The Study by John Krieger, MD is a landmark in urology and is the most
important study of the prostate ever done in this reviewers opinion. I
would like to point out what it seems to say:
1) All non-bacterial prostatitis is probably bacterial. Using meticulous
controls for skin contamination, the study found that 77% of
"non-bacterial" prostatitis patients as defined by the now antique (25
year old) Meares and Stamey 4 culture test, have bacterial DNA in their
prostate biopsy specimens when they are tested for bacterial DNA using the
polymerase chain reaction (PCR).
2) An addtional 10% of the 135 patients had Mycoplasma, Chlamydia, or
Trichomonas. Adding this to the 77% with bacterial DNA means that 87% of
the patients with so called non-bacterial prostatitis had microorganisms
in their prostates.
3) The 77% that had bacteria had bacteria that have never before been
cultured or discovered. Apparently, two or more new species of bacteria
have been found that are related to prostatitis. What antibiotic would
work in these cases is totally up in the air. Krieger's group, I assume,
ran out of money to keep sequencing the DNA that they found and thus only
sequenced a small proportion of the bacterial DNA that they had found.
4) All this DNA from the study needs to be sequenced and methods to
culture these unculturable organisms need to be developed. Once this is
achieved, antibiotic sensitivities can be determined.
5) Since prostatitis was found in 97% of cases of BPH in one study, and is
always found in over 50% of prostates being biopsied to rule out cancer,
these DNA techniques should immediately be used on those patients as well.
6) Krieger and his University of Washington group have clearly emerged
head and shoulders above everyone else in the USA at this time as leaders
in prostatitis research.
7) The article is: Prokaryotic DNA Sequences in Patients with Chronic
Idiopathic Prostatitis, by John N. Krieger, Donald E. Riley, Marilyn C.
Roberts, and Richard Berger. The study appears in the Journal of Clinical
Microbiology, Dec. 1996, Vol. 34, No. 12, pp. 3120-3128.
Brad H, MD
Chicago
