The Changing Epidemiology and Microbiology of Patients With Prostate Abscess: Increase in Staphylococcal Infection

Abstract

Background Prostatic abscesses are rare and have been most commonly associated with gram-negative bacteria; however, Staphylococcus aureus has emerged as a leading cause, particularly in persons who are immunocompromised. Methods We conducted a retrospective chart review of all patients discharged from Ben Taub Hospital with a diagnosis of prostatic abscess during January 2011–January 2019. Demographic, clinical, microbiologic, and radiographic data were abstracted from the patients’ charts and analyzed for comorbidities, causative organisms, clinical course, and outcomes. Results We identified 32 patients with a prostatic abscess during the study period. S. aureus was the most common causative organism (18/32, 56%). Most patients (24/32, 75%) were admitted to a general medicine service, and the median length of stay was 9 days. Twenty-one patients (66%) were treated with a combination of surgical drainage and antibiotic therapy; 11 (34%) were treated with antibiotics alone. All patients treated with antibiotics alone had full clinical recovery. Two patients (6.3%) died, both of whom had septic shock secondary to disseminated S. aureus infection. Conclusions Prostatic abscesses are rare and can be difficult to diagnose, leading to significant morbidity and mortality. S. aureus is a frequent causative organism especially in persons with diabetes mellitus or other immunocompromising conditions. Hematogenous spread of S. aureus infection to the prostate appears common. Prostatic abscesses can serve as the nidus of disseminated S. aureus infection.

Transurethral Drainage Of Prostatic Abscess/Case Study

“…Moreover, immunosuppression brought on by hemodialysis for liver cirrhosis, renal failure, and immunosuppressive drugs like chemotherapy have all been linked to the development of PA (11). In addition, the most common risk factors include recent lower urinary tract instrumentation indwelling catheters and the obstruction of the bladder outflow (12). Our case was a unique presentation as no such risk factor was found in our case.…”

Prostatic Abscess Secondary to Staphylococcus haemolyticus and Escherichia coli: A Case Report

“…Staphylococcal aureus infections are increasingly encountered in prostate abscesses in the post-antibiotic era, particularly in immunocompromised patients [10]. Staphylococcus haemolyticus has never been reported as a gram-positive bacterial etiology of a prostatic abscess, despite its known notoriety in CBP [1,3].…”

Prostatic Abscess Combined With Spleen Abscess Due to Multi-Drug-Resistant Gram-Negative Bacilli: A Case Report and Literature Review

“…The severe infection of the prostate is frequently caused by the reflux of infected urinary contents into prostatic ducts, especially in patients with diabetes, immunosuppressive state, chronic prostatitis, epididymitis, gonorrhea, or undertaking prostate biopsy, and so on ( Caulier et al., 2009 ; Dell’atti, 2013 ; Nomura et al, 2021 ; Tay et al, 2021 ). Gram-negative Enterobacteriaceae causing urinary tract infections is the dominant pathogenic bacteria, while Gram-positive bacteria had also been reported as the cause of prostate abscesses in uncontrolled diabetes patients ( McCormick et al, 2021 ; Merchant et al, 2016 ). Hematogenous dissemination from the primary infected focus includes appendicitis, peritonitis, liver or perirenal abscess, diverticulitis, or from severe subcutaneous infections of Staphylococcus aureus , could also lead to an abscess in prostatic tissue ( Liao et al, 2016 ).…”