PDF(Pubmed)
Abstract：
Background: Chronic Bacterial Prostatitis (CBP) is inflammation of the prostate caused by bacterial infection. An estimated 8.2% of men have prostatitis, most commonly under the age of 50. Antibiotics often fail to treat CBP due to presence of bacterial biofilms and rising antibiotic resistance of pathogenic bacterial strains. The multidrug resistant (MDR) bacterial strains often implicated in cases of CBP include Extended Spectrum Beta Lactam resistant Escherichia coli, Vancomycin resistant Enterococci, Gram-positive bacterial strains like Staphylococci and Streptococci, Enterobacteriaceae like Klebsiella and Proteus, and Pseudomonas aeruginosa. CBP patients experience significant deterioration in quality of life, with impact on mental health comparable with patients of diabetes mellitus and chronic heart failure, leading patients to explore alternatives like phage therapy. Case presentation: We present the case of a patient diagnosed with and exhibiting typical symptoms of CBP. Tests of the prostatic and seminal fluids identified E. coli as the causative pathogen. The patient did not experience favourable long-term treatment outcomes despite repeated antibiotic courses administered over 5 years. This led him to seek phage therapy for treatment of his condition. Methods and outcome: The cultured strain of E. coli was tested against bacteriophage preparations developed by the Eliava Institute, Georgia. Preparations showing lytic activity against the strain were used for the patient\'s treatment at the Eliava Phage Therapy Center (EPTC). The patient underwent two courses of treatment with the EPTC. The first treatment course resulted in significant symptomatic improvement, followed by complete resolution of symptoms post the second course of phage therapy. Samples tested during treatment showed declining bacterial growth, corresponding with symptomatic improvement. Post-treatment cultures had no growth of pathogenic bacteria. Discussion: This case illustrates the efficacy of bacteriophages in treating CBP, a condition that is often resistant to antibiotic therapies. Antibiotics such as ofloxacin, Fosfomycin, trimethoprim, nitrofurantoin and ceftriaxone were administered in multiple courses over 5 years, but the infection recurred after each course. After two courses of phage therapy, the patient experienced long-term symptom resolution and substantial reduction in bacterial load. Increasing numbers of such cases globally warrant further research into the potential for bacteriophages for treating MDR and chronic infections.
摘要：
背景：慢性细菌性前列腺炎（CBP）是由细菌感染引起的前列腺炎症。估计有8.2%的男性患有前列腺炎，最常见的是50岁以下。由于细菌生物膜的存在和病原菌菌株的抗生素耐药性上升，抗生素通常无法治疗CBP。CBP病例中经常涉及的多药耐药（MDR）细菌菌株包括超广谱β-内酰胺耐药大肠杆菌，耐万古霉素肠球菌,革兰氏阳性细菌菌株，如葡萄球菌和链球菌，肠杆菌科，如克雷伯菌和变形杆菌，还有铜绿假单胞菌.CBP患者生活质量显著恶化，对心理健康的影响与糖尿病和慢性心力衰竭患者相当，引导患者探索噬菌体疗法等替代品。病例介绍：我们介绍了诊断为CBP并表现出典型症状的患者的病例。对前列腺和精液的测试将大肠杆菌确定为病原体。尽管反复使用抗生素疗程超过5年，但患者并未获得良好的长期治疗结果。这导致他寻求噬菌体疗法来治疗他的病情。方法和结果：培养的大肠杆菌菌株针对Eliava研究所开发的噬菌体制剂进行了测试，格鲁吉亚。在Eliava噬菌体治疗中心(EPTC)将显示针对菌株的裂解活性的制剂用于患者的治疗。患者接受了两个疗程的EPTC治疗。第一个疗程导致症状明显改善，在第二个疗程的噬菌体治疗后，症状完全缓解。在治疗期间测试的样品显示细菌生长下降，与症状改善相对应。后处理培养物没有病原菌的生长。讨论：这个案例说明了噬菌体在治疗CBP中的功效，一种通常对抗生素疗法有抗性的疾病。抗生素如氧氟沙星，磷霉素,甲氧苄啶,呋喃妥因和头孢曲松分5年多疗程给药,但是每个疗程后感染都会复发。经过两个疗程的噬菌体治疗，患者经历了长期症状缓解和细菌载量显著减少。全球越来越多的此类病例需要进一步研究噬菌体治疗MDR和慢性感染的潜力。
