Moderated Poster

Poster, Podium & Video Sessions

MP11-08: Reassesment of Non-traditional Uropathogens in Chronic Pelvic Pain Syndrome (CP/CPPS)

Friday, May 12
1:00 PM - 3:00 PM
Location: BCEC: Room 151

Presentation Authors: Daniel Mazur, Jonathan Anker, Stephen Murphy, Anthony Schaeffer, Praveen Thumbikat*, Chicago, IL

Introduction: Localization of traditional uropathogenic bacteria to the prostate has been reported in up to 8% of patients with CP/CPPS and in healthy controls. However, the frequency and significance of non-pathogenic bacteria have been highly variable.

Methods: We retrospectively reviewed prostate localization cultures done at our institution from 05/2010 to 11/2014 and the associated patient clinical information. Cultures were considered to be localized to the prostate if bacteria count was 1 log greater in the EPS or VB3 than that in the VB1 and VB2 (criteria 1), or 1 log greater than only that in the VB2 (criteria 2). Bacteria were analyzed for their ability to induce inflammation using THP1-Blue cells reporting NFkB expression.

Results: Using criteria 1, 14% (20 of 146) of patients with the diagnosis of CP/CPPS had localizing cultures all performed by (AJS). A total of 28 bacteria, all gram-positive, localized to their prostates. Using criteria 2, the localizing population included patients seen by other urologists and with 1 of 3 diagnoses: CP/CPPS (group 1, 37 patients), elevated PSA with no pelvic pain (group 2, 12 patients), and category II chronic bacterial prostatitis (CBP) or recurrent UTIs (group 3, 15 patients). Gram-positive bacteria comprised 100% of group 1 localizations, and 92% of group 2, while group 3 was 27% gram-negative. A high NFkB response was noted in 20%, 9%, and 42% of bacteria in groups 1, 2, and 3, respectively. While 100% of gram-negative organisms induced a high NFkB response, there was a subgroup of gram-positives (11% of E. faecalis, 13% of S. haemolyticus, 19% of S. epidermidis; 12 total) that also induced a high response. 100% and 83% of patients with bacteria in this subgroup reported pain and voiding complaints, respectively, compared to 66% and 69% of patients with low NFkB inducing gram-positive prostate bacteria.

Conclusions: Traditional gram-negative uropathogenic bacteria with high inflammatory response were prevalent among patients with CBP or UTIs. A subset of gram-positive bacteria from patients with CP/CPPS also showed a high inflammatory response and association with more pain and voiding complaints. A subset of traditional non-uropathogenic bacteria may contribute to inflammation and symptoms in patients with CP/CPPS.

Source Of Funding: NIH NIDDK R01DK094898, R01DK108127

Praveen Thumbikat, DVM, PhD

Northwestern University

Praveen Thumbikat, DVM, PhD
O'Connor Family Research Professor of Urology
Associate Professor of Urology and Pathology
Northwestern University Feinberg School of Medicine
I am an academic researcher with a major focus on the immune basis of prostate disease in humans. We have a particular emphasis on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), a debilitating medical condition characterized by dysuria and pelvic pain. My laboratory is also very interested in understanding the mechanism underlying inflammation of the human prostate and it's impact on benign disease and carcinogenesis. My laboratory utilizes comparative animal models that closely track human prostate disease as tools for translational research. Some specific areas of research interest are as follows - 1. Th1/Th17 mechanisms in chronic pelvic pain: We are interested in understanding the mechanism of T cell mediated pain, the effectors of the pain pathway and measures to modulate Th1/Th17 immune response in animal models and ultimately in humans. 2. Mast cell mediated mechanisms in chronic pelvic pain and LUTS: We study the role of mast cells in pelvic pain and LUTS by focusing on neuroimmune mechanisms as well as fibrosis.

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MP11-08: Reassesment of Non-traditional Uropathogens in Chronic Pelvic Pain Syndrome (CP/CPPS)



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