemiología de las ITU en nuestra Área Sanitaria, así como conocer la sensibilidad antibiótica de los microorganismos aislados más prevalentes para orientar el tratamiento empírico. PACIENTES Y MÉTODOS: Se realizó un estudio descriptivo-retrospectivo a partir de los resultados de12.204 urocultivos del año 2018. Se calculó la actividad empírica global de los antibióticos ensayados, diferenciando entre episodios de la comunidad y de pacientes hospitalizados, adultos y niños. RESULTADOS: Escherichia coli fue el microorganismo más frecuentemente aislado en todos los grupos estudiados. Los siguientes microorganismos en frecuencia, en los adultos, fueron Enterococcus faecalis, Klebsiella pneumoniae y levaduras (8%). En el grupo de los niñosestos fueron Enterococcus faecalis y Proteus mirabilis.N o hubo diferencia en la actividad de los antibióticos frente a Escherichia coli, en adultos o en niños, de la comunidad u o hospitalizado, con sensibilidad a fosfomicina y nitrofurantoína superior al 96%; a imipenem y piperacilina-tazobactam superior al 94% y cefalosporinas de tercera generación superior al 90%. Sin embargo,la actividad empírica global, sin distinción por microorganismo, fue para fosfomicina del 77,96-80,60% en adultos y del 92,73-94,50% en niños; para imipenem del 77,70-78,74% en adultos y del 92,36-91,28% en niños; para piperacilina-tazobactam del 77,57-80,03% en adultos y del 89,09-94,04% en niños; y para cefotaxima del 53,28-54,76% en adultos y del 68,73-74,77% en niños. CONCLUSIONES: Fosfomicina, piperacilina-tazobactame imipenem fueron la mejor opción de tratamiento empírica, sin cubrir todos los episodios en los adultos. Cada centro de trabajo debe establecer un perfil razonado de tratamiento empírico de la infección, que además deben tener en cuenta los factores de riesgo para un microorganismo y la gravedad clínica.

Etiología de las infecciones urinarias en nuestra área sanitaria y perfil de sensibilidad de los uropatógenos más frecuentes / Etiology of urinary tract infections in our health area and susceptibility profile of the most common uropathogens

ANTECEDENTES Y OBJETIVO: Se debe establecer un tratamiento empírico adecuado que acabe con la mayor parte de las infecciones del tracto urinario (ITU), teniendo en cuenta la prevalencia de los microorganismos más frecuentes en cada área geográfica y la sensibilidad de estos a los distintos antibióticos. El objetivo del estudio es analizar la epidemiología de las ITU en nuestra Área Sanitaria, así como conocer la sensibilidad antibiótica de los microorganismos aislados más prevalentes para orientar el tratamiento empírico. PACIENTES Y MÉTODOS: Se realizó un estudio descriptivo-retrospectivo a partir de los resultados de12.204 urocultivos del año 2018. Se calculó la actividad empírica global de los antibióticos ensayados, diferenciando entre episodios de la comunidad y de pacientes hospitalizados, adultos y niños. RESULTADOS: Escherichia coli fue el microorganismo más frecuentemente aislado en todos los grupos estudiados. Los siguientes microorganismos en frecuencia, en los adultos, fueron Enterococcus faecalis, Klebsiella pneumoniae y levaduras (8%). En el grupo de los niñosestos fueron Enterococcus faecalis y Proteus mirabilis.N o hubo diferencia en la actividad de los antibióticos frente a Escherichia coli, en adultos o en niños, de la comunidad u o hospitalizado, con sensibilidad a fosfomicina y nitrofurantoína superior al 96%; a imipenem y piperacilina-tazobactam superior al 94% y cefalosporinas de tercera generación superior al 90%. Sin embargo,la actividad empírica global, sin distinción por microorganismo, fue para fosfomicina del 77,96-80,60% en adultos y del 92,73-94,50% en niños; para imipenem del 77,70-78,74% en adultos y del 92,36-91,28% en niños; para piperacilina-tazobactam del 77,57-80,03% en adultos y del 89,09-94,04% en niños; y para cefotaxima del 53,28-54,76% en adultos y del 68,73-74,77% en niños. CONCLUSIONES: Fosfomicina, piperacilina-tazobactame imipenem fueron la mejor opción de tratamiento empírica, sin cubrir todos los episodios en los adultos. Cada centro de trabajo debe establecer un perfil razonado de tratamiento empírico de la infección, que además deben tener en cuenta los factores de riesgo para un microorganismo y la gravedad clínica

BACKGROUND AND OBJECTIVE: Adequate empirical treatment should be established for treatment urinary tract infections, considering the prevalence of the most frequent microorganisms in each geographic area and their susceptibility to different antibiotics. The objective of the study is to analyze the epidemiology of UTIs in our Health Area as well as to understand the antibiotic susceptibility of the most prevalent isolated microorganisms to guide empirical treatment. The objective was to establish a reasoned system for recommending ITU empirical therapy, based on the microorganisms causing episodes assisted in a Regional Hospital, knowing their antibiotic susceptibility. PATIENTS AND METHODS: A descriptive-retrospective study was carried out based on the results of 12,204 urine cultures of the year 2018. The overall empirical activity of the antibiotics tested was calculated, differentiating between episodes of the community and of inpatients, adults and children. RESULTS: Escherichia coli was the most frequently isolated microorganism in all studied groups. The following microorganisms in frequency, in adults, were Enterococcus faecalis, Klebsiella pneumoniae and yeasts (8%). In the group of children these were Enterococcus faecalis and Proteus mirabilis. There was no difference in the activity of antibiotics against Escherichia coli, in adults or in children, of the community or inpatients, with sensitivity to fosfomycin and nitrofurantoin greater than 96%; at imipenem and piperacillin-tazobactam greater than 94% and third generation cephalosporins greater than 90%. However, the overall empirical activity, without distinction by microorganism, was for fosfomycin 77.96-80.60% in adults and 92.73-94.50% in children; to prevent 77.70-78.74% in adults and 92.36-91.28% in children; for piperacillin-tazobactam of 77.57-80.03% in adults and 89.09-94.04% in children; and for cefotaxime of 53.28-54.76% in adults and 68.73-74.77% in children. CONCLUSIONS: Fosfomycin, piperacillin-tazobactam or imipenem were the best option for empirical treatment without covering all episodes in adults. Each Center must establish a reasoned profile of empirical treatment of the infection, which should also take into account risk factors for a microorganism and clinical severity

Potential clinical use of azithromycin against gastroenteritis-causing pathogens other than Campylobacter.

The activity of azithromycin against enteritis-producing agents other than Campylobacter spp. was studied. The susceptibility to azithromycin, through gradient test, of 88 clinical isolates (51 Salmonella spp., 23 Aeromonas spp., 10 Shigella sonnei and 4 Yersinia enterocolitica) for one year was studied prospectively. The results were compared with the activity of ampicillin, trimethoprim-sulfamethoxazole and ciprofloxacin by microdilution. For azithromycin, the minimum inhibitory concentration (MIC) 50 and MIC90 were 4 and 12 mg/l, respectively. Six (6.8%) isolates were simultaneously resistant to ampicillin, trimethoprim- sulfamethoxazole and ciprofloxacin, and 3 (50%) of them presented a MIC >256 mg/l. Azithromycin may be a good empirical therapeutic option for the treatment of bacterial enteritis.

High clinical impact of rapid susceptibility testing on CHROMID ESBL® medium directly from swabs.

BACKGROUND: Antibiotic resistance is a serious public health challenge exacerbated by the widespread use of ß-lactam and glycopeptide antibiotics. The identification of resistances is crucial, and CHROMID ESBL medium has been developed to detect enterobacteria with extended-spectrum ß-lactamases (ESBL). The objective of this study was to evaluate the potential of this medium to detect other types of resistant bacteria. METHODS: Vancomycin, cefoxitin, imipenem, and cefepime disks were used to measure growth on CHROMID ESBL medium of ß-lactam-resistant Gram-negative (83 with ESBL, 57 with carbapenemases, 35 with AmpC and 3 Stenotrophomonas maltophilia) and Gram-positive [37 vancomycin-susceptible (vancoS) microorganisms and 21 vancomycin-resistant (vancoR) Enterococcus faecium] clinical isolates (retrospective study) and colonization by the aforementioned bacteria (prospective study), using 649 rectal swabs, 314 pharyngeal swabs, and 44 swabs from other localizations. RESULTS: Retrospective study: species grown on the medium exhibited different colors. Growth on the medium was observed for: all ESBL enterobacteria, which were susceptible to imipenem and cefoxitin; 95% of isolates with carbapenemases, mostly resistant to imipenem; 80% of those with AmpC; 86% of vancoR E. faecium isolates; and 42% of vancoS E. faecalis isolates, with large growth inhibition halos around the vancomycin disk. Prospective study: vancoR E. faecium, ESBL Klebsiella, Pseudomonas with carbapenemases, A. baumannii (mostly from rectal swabs), S. maltophilia, Achromobacter xylosoxidans, and Burkholderia cenocepacia (mostly from pharyngeal swabs) were isolated from the 246 positive samples. CONCLUSIONS: CHROMID ESBL medium permitted the differential growth of Gram-negative bacteria, many with ESBL and carbapenemases. ESBL enterobacteria were susceptible to imipenem, carbapenemase-producing microorganisms grew around the imipenem disk, and vancoR E. faecium was isolated on the medium. Results of the prospective study demonstrate the potential clinical relevance of this medium. S. maltophilia was more frequently detected with pharyngeal swabs and ESBL Klebsiella, A. baumannii, and Pseudomonas with rectal swabs.

Evolución de la sensibilidad a los antibióticos de Enterobacter cloacae, Morganella morganii, Klebsiella aerogenes y Citrobacter freundii causantes de infecciones del tracto urinario: un estudio de vigilancia epidemiológica de 11 años / Susceptibility evolution to antibiotics of Enterobacter cloacae, Morganella morganii, Klebsiella aerogenes and Citrobacter freundii involved in urinary tract infections: an 11-year epidemiological surveillance study

INTRODUCCIÓN: El objetivo fue la detección en urocultivos de Citrobacter freundii, Klebsiella aerogenes, Enterobacter cloacae, Serratia marcescens, Providencia stuartii y Morganella morganii (grupo CESPM) para el estudio de su perfil de sensibilidad a los antibióticos. MÉTODOS: Entre 2006 y 2016 se analizaron todos los aislados de enterobacterias del grupo CESPM de urocultivos de centros de atención primaria o del complejo hospitalario Virgen de las Nieves (Granada). Se estudió la sensibilidad a aminoglucósidos, fosfomicina, nitrofurantoína, quinolonas, piperacilina/tazobactam, cefepime, imipenem y trimetoprim/sulfametoxazol, según normas del CLSI. RESULTADOS: Se estudiaron 736 aislamientos (30,57% E. cloacae; 23,50% M. morganii; 20,38% K. aerogenes; 10,32% C. freundii; 8,83% S. marcescens y 6,38% P. stuartii). Se observó una disminución significativa de la sensibilidad. Para gentamicina, ciprofloxacino, imipenem y cefepime presentaron sensibilidad superior al 80%. CONCLUSIÓN: E. cloacae, M. morganii y K. aerogenes fueron las especies más frecuentemente aisladas. Cefepime e imipenem siguen siendo una buena alternativa terapéutica empírica por su actividad in vitro

INTRODUCTION: The objective of this study was to analyse the susceptibility to antibiotic of Citrobacter freundii, Klebsiella aerogenes, Enterobacter cloacae, Serratia marcescens, Providencia stuartii and Morganella morganii (CESPM group), detected in urine cultures. METHODS: Between 2006 and 2016 we analyzed CESPM group Enterobacteria isolated from urine cultures from both primary health-care centers and Hospital Virgen de las Nieves (Granada). We studied the susceptibility to aminoglycosides, fosfomycin, nitrofurantoin, quinolones, piperacillin/tazobactam, cefepime, imipenem and trimethoprim/sulfamethoxazole following CLSI interpretation criteria. RESULTS: A total of 736 isolates were studied: 30.57% E. cloacae, 23.50% M. morganii, 20.38% K. aerogenes, 10.32% C. freundii, 8.83% S. marcescens and 6.38% P. stuartii. A significant decrease in the antibiotic susceptibility was observed. Gentamicin, ciprofloxacin, imipenem and cefepime showed susceptibility over 80%. CONCLUSIONS: E. cloacae, M. morganii and K. aerogenes were the most common isolates. Cefepime and imipenem are still a good empiric therapeutic alternative given its activity in vitro

Susceptibility evolution to antibiotics of Enterobacter cloacae, Morganella morganii, Klebsiella aerogenes and Citrobacter freundii involved in urinary tract infections: an 11-year epidemiological surveillance study. / Evolución de la sensibilidad a los antibióticos de Enterobacter cloacae, Morganella morganii, Klebsiella aerogenes y Citrobacter freundii causantes de infecciones del tracto urinario: un estudio de vigilancia epidemiológica de 11 años.

INTRODUCTION: The objective of this study was to analyse the susceptibility to antibiotic of Citrobacter freundii, Klebsiella aerogenes, Enterobacter cloacae, Serratia marcescens, Providencia stuartii and Morganella morganii (CESPM group), detected in urine cultures. METHODS: Between 2006 and 2016 we analyzed CESPM group Enterobacteria isolated from urine cultures from both primary health-care centers and Hospital Virgen de las Nieves (Granada). We studied the susceptibility to aminoglycosides, fosfomycin, nitrofurantoin, quinolones, piperacillin/tazobactam, cefepime, imipenem and trimethoprim/sulfamethoxazole following CLSI interpretation criteria. RESULTS: A total of 736 isolates were studied: 30.57% E. cloacae, 23.50% M. morganii, 20.38% K. aerogenes, 10.32% C. freundii, 8.83% S. marcescens and 6.38% P. stuartii. A significant decrease in the antibiotic susceptibility was observed. Gentamicin, ciprofloxacin, imipenem and cefepime showed susceptibility over 80%. CONCLUSIONS: E. cloacae, M. morganii and K. aerogenes were the most common isolates. Cefepime and imipenem are still a good empiric therapeutic alternative given its activity in vitro.

Prevalencia en varones de la población general de agentes productores de infecciones no ulcerativas del aparato genital, asistidos en atención especializada / Prevalence among males from the general population of agents responsible of not ulcerative genital tract infections, assisted in specialized care

OBJETIVO: Las infecciones de los órganos genitales en el hombre representan un grave problema por su frecuencia, morbilidad e implicación en casos de infertilidad masculina. En este trabajo se investiga, en varones asistidos en atención especializada, la presencia de los agentes productores de infecciones no ulcerativas del aparato genital. MATERIAL Y MÉTODOS: Se estudiaron de forma descriptiva y retrospectiva los resultados microbiológicos de 3.066 muestras de pacientes varones, con diagnóstico de sospecha de episodio de infección del tracto genital, recibidas entre el 1 de enero de 2016 y 31 de diciembre de 2017. La detección de los microorganismos en la muestra se realizó mediante técnicas de cultivo en medios artificiales y de PCR (BD-MAX). RESULTADOS: 451 (14,71%) muestras fueron positivas, siendo, mediante cultivo, los patógenos más frecuentes enterobacterias (18,40%), Enterococcus (13,75%), Haemophilus (8,65%), Neissseria gonorrhoeae (8,43%), Ureaplasma (5,10%) y Candida (3,77%). Mediante PCR se detectaron N. gonorrhoeae (28,37%), Chlamydia trachomatis (26,95%), Ureaplasma urealyticum (17,73%), Mycoplasma hominis y Ureaplasma parvum (10,64%), y Mycoplasma genitalium (7,10%). Se encontró mayor edad en el grupo de pacientes con presencia de enterobacterias, Candida o Enterococcus, y menor para los que tuvieron N. gonorrhoeae. CONCLUSIONES: N. gonorrhoeae y C. trachomatis siguen siendo los patógenos más frecuentes en la infección genital masculina, aunque otros microorganismos cultivables tienen un importante papel. Los ponen de manifiesto la importancia del uso sistemático tanto del cultivo tradicional como de las nuevas técnicas de PCR para la detección de patógenos

OBJECTIVE: Male genital infections are a major problem due to their high frequency and morbidity and their role in cases of male infertility. We studied the presence, in males assisted in specialized care, of non-ulcerative genital tract infections-producing agents. MATERIALS AND METHODS: We studied descriptively and retrospective microbiological results of 3,066 samples of male patients, with diagnosis of genital tract infection episode, received between January 1, 2016 and December 31, 2017. Detection of microorganisms in the sample was performed using techniques of artificial culture and PCR (BD-MAX). RESULTS: Positive results were obtained in 451 samples (14.71%). By culture, the most frequent pathogens were Enterobacterales (18.40%), Enterococcus (13.75%), Haemophilus (8.65%), Neisseria gonorrhoeae (8.43%), Ureaplasma (5.10%), and Candida (3.77%). By polymerase chain reaction (PCR), the most frequent were N. gonorrhoeae (28.37%), Chlamydia trachomatis (26.95%), Ureaplasma urealyticum (17.73%), Mycoplasma hominis/Ureaplasma parvum (10.64%), and Mycoplasma genitalium (7.10%). The age was older in patients infected with Enterobacterales, Candida, or Enterococcus and younger in those infected with N. gonorrhoeae. CONCLUSIONS: N. gonorrhoeae and C. trachomatis are still more common in male genital infection pathogens, although other culturable microorganisms have an important role. These findings demonstrate the importance of systematically applying both conventional culture and PCR techniques for pathogen detection

Presencia de Streptococcus bovis en muestras de orina de sujetos con síntomas de infección del aparato urinario / Presence of Streptococcus bovis in urine samples from patients experiencing symptoms of urinary tract

Dada la importancia de la correcta validación clínica de los aislamientos de Streptococcus bovis, nos planteamos la revisión de su presencia en muestras de orina con el objetivo de conocer su frecuencia relativa y su patrón de sensibilidad antibiótica. Se revisó retrospectivamente la sensibilidad a los antibióticos de 91 aislados de S. bovis recuperados de muestras de orina durante un período de 4 años (2012-2015). La media de la edad de los pacientes fue de 55 años y en su mayoría fueron mujeres (81%). El 37,4% eran pacientes hospitalizados con enfermedades urológicas (61%). La sensibilidad a penicilina, vancomicina y teicoplanina fue del 97,8%. Aunque S. bovis puede ser poco común en los aislamientos de orina, su presencia en sujetos con enfermedades de base justifica la realización de estudios de patogenicidad que demuestren la verdadera capacidad de producir enfermedad de este grupo de bacterias.

Given the relevance of proper clinical validation of Streptococcus bovis, we here consider revising its presence in urine samples in order to determine its relative frequency and the pattern of antibiotic susceptibility. The susceptibility to antibiotics of 91 isolates of S. bovis from urine samples was retrospectively reviewed over a period of 4 years (2012-2015). The mean age of patients was 55 years, 81% of whom were women and 37.4% were hospitalized patients suffering from urological diseases (61%). Susceptibility to penicillin, vancomycin and teicoplanin was 97.8%. Due to the fact that S. bovis can be infrequent in urine isolates and given its presence in patients suffering from urological diseases, further pathogenic studies, showing the true ability of this group of bacteria to produce disease, are required.

[Presence of Streptococcus bovis in urine samples from patients experiencing symptoms of urinary tract]. / Presencia de Streptococcus bovis en muestras de orina de sujetos con síntomas de infección del aparato urinario.

Given the relevance of proper clinical validation of Streptococcus bovis, we here consider revising its presence in urine samples in order to determine its relative frequency and the pattern of antibiotic susceptibility. The susceptibility to antibiotics of 91 isolates of S. bovis from urine samples was retrospectively reviewed over a period of 4 years (2012-2015). The mean age of patients was 55 years, 81% of whom were women and 37.4% were hospitalized patients suffering from urological diseases (61%). Susceptibility to penicillin, vancomycin and teicoplanin was 97.8%. Due to the fact that S. bovis can be infrequent in urine isolates and given its presence in patients suffering from urological diseases, further pathogenic studies, showing the true ability of this group of bacteria to produce disease, are required.

Prostatitis crónica bacteriana. Estudio clínico y microbiológico de 332 casos / Chronic bacterial prostatitis. Clinical and microbiological study of 332 cases

Fundamento y objetivos: La prostatitis crónica bacteriana (PCB) se caracteriza por una clínica de larga duración, frecuentemente asociada a trastornos psicosomáticos. El objetivo del estudio fue estudiar clínica y microbiológicamente la PCB en nuestro medio. Métodos: Entre enero de 2013 y diciembre de 2014 se estudiaron 761 pacientes con sospecha de PCB. De ellos, 332 (43,6%) fueron sometidos a un estudio microbiológico completo y se recogieron los principales signos y síntomas clínicos. Resultados: Un 18,4% de los pacientes fueron diagnosticados microbiológicamente de PCB, siendoEnterococcus faecalis el principal agente etiológico (37,7%), seguido de Escherichia coli(22,2%). El 96,7% de las PCB presentaron cultivos de semen positivos, mientras que tan solo un 22,95% tuvieron cultivos de orina postsemen positivos. Los datos de sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo del cultivo de semen fueron 96,7; 95,9; 84,3 y 99,3% respectivamente; y del cultivo de la orina postsemen 22,9; 99,3; 87,5 y 85,1% respectivamente. Destacaron el dolor perineotesticular (44,3%) de los pacientes, molestias eyaculatorias (27,9%) y la hemospermia (26,2%) como principales manifestaciones clínicas de los pacientes con estudio microbiológico significativo. Conclusiones: El cultivo fraccionado para el diagnóstico microbiológico de PCB podría simplificarse mediante el cultivo de la orina presemen y del semen, sin necesidad del cultivo de la orina postsemen. El principal agente etiológico de PCB en nuestro medio fue Enterococcus faecalis, seguido deEscherichia coli (AU)

Background and objective: Chronic bacterial prostatitis (CBP) is characterized by long-lasting symptoms, frequently associated with psychosomatic disorders. The objective of the study was to study PCB in our environment clinically and microbiologically. Methods: Between January 2013 and December 2014 761 patients with suspected CBP were studied. Of these patients 332 (43.6%) underwent a complete microbiological study and the major clinical signs and symptoms were collected. Results: Eighteen point four percent of patients were diagnosed microbiologically with CBP,Enterococcus faecalis being the main aetiologic agent (37.7%), followed by Escherichia coli(22.2%). Ninety-six point seven percent of the CBP had positive semen cultures, while only 22.9% had positive urine post-semen cultures. Data of sensitivity, specificity, positive predictive value and negative predictive value of semen were 96.7%, 95.9%, 84.3% and 99.3%, respectively and urine post-semen 22.9%, 99.3%, 87.5% and 85.1%, respectively. Testicular perineum pain (44.3%), ejaculatory discomfort (27.9%) and haemospermia (26.2%) were highlighted as the patients’ main clinical manifestations. Conclusions: Fractionated culture for the microbiological diagnosis of CBP could be simplified by the culture of urine pre-semen and semen, without the need for the culture of urine post-semen. The main aetiologic agent of CBP in our media was Enterococcus faecalis, followed by Escherichia coli (AU)

[Chronic bacterial prostatitis. Clinical and microbiological study of 332 cases]. / Prostatitis crónica bacteriana. Estudio clínico y microbiológico de 332 casos.

BACKGROUND AND OBJECTIVE: Chronic bacterial prostatitis (CBP) is characterized by long-lasting symptoms, frequently associated with psychosomatic disorders. The objective of the study was to study PCB in our environment clinically and microbiologically. METHODS: Between January 2013 and December 2014 761 patients with suspected CBP were studied. Of these patients 332 (43.6%) underwent a complete microbiological study and the major clinical signs and symptoms were collected. RESULTS: Eighteen point four percent of patients were diagnosed microbiologically with CBP, Enterococcus faecalis being the main aetiologic agent (37.7%), followed by Escherichia coli (22.2%). Ninety-six point seven percent of the CBP had positive semen cultures, while only 22.9% had positive urine post-semen cultures. Data of sensitivity, specificity, positive predictive value and negative predictive value of semen were 96.7%, 95.9%, 84.3% and 99.3%, respectively and urine post-semen 22.9%, 99.3%, 87.5% and 85.1%, respectively. Testicular perineum pain (44.3%), ejaculatory discomfort (27.9%) and haemospermia (26.2%) were highlighted as the patients' main clinical manifestations. CONCLUSIONS: Fractionated culture for the microbiological diagnosis of CBP could be simplified by the culture of urine pre-semen and semen, without the need for the culture of urine post-semen. The main aetiologic agent of CBP in our media was Enterococcus faecalis, followed by Escherichia coli.

Especies de levaduras aisladas en muestras de orina en un hospital regional de España / Isolated yeast species in urine samples in a Spanish regional hospital

La detección de candiduria en pacientes hospitalizados o inmunodeprimidos tiene una gran relevancia clínica. El objetivo de nuestro trabajo fue describir la frecuencia de aislamiento de diferentes especies significativas de levaduras en las muestras de orina procesadas en nuestro hospital en el periodo 2010-2013 y analizar su sensibilidad a los antifúngicos de uso habitual. La identificación de especies se realizó por siembra en un medio cromogénico, prueba de filamentación y sistemas automatizados (ASM Vitek y MALDI Biotyper), mientras que la sensibilidad a los antifúngicos se determinó con el sistema ASM Vitek. De los 632 aislamientos de levaduras obtenidos, 371 fueron Candida albicans y 261 especies de Candida no C. albicans. Las especies con mayor número de aislados resistentes fueron Candida glabrata y Candida krusei. Basados en nuestros resultados, consideramos que la identificación de la especie y el estudio de la sensibilidad a los antifúngicos deberían ser prácticas habituales por parte de los laboratorios cuando se aíslan especies diferentes a C. albicans

Candiduria detection in hospitalized or immunocompromised patients is of great clinical significance. The aim of our study was to describe the isolation frequency of significant species of yeasts in urine samples processed in our hospital during the period 2010- 2013, and to analyze their susceptibility to commonly used antifungal agents. Species identification was performed by seeding on a chromogenic medium, the filamentation test and automated systems (ASM Vitek and MALDI Biotyper), while susceptibility was determined using the ASM Vitek system. Of the 632 yeast isolates in urine, 371 were Candida albicans species and 261 non-C. albicans Candida spp. The species with the highest number of resistant isolates were Candida glabrata and Candida krusei. Based on the results obtained, we believe that species identification and the susceptibility study should be current practice in the laboratories when species other than C. albicans are isolated

[Isolated yeast species in urine samples in a Spanish regional hospital]. / Especies de levaduras aisladas en muestras de orina en un hospital regional de España.

Candiduria detection in hospitalized or immunocompromised patients is of great clinical significance. The aim of our study was to describe the isolation frequency of significant species of yeasts in urine samples processed in our hospital during the period 2010- 2013, and to analyze their susceptibility to commonly used antifungal agents. Species identification was performed by seeding on a chromogenic medium, the filamentation test and automated systems (ASM Vitek and MALDI Biotyper), while susceptibility was determined using the ASM Vitek system. Of the 632 yeast isolates in urine, 371 were Candida albicans species and 261 non-C. albicans Candida spp. The species with the highest number of resistant isolates were Candida glabrata and Candida krusei. Based on the results obtained, we believe that species identification and the susceptibility study should be current practice in the laboratories when species other than C. albicans are isolated.