What are the possible etiologies of acute bacterial prostatitis?

Updated: Nov 01, 2019
  • Author: Paul J Turek, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Acute bacterial prostatitis may be caused by ascending infection through the urethra, refluxing urine into prostate ducts, or direct extension or lymphatic spread from the rectum. Approximately 80% of the pathogens are gram-negative organisms (eg, Escherichia coli, Enterobacter, Serratia, Pseudomonas, Enterococcus, and Proteus species). [6, 7] Mixed bacterial infections are uncommon. One case report of prostatitis caused by methicillin-resistant Staphylococcus aureus was documented in a diabetic patient.

Consider Neisseria gonorrhoeae and Chlamydia trachomatis infection in any male younger than 35 years presenting with urinary tract symptoms.

Nursing home patients with indwelling urethral catheters may also be at increased risk of acute bacterial prostatitis. Sclerotherapy for rectal prolapse may also increase risk. [8]

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