{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:48:28Z","timestamp":1791229708657,"version":"4.1.0"},"reference-count":28,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,7,25]],"date-time":"2021-07-25T00:00:00Z","timestamp":1627171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objective: To evaluate spectrum and resistance rates to antibacterial agents in causative pathogens of bacterial prostatitis in patients from Southern Europe, the Middle East, and Africa. Materials: 1027 isolates from cultures of urine or expressed prostatic secretion, post-massage urine or seminal fluid, or urethral samples were considered. Results: Escherichia coli (32%) and Enterococcus spp. (21%) were the most common isolates. Other Gram-negative, Gram-positive, and atypical pathogens accounted for 22%, 20%, and 5%, respectively. Resistance was &lt;15% for piperacillin\/tazobactam and carbapenems (both Gram-negative and -positive pathogens); &lt;5% for glycopeptides against Gram-positive; 7%, 14%, and 20% for aminoglycosides, fosfomycin, and macrolides against Gram-negative pathogens, respectively; 10% for amoxicillin\/clavulanate against Gram-positive pathogens; &lt;20% for cephalosporins and fluoroquinolones against to Gram-negative pathogens (higher against Gram-positive pathogens); none for macrolides against atypical pathogens, but 20% and 27% for fluoroquinolones and tetracyclines. In West Africa, the resistance rates were generally higher, although the highest rates for ampicillin, cephalosporins, and fluoroquinolones were observed in the Gulf area. Lower rates were observed in Southeastern Europe. Conclusions: Resistance to antibiotics is a health problem requiring local health authorities to combat this phenomenon. Knowledge of the spectrum of pathogens and antibiotic resistance rates is crucial to assess local guidelines for the treatment of prostatitis.<\/jats:p>","DOI":"10.3390\/diagnostics11081333","type":"journal-article","created":{"date-parts":[[2021,7,25]],"date-time":"2021-07-25T22:06:21Z","timestamp":1627250781000},"page":"1333","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Spectrum of Causative Pathogens and Resistance Rates to Antibacterial Agents in Bacterial Prostatitis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9394-8292","authenticated-orcid":false,"given":"Alberto","family":"Trinchieri","sequence":"first","affiliation":[{"name":"School of Urology, University of Milan, 20100 Milan, Italy"},{"name":"U Merge Ltd., London & Dubai, London 14561, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid Mohammed","family":"Abdelrahman","sequence":"additional","affiliation":[{"name":"Urology Section, HMC Alkhor, Alkhor 3050, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4259-8250","authenticated-orcid":false,"given":"Kamran Hassan","family":"Bhatti","sequence":"additional","affiliation":[{"name":"U Merge Ltd., London & Dubai, London 14561, UK"},{"name":"Urology Section, HMC Alkhor, Alkhor 3050, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5425-6798","authenticated-orcid":false,"given":"Jibril O.","family":"Bello","sequence":"additional","affiliation":[{"name":"U Merge Ltd., London & Dubai, London 14561, UK"},{"name":"Urology Unit, Department of Surgery, University of Ilorin Teaching Hospital, Ilorin 40001, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishanu","family":"Das","sequence":"additional","affiliation":[{"name":"U Merge Ltd., London & Dubai, London 14561, UK"},{"name":"Bahrain Specialist Hospital, Juffair 10588, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ognyan","family":"Gatsev","sequence":"additional","affiliation":[{"name":"Clinic of Endourology and SWL, Military Medical Academy, 1606 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivanka","family":"Gergova","sequence":"additional","affiliation":[{"name":"Clinic of Endourology and SWL, Military Medical Academy, 1606 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Magri","sequence":"additional","affiliation":[{"name":"Urology Secondary Care Clinic, ASST-Nord, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikos","family":"Mourmouras","sequence":"additional","affiliation":[{"name":"Department of Urology, Tzaneio Hospital, 18536 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Mourmouris","sequence":"additional","affiliation":[{"name":"Division of Urology II, National and Kapodistrian University of Athens, 10679 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soni","family":"Murdeshwar","sequence":"additional","affiliation":[{"name":"Bahrain Specialist Hospital, Juffair 10588, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianpaolo","family":"Perletti","sequence":"additional","affiliation":[{"name":"Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, 21100 Varese, Italy"},{"name":"Faculty of Medicine and Medical Sciences, Ghent University, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iliya","family":"Saltirov","sequence":"additional","affiliation":[{"name":"U Merge Ltd., London & Dubai, London 14561, UK"},{"name":"Clinic of Endourology and SWL, Military Medical Academy, 1606 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idrissa","family":"Sissoko","sequence":"additional","affiliation":[{"name":"U Merge Ltd., London & Dubai, London 14561, UK"},{"name":"Urology Department, Kati University Hospital, Kati 25091, Mali"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7574-3069","authenticated-orcid":false,"given":"Konstantinos","family":"Stamatiou","sequence":"additional","affiliation":[{"name":"Department of Urology, Tzaneio Hospital, 18536 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor","family":"Buchholz","sequence":"additional","affiliation":[{"name":"U Merge Ltd., London & Dubai, London 14561, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1007\/s00345-013-1055-x","article-title":"Bacterial prostatitis","volume":"31","author":"Wagenlehner","year":"2013","journal-title":"World J. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1007\/s10156-011-0350-y","article-title":"Acute bacterial prostatitis: How to prevent and manage chronic infection?","volume":"18","author":"Yoon","year":"2012","journal-title":"J. Infect. Chemother."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s11934-020-00978-z","article-title":"Management of Chronic Bacterial Prostatitis","volume":"21","author":"Su","year":"2020","journal-title":"Curr. Urol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/bju.13101","article-title":"Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis\/chronic pelvic pain syndrome: A consensus guideline","volume":"116","author":"Rees","year":"2015","journal-title":"BJU Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1038\/aja.2009.5","article-title":"Semen analysis in chronic bacterial prostatitis: Diagnostic and therapeutic implications","volume":"11","author":"Magri","year":"2009","journal-title":"Asian J. Androl."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"177","DOI":"10.4081\/aiua.2019.3.177","article-title":"Chronic prostatic infection: Microbiological findings in two Mediterranean populations","volume":"91","author":"Stamatiou","year":"2019","journal-title":"Arch. Ital. Urol. Androl."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"460","DOI":"10.4111\/icu.2017.58.6.460","article-title":"Chlamydia trachomatis versus common uropathogens as a cause of chronic bacterial prostatitis: Is there any difference? Results of a prospective parallel-cohort study","volume":"58","author":"Cai","year":"2017","journal-title":"Investig. Clin. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"504","DOI":"10.3389\/fphar.2020.00504","article-title":"Pharmacological interventions for bacterial prostatitis","volume":"11","author":"Xiong","year":"2020","journal-title":"Front. Pharmacol."},{"key":"ref_9","first-page":"CD009071","article-title":"Antimicrobial therapy for chronic bacterial prostatitis","volume":"8","author":"Perletti","year":"2013","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.eururo.2019.06.011","article-title":"Time to Adapt Our Practice? The European Commission has restricted the use of fluoroquinolones since March 2019","volume":"76","author":"Bonkat","year":"2019","journal-title":"Eur. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"573903","DOI":"10.3389\/fphar.2020.573903","article-title":"Commentary: Pharmacological interventions for bacterial prostatitis","volume":"11","author":"Magri","year":"2020","journal-title":"Front. Pharmacol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1038\/aja.2011.36","article-title":"Fluoroquinolone-macrolide combination therapy for chronic bacterial prostatitis: Retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction","volume":"13","author":"Magri","year":"2011","journal-title":"Asian J. Androl."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/S2213-2600(20)30080-1","article-title":"Immunomodulation by macrolides: Therapeutic potential for critical care","volume":"8","author":"Reijnders","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1093\/jac\/dkz015","article-title":"Oral fosfomycin for the treatment of chronic bacterial prostatitis","volume":"74","author":"Karaiskos","year":"2019","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_15","first-page":"42","article-title":"Usage and dosage of fosfomycin for NIH category II chronic bacterial prostatitis","volume":"31","author":"Perletti","year":"2019","journal-title":"Hell. Urol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"106106","DOI":"10.1016\/j.ijantimicag.2020.106106","article-title":"Fosfomycin for bacterial prostatitis: A review","volume":"56","author":"Kwan","year":"2020","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1159\/000074526","article-title":"Penetration of antimicrobial agents into the prostate","volume":"49","author":"Charalabopoulos","year":"2003","journal-title":"Chemotherapy"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"477","DOI":"10.4111\/kju.2013.54.7.477","article-title":"Antimicrobial resistance pattern in Enterococcus faecalis strains Isolated from expressed prostatic secretions of patients with chronic bacterial prostatitis","volume":"54","author":"Seo","year":"2013","journal-title":"Korean J. Urol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"85","DOI":"10.4081\/aiua.2018.2.85","article-title":"Resistance of uropathogens to antibacterial agents: Emerging threats, trends and treatments","volume":"90","author":"Perletti","year":"2018","journal-title":"Arch. Ital. Urol. Androl."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1093\/cid\/cir709","article-title":"Chronic bacterial prostatitis: Enterococcal disease?","volume":"53","author":"Magri","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.ijantimicag.2017.07.002","article-title":"Antimicrobial resistance in West Africa: A systematic review and meta-analysis","volume":"50","author":"Langendorf","year":"2017","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_22","first-page":"147","article-title":"Emergence and spread of antibiotic resistance in West Africa: Contributing factors and threat assessment","volume":"27","author":"Ouedraogo","year":"2017","journal-title":"Med. Sante Trop."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/2047-2994-1-26","article-title":"The prevalence of antimicrobial resistance in clinical isolates from Gulf Corporation Council countries","volume":"1","author":"Aly","year":"2012","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"479","DOI":"10.26719\/2011.17.6.479","article-title":"Rising bacterial resistance to common antibiotics in Al Ain, United Arab Emirates","volume":"17","author":"Tariq","year":"2011","journal-title":"East. Mediterr. Health J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"491","DOI":"10.3855\/jidc.466","article-title":"Self-medication with antibiotics by the community of Abu Dhabi Emirate, United Arab Emirates","volume":"3","author":"Abasaeed","year":"2009","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/S0140-6736(05)17907-0","article-title":"ESAC Project Group Outpatient antibiotic use in Europe and association with resistance: A cross-national database study","volume":"365","author":"Goossens","year":"2005","journal-title":"Lancet"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Bell, B.G., Schellevis, F., Stobberingh, E., Goossens, H., and Pringle, M. (2014). A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-13"},{"key":"ref_28","unstructured":"Bonkat, G., Bartoletti, R., Bruy\u00e8re, F., Cai, T., Geerlings, S.E., K\u00f6ves, B., Schubert, S., and Wagenlehner, F. (2021). Urological infections. EAU Guidelines, EAU Guidelines Office. Available online: http:\/\/uroweb.org\/guideline\/urological-infections\/#3."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/8\/1333\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:34:41Z","timestamp":1760164481000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/8\/1333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,25]]},"references-count":28,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8]]}},"alternative-id":["diagnostics11081333"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11081333","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,25]]}}}