Background: A febrile urinary tract infection in men should suggest acute prostatitis. Any infection of the male urinary tract has the potential to affect the prostate. Acute prostatitis happens when your prostate gland becomes suddenly inflamed. The objectives of our study were to determine the prevalence of urinary tract infections and the associated risk factors in men presenting chronic and/or acute prostatitis. Also, to identify the associated bacterial strains and finally to establish their antibiotic susceptibility profile.

Materials and Method: We conducted a prospective and cross-sectional study. A total of 77 male participants were recruited, aged 24 years to 84 years at the Urology Department of the Yaounde Central Hospital that presented with clinical signs and symptoms of urinary tract infection from February to June 2021. Urine specimens were collected and analyzed at the Bacteriology laboratory of the Yaoundé University Teaching Hospital. Isolation and identification of bacteria were done using conventional methods. Antibiotic susceptibility testing and interpretation were performed according to CASFM 2021, V.1.0 April. The statistical analysis of our data was done using SPSS version 22.0 software.

Results: The prevalence of urinary tract infection in our studied population was 15.58% (12/77). Among the 12 participants with urinary tract infection, we isolated and identified six (6) bacteria species; Escherichia coli 25% (3/12), Proteus vulgaris 25% (3/12), Citrobacter freundii 16.67% (2/12), Pseudomonas fluorescent 16.67% (2/12), Enterococcus spp. 8.33% (1/12) and Proteus penneri 8.33% (1/12) respectively. Antibiotic susceptibility testing revealed reduced susceptibility to 3rd generation cephalosporins (cefotaxime, ceftazidime, ceftriaxone). Beta-lactams showed very low activity on almost all the family of Enterobacteriaceae strains isolated. Flouroquinolones (ciprofloxacin, ofloxacin and nalidixic acid) showed a resistance of more than 50% on the majority of the species isolated. All the isolated Gram negative bacteria were multi-drug resistant. Patients with a history of urinary tract tumors, urinary catheters, and diabetes were the most exposed to urinary tract infection; 58.33% (7/12 patients), 50.00 % (6/12) and 41.66% (5/12 patients) respectively. Participants of age >55 years were those presenting the most with urinary tract infection.

Conclusions: Overall, Enterobacteriaceae were primarily isolated from patients with prostatitis. Urological history such as urinary tract tumors, and Diabetes were significantly associated with UTI.


Download data is not yet available.


The clinical term “prostatitis” is used to describe a clinical condition defined by the following 4 distinct entities: acute bacterial prostatitis (grade 1), chronic bacterial prostatitis (grade 2), chronic prostatitis/chronic pelvic pain syndrome (grade 3) and asymptomatic prostatitis (grade 4) [1]. Prostatitis is a common inflammation of the urinary tract that poses challenges for doctors in terms of effective treatment [2]. It is the third most common urinary tract disease in men following prostate cancer and benign prostatic hyperplasia (BPH) [2]. Prostatitis is one of the most common diseases seen in urology, its diagnosis is made in about 25% of male patients with genitourinary symptoms. Autopsy studies have shown that 64-86% of men have evidence of prostatitis on a histological level and about 8.2% of men experience prostatitis at some point in their lives [3]. Prostatitis has a prevalence of about 8% to 16%. However, 5% to 10% of cases are identified as having a bacterial origin (bacterial prostatitis) [4].

Bacterial prostatitis is a bacterial infection of the prostate occurring in a bimodal distribution in younger and older men [4]. It can be acute or chronic in nature and, if not treated appropriately, can lead to significant morbidity [4]. Enterobacteriaceae (Escherichia coli in particular) are the predominant pathogens in acute and chronic bacterial prostatitis, but an increasing role of enterococci has been reported [5]. Immunocompromised patients are more likely to have rare causes of prostatitis, such as Salmonella, Candida and Cryptococcus species [6]. Many strains of these uropathogens show the ability to form a biofilm and are multi-resistance [5].

Bacterial prostatitis is a potentially serious infection, which may result in complication such as severe sepsis, prostatic abscess or becoming chronic, especially in diabetics and immunocompromised persons [7]. Also, antibiotic therapy is difficult due to poor prostatic diffusion of many compounds (β-lactams, aminoglycosides), especially in chronic forms due to fibrosis. The diagnostic and therapeutic strategy varies according to the clinical form [7]. Its diagnosis is based primarily on history and physical examination, but can be aided by urinalysis [8]. Urine cultures should be obtained from all patients suspected of having acute bacterial prostatitis to determine the causative bacterium and its pattern of antibiotic susceptibility [8].

Urinary tract infection is one of the most common infections in general practice and in hospitals settings. In Cameroon there is little information on the prevalence and incidence of acute bacterial prostatitis. Therefore, we found it useful to carry out this study on the cytobacteriological examination of urine in patients with prostatitis at the Yaoundé Central Hospital (YCH).

Materials and Methods

Study Design and Setting

Our study was a prospective cross-sectional study conducted from February to June 2021 in Yaoundé, centre region of Cameroon. Our site of patient recruitment and sample collection was the Urology department of the Yaoundé Central Hospital and the site of sample analyse was the Bacteriology laboratory of the Yaoundé University Teaching Hospital (YUTH).

Study Population and Sampling Method

The study population consisted of male patients with a confirm acute or chronic prostatitis presenting sign and symptoms of urinary tract infection (UTI) were considered eligible for the study. Non-inclusion criteria involved patients presenting other urological problems. A total of 77 patients coming for consultation at the Urology Department of the Yaoundé Central Hospital, were recruited using an accidental non-probabilistic method.

Ethical Consideration

Ethical clearance was granted by the Human Health Ethics Committee of the Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I. Research authorisation was obtained from both the Yaoundé Central Hospital (No 201/20/AR/MINISANTE/SG/DHCY/ CM/SM) and the Yaoundé University Teaching Hospital (No 3205/AR/CHUY/DG/DGA/CAPRC). Participants to the study were informed about the study’s purpose and potential benefits, and they provided their consent after understanding its scope.

Sample Collection and Analysis

A total of 77 male patient were recruited using purposive standard sampling technique. Mid-stream urine samples were from non-catheterized patients, while urine was collected from catheterised patient after clamping the urinary catheter for 30 minutes. The samples were collected in sterile universal containers and transported to the site of analysis with in a delay of 1 hour for processing. Samples were processed immediately on arrival in the laboratory. The centrifuged urine specimen was examined under 10X and 40X of bright field microscope to check for the presence of pus cells, RBCs, casts, crystals and bacterial cells and recorded accordingly. Using a Kova slide (cell counter), quantitative numeration of WBC and RBC was done using un-centrifuged urine. An initial Gram stain was done using the centrifuge urine, the Gram bacterial morphology and polymorpho-nuclear cells were examined and noted. The specimens were cultured, using a standard wire loop of 4 mm, on CLED, Mac Conkey, Mannitol salt and Blood agar. The seeded plates were incubated at 37 °C for 18–24 hours. Plates were examined for bacterial growth. Bacterial growths of ≥105 cfu/ml were considered significant. The isolates were identified based colony morphology, Gram staining, motility testing, oxidase test and necessary biochemical tests.

Antibiotic susceptibility tests were carried out by using Disc diffusion method (Kirby Bauer method). The Gram negative isolates were tested against Amoxicillin (10 µg), Amoxicillin + clavulanic acid (20 µg), Ertapenem (10 µg), Meropenem (10 µg), Imipenem (10 µg), Ticarcillin (75 µg), Ticarcillin + clavulanic acid (75 µg), Piperacillin (30 µg), Cefoxitin (30 µg), Cefuroxime (30 µg), Cefalotine (30 µg), Cefurotaxime (30 µg), Cefotaxime (5 µg), Ceftazidime (10 µg), Aztreonam (30 µg), Amikacin (30 µg), Gentamicin (10 µg), Oflaxacine (5 µg), Ciprofloxacin (5 µg), Fosfomycin (200 µg) and Furane (). While the Gram positive bacteria were tested against Streptomycin (300 µg), Cotrimoxazole (25 µg), Imipenem (10 µg), Erythromycin (15 µg), Pristinamycin (15 µg), Clindamycin (2 µg), Rifampicin (5 µg), Ciprofloxacin (5 µg), Chloramphenicol (30 µg) and Nitrofurantoin (100 µg). Zones of inhibition diameters were interpreted according to the guidelines (interpretation chart) provided by CASFM-EUCAST (Comite d’Antibiogramme de la Societe Francaise de Microbiology/The European Committee on Antimicrobial Susceptibility Testing) 2021 criteria [9].

Statistical Analysis

Collected Data was inputted into Statistical Package for Social Sciences (SPSS), version 25 and Microsoft Excel 2016. Descriptive statistics were utilized to analysed data, which involed the use of tables, percentages and proportions to interpret the findings. Bivariate analysis was conducted to assess the association between variables and UTI. A chi square value below 0.05 was considered statistical significant in determining association.


Sociodemographic Characteristics

A total of 77 male patients with a confirm acute or chronic prostatitis presenting signs and symptoms of UTI were included in the present study. The age range of the participants was between 24 and 82 years with a mean age 52 (±16.45). Majority of the study participant were aged ≤35 (24.7%) and 56–65years (24.7%). Also, 52 (67.5%) of the study participants were married (Table I).

Characteristics Total (n = 77)
Participants (n) Percentage (%)
Age group (Years)
<35 19 24.7
36–45 6 7.8
46–55 15 19.5
56–65 19 24.7
>65 18 23.4
Marital status
Married 52 67.5
Single 16 20.8
Widow 8 10.4
Divorced 1 1.3
Type of toilet
Modern 44 57.1
Traditional 33 42.9
Posture during work
Sitting 41 53.2
Standing 36 46.8
Table I. Sociodemographic Characteristics of Male Patients Suffering from Acute and/or Chronic Prostatitis at the Yaoundé Centrale Hospital (YCH), Cameroon, February-June 2021

Urologic Antecedent of Study Population

With respect to Urologic antecedent, majority of the male participant had urinary tract tumour (36.4%), 8 (10.4%) had undergone urologic procedures (Urinary catheterization) and 6 (7.8%) had urologic disease (Urinary schistosomiasis). The participants had kidney disorders as 7.8% suffered from Nephrotic syndrome and Urolithiasis respectively. Testicular disorder included Epididymal cyst (2.6%), Hydrocele (1.3%), and Variocele (1.3%). Other urologic antecedent included urological malformation (5.2%) and prostate enlargement (3.9%) (Table II).

Urologic antecedent Frequency (N = 77) Percentage (%)
Urinary tract tumour 28 36.4
Urinary catheterization 8 10.4
Nephrotic syndrome 6 7.8
Urolithiasis 6 7.8
Urinary schistosomiasis 6 7.8
Urological malformation 4 5.2
Enlarged prostate 3 3.9
Epididymal cyst 2 2.6
Varicocele 1 1.3
Testicular hypertrophy 1 1.3
Hydrocele 1 1.3
Table II. Urologic Antecedent of Male Patients Suffering from Acute and/or Chronic Prostatitis at the YCH, Cameroon, February-June 2021

Frequency of Symptoms

More than half of the study participants manifested dysuria (74.0%), this was followed by pollakiuria and polyuria as 26 (33.8%) and 13 (16.9%) respectively. Other symptoms manifested by the participants are presented in Table III.

Symptoms Frequency (N = 77) Percentage (%)
Dysuria 57 74.0
Pollakiuria 26 33.8
Polyuria 13 16.9
Pyuria 5 6.5
Sexual weakness 5 6.5
Testicular pain 5 6.5
Haematuria 4 5.2
Urinary retention 2 2.6
Table III. Frequent Symptoms Manifested by Male Patients Suffering from Acute and/or Chronic Prostatitis at the YCH, Cameroon, February-June 2021

Medical Antecedent of the Study Population

In relation to medical antecedent, 19.5% (15) of the participants had hypertension followed by diabetes with (9.1%, 7/77). Other symptoms manifested by the participants are presented in Table IV.

Symptoms Frequency (N = 77) Percentage (%)
Hypertension 15 19.5
Diabetes 7 9.1
Hepatitis B 2 2.6
Asthma 1 1.3
Heamorrhiods 1 1.3
Table IV. Medical Antecedent of Male Patients with Acute and/or Chronic Prostatitis at the YCH, Cameroon, February-June 2021

Frequency of Bacterial Isolates from UTI Suspected Participants

The overall prevalence of urinary tract infections among male participant presenting with either chronic or acute prostatitis was 15.58% (12/77). Of the total positive culture, majority were patient aged >65 years (Table V).

Factor Numbernegative (%) Numberpositive (%) P-value
Age group(Years)
<35 18 (94.7) 1 (5.3)
36–45 5 (83.3) 1 (16.7)
46–55 14 (93.3) 1 (6.7) 0.296
56–65 15 (78.9) 4 (21.1)
>65 13 (72.2) 5 (27.8)
Total 65 12
Type of toilet
Modern 39 (88.6) 5 (11.4) 0.342
Traditional 26 (78.8) 7 (21.2)
Total 65 12
Urinary catheterization
No 64 (92.8) 5 (7.2)
Yes 1 (12.5) 7 (87.5) <0.001
Total 65 12
Urinary tract tumour
No 44 (89.8) 5 (10.2)
Yes 21 (75.0) 7 (25.0) 0.108
Total 65 12
Urological malformation
No 62 (84.9) 11 (15.1) 0.500
Yes 3 (75.0) 1 (25.0)
Total 65 12
High blood pressure
No 54 (87.1) 8 (12.9) 0.234
Yes 11 (73.3) 4 (26.7)
Total 65 12
No 62 (88.6) 8 (11.4) 0.010
Yes 3 (42.9) 4 (57.1)
Total 65 12
Table V. Predictors of Urinary Tract Infections Among Male Patients Suffering of Acute and/or Chronic Prostatitis Attending the Department of Urology at the YCH, Center, Cameroon, February-June 2021

Both Gram-negative and Gram-positive bacterial species were recovered, 11/12 (91.7%) and 1/12 (8.3%), respectively. Among the Gram-negative bacterial species, E. coli and Proteus vulgaris were the most frequently isolated bacteria with a rate of 3/11 (27.3%) and 25% (3/12) of the total isolated bacteria, each. Enterococcus spp was the only Gram-positive bacteria isolated with a rate of 1/12 (8.3%) of the total isolated bacteria (Fig. 1).

Fig. 1. Frequency of bacteria isolated.

Antimicrobial Susceptibility Patterns of Gram-Negative Bacterial Isolates

Among the tested Gram-negative bacterial isolates, 10/11 (90.9%) were susceptible to amoxicillin and amikacin, followed by meropenem 9/11 (81.8%), imipenem 9/11 (81.8%), and gentamicin 8/11 (72.7%). However, 9/11 (81.8%) resistance rate was observed to cefalotine followed by cefuroxime 8/11 (72.7%). Above 65% of E. coli isolated were susceptible to meropenem, imipenem, cefoxitin, cefuroxime, cefurotaxime, aztreonam, amikacin, gentamicin and fosfomycin. This isolated E. coli showed a high level of resistance to amoxicillin and piperacillin (100% each). Proteus vulgaris was another bacterium isolate that showed a high level of resistance to cefalotin and amikacin of 100% each. The isolated Gram-negative bacteria showed a high level of Multi drug resistance with all the isolated species being resistant to more than 3 antibiotics (Table VI).

Bacteria Escherichia coli(n = 3) Proteus vulgaris(n = 3) Citrobacter freundii(n = 2) Pseudomonas fluorescent (n = 2) Proteus penneri(n = 1) Total (N = 11)
Sen. S I R S I R S I R S I R S I R S I R
AMX 3(100) 3(100) 1(50) 1(50) 2(100) 1(100) 10(90.9) 1(9.1)
AMC 1(33.3) 1(33.3) 1(33.3) 2(66.7) 1(33.3) 2(100) 2(100) 1(100) 3(27.3) 1(9.1) 7(63.6)
ETP 1(33.3) 2(66.7) 2(66.7) 1(33.3) 1(50) 1(50) 2(100) 1(100) 4(36.4) 3(27.3) 4(36.4)
MER 2(66.7) 1(33.3) 3(100) 2(100) 1(50) 1(50) 1(100) 9(81.8) 1(9.1) 1(9.1)
IMP 3(100) 2(66.7) 1(33.3) 2(100) 1(50) 1(50) 1(100) 9(81.8) 2(18.2)
TIC 1(33.3) 2(66.7) 1(33.3) 2(66.7) 1(50) 1(50) 1(50) 1(50) 1(100) 1(9.1) 3(27.3) 7(63.6)
TIM 1(33.3) 2(66.7) 3(100) 1(50) 1(50) 1(50) 1(50) 1(100) 2(18.2) 4(36.4) 5(45.5)
PIP 3(100) 1(33.3) 2(66.7) 1(50) 1(50) 2(100) 1(100) 4(36.4) 2(18.2) 5(45.5)
FOX 2(66.7) 1(33.3) 1 1(33.3) 1(33.3) 1(50) 1(50) 2(100) 1(100) 5(45.5) 1(9.1) 5(45.5)
CXM 2(66.7) 1(33.3) 1(33.3) 2(66.7) 2(100) 2(100) 1(100) 3(27.3) 8(72.7)
CEP 1(33.3) 1(33.3) 1(33.3) 3(100) 2(100) 2(100) 1(100) 1(9.1) 1(9.1) 9(81.8)
CTX 1(33.3) 1(33.3) 1(33.3) 2(66.7) 1(33.3) 1(50) 1(50) 2(100) 1(100) 1(9.1) 4(36.4) 6(54.5)
CTZ 2(66.7) 1(33.3) 2(66.7) 1(33.3) 1(50) 1(50) 1(50) 1(50) 1(100) 5(45.5) 2(18.2) 4(36.4)
CRO 1(33.3) 1(33.3) 1(33.3) 1 1(33.3) 1(33.3) 1(50) 1(50) 2(100) 1(100) 3(27.3) 2(18.2) 6(54.5)
ATM 2(66.7) 1(33.3) 1 1(33.3) 1(33.3) 1(50) 1(50) 1(50) 1(50) 1(100) 4(36.4) 3(27.3) 4(36.4)
AMK 3(100) 2 (66.7) 1(33.3) 2(100) 2(100) 1(100) 10(90.9) 1(9.1)
GEN 3(100) 1(33.3) 2(66.7) 1(50) 1(50) 2(100) 1(100) 8(72.7) 3(27.3)
NA 1(33.3) 2(66.7) 1(33.3) 2(66.7) 1(50) 1(50) 2(100) 1(100) 3(27.3) 1(9.1) 7(63.6)
OFX 1(33.3) 1(33.3) 1(33.3) 2(66.7) 1(50) 1(50) 2(100) 2(100) 2(18.2) 2(18.2) 7(63.6)
CIP 1(33.3) 2(66.7) 1(33.3) 2(66.7) 1(50) 1(50) 1(50) 1(50) 1(100) 2(18.2) 2(18.2) 7(63.6)
FO 3(100) 1(33.3) 2(66.7) 2(100) 2(100) 1(100) 6(54.5) 1(9.1) 4(36.4)
Table VI. Antibiotic Susceptibility Pattern of Gram-Negative Bacterial Isolates from Urine Samples of Male Patient Suffering from Chronic and/or Acute Prostatitis at the YCH, Cameroon, February-June 2021

Antimicrobial Susceptibility Patterns of Gram-Positive Bacterial Isolates

The Gram-positive isolate (Enterococcus spp) was sensitive only to nitrofurantoin and showed resistance to cotrimoxazole, erthromycin, pristinamycin, clindamycin, rifampicin, and ciprofloxacin. The isolated Enterococcus specie showed MDR (Table VII).

Bacteria Sen. S COT IMP E INN CM RA CIP VA C NIT Total(N = 1)
Enterococcus S 1(100) 1 (9.1)
specie (n = 1) I 1(100) 1(100) 1(100) 1(100) 4 (36.4)
R 1(100) 1(100) 1(100) 1(100) 1(100) 1(100) 6 (54.5)
Table VII. Antibiotic Susceptibility Patterns of Gram-Positive Bacterial Isolates from Urine Samples of Male Patient Suffering from Chronic and/or Acute Prostatitis at the YCH, Centre, Cameroon, February-June 2021

Associated Factors

In relation to the age group, the highest prevalence rate of 27.8% (5/18) was obtained among participants aged >65 years, while the least prevalence rate of UTI (5.3%) was recorded among those aged <35 years. However, there was no significant association between age group and prevalence of UTI (p = 0.296). With respect to Urinary catheterization, participant who had done the procedure had a higher prevalence rate (28.7%, 2/7) than those who did not go through the procedure. There was a significant association between urinary catheterization and prevalence of UTI (p > 0.01). Similarly, there was a statistical significant association between high blood pressure and the prevalence of UTI (p = 0.010). Again, patients suffering from diabetes had a higher (57.1%, 4/7) prevalence rate than those not having the disease.

Type of toilet (p = 0.342), urinary tract tumour (p = 0.108), urinary malformation (p = 0.500) or high blood pressure (p = 0.234), did not impact significantly on the likelihood of having UTI. This is further illustrated in Table VII.


Prostatitis is a prevalent urological condition that poses major challenges for urologist in terms of effective treatment. It is estimated that around half of all men experiences symptoms of prostatitis during their lifetime [10]. Urinary tract infections are a major complication in patients with prostatitis, which commonly affects elderly males worldwide [11]. Despite recent advancements in the treatment of CBP, relapses are still common probably due to increasing antibiotic resistance patterns of the bacteria responsible for CBP [12], [13]. There are a limited number of studies addressing this subject in Cameroon and Yaoundé in particular. Therefore, our objective was to investigate the antibiotic sensitivity pattern of responsible bacteria isolated from patients with acute or chronic prostatitis and identify the risk factors.

The average age of the study population was 59 years old (SD ± 16.45) higher than that reported by Stamatiou et al. [14] of 41.8 years in patients diagnosed with chronic bacterial prostatitis. This difference in mean age may be explain by the difference in the study design, population and seasonal variation. More than half of the patient acknowledge having dysuria (74.0%, 57/77) followed by pollakiuria with 33.8% (26/77). Urinary tract tumour (28/77, 36.4%) and hypotension (15/77, 19.5%) were the common urologic and medical condition manifested by the participants.

We got an overall prevalence of Urinary Tract Infection of 19.5% (12/70) among male patients presenting with either chronic or acute prostatitis. This is lower than the 43.0% reported by Turay et al. [15] in Nigeria, 36.2% reported by Adegoke et al. [16] in 2012 in Nigeria and a prevalence of up to 62.86% in a study carried out by Mishra et al. [17] 2015 in India. This differences might be due to difference in pre-existing prostatitis. A higher prevalence rate (27.8%) of UTI was observed in patients aged above 65 years old than those of the other age groups. Urinary tract infections (UTIs) are more prevalent in elderly men due to factors such as residual urine in the urine, poor emptying the bladder caused by prostatic hyperplasia and increased use of medical instruments [18]. But incomplete emptying of the bladder is believed to be the primary source especially in pathologies like prostatitis [15]. There was a significant association established between UTI and presence of urinary catheter (p > 0.001) and Diabetes (p = 0.01).

Though UTI can be caused by both Gram-negative and Gram-positive bacteria, Gram-negative bacteria are the more commonly responsible because they naturally inhabit the intestinal microbiota [19]. The infection typically begins with contamination around the urethra by uropathogen from the gut; followed by colonisation of the urethra and subsequently, migration to the bladder [20]. Our study confirmed this pattern, with 91.7% of isolated bacteria being Gram-negative and 8.3% being Gram-positive bacteria.

Of the isolated Gram-negative bacteria, E. coli and P. vulgaris were the predominant species isolated accounting for 27.3% (3/11) of the total isolated bacteria. The reason for their dominance could be attributed to their distinct features like flagella and pili, which enable them to attach to the urinary tract epithelial and consequently raise the likelihood of infection [21]. Our finding aligns with other study [22]–[24], which states that the Enterobacteriaceae (in general) and E. coli in particular, are the predominant pathogens in bacterial prostatitis, while other studies shows E. coli being isolated in a lesser extent than other uropathogens [16], [17], [25]. The tested Gram-negative bacteria, show a high sensitivity to amikacin (90.9%), ampicillin (90.9%), meropenem (81.8%) and imipenem (81.8%). This aligns to the work of Misrha et al. in 2016 [17] however different to that reported by Karami et al. [24] were the isolated Gram negative bacteria were highly resistant to amikacin (100%), ampicillin (100%) and imipenem (95%). Furthermore, it was observed that the isolated Escherichia coli were highly resistant to amoxicillin (100%) and piperacillin (100%). This finding bear resemblance to that reported by Karami et al. [24] with 100% resistance against amoxicillin.

Enterococcus spp was the unique Gram positive bacteria isolated, this result differs from to other studies [15]–[17], [23], [24], [26] where other bacteria such as Staphylococcus species and Streptococcus species were also isolated. The Enterococcus spp was sensitive only to nitrofurantoin and showed resistance to cotrimoxazole, erthromycin pristinamycin, clindamycin, rifampicine, and ciprofloxacine. Similar Sensitivity rate was reported by Karami et al. [24] among isolated Enterococcus species. Effectiveness of nitrofurantoin against uropathogenes and vancomycin resistant enterococcus has been reported in several studies [27]–[29], exactly why nitrofurantoin has not fallen to resistance mechanism of enterococci after more than 20 years is unknown.


The prevalence of UTI in our study participants was high. Half of the isolates were represented by Escherichia coli and Proteus vulgaris in equal proportions. All the isolated Gram negative bacteria were multi-drug resistant, however they show a high sensitivity to amoxicillin and amikacin antibiotics. Urological history such as urinary tract tumors, and patients undergoing urinary catheterization were found to impact significantly the occurrence of UTI in our study population.


  1. Schoeb DS, Schlager D, Boeker M, Wettraue U, Schoenthaler M, Herrmann TRW, et al. Surgical therapy of prostatitis: a systematic review. World J Urol. 2017;35(11):1659–68. doi: 10.1007/s00345-017-2054-0.
     Google Scholar
  2. Khan FU, Ihsan AU, Khan HU, Jana R, Wazir J, Khongorzul P, et al. Comprehensive overviewof prostatitis. Biomed Pharmacother. 2017;94:1064–76. doi: 10.1016/j.biopha.2017.08.016.
     Google Scholar
  3. Kwan ACF, Beahm NP. Fosfomycin for bacterial prostatitis: a review. Int J Antimicrob Agents. Octobre 2020;56(4). doi: 10.1016/j.ijantimicag.2020.106106. https://www.sciencedirect.com/science/article/abs/pii/S0924857920302892.
     Google Scholar
  4. Gill BC, Shoskes DA. Bacterial prostatitis. Curr Opin Infect Dis. 2016;29(1):86–91. doi: 10.1097/QCO.0000000000000222.
     Google Scholar
  5. Lobel B. La prostatite aigue et chronique, quelle prise en charge? Perspective pour les dix prochaines années. Rev Med Suisse. 2006;2:31892.
     Google Scholar
  6. Gonsu Kamga H, Nzengang R, Toukam M, Sando Z, Koulla Shiro S. Phenotypes de resistance des souches d’Escherichia coli responsables des infections urinaires communautaires dans la ville de Yaounde (Cameroun). Afri J Pathol Microbiol. 2014;3:4, Article ID 235891. doi: 10.4303/ajpm/235891.
     Google Scholar
  7. Kogan MI, Naboka YL, Ismailov RS, Belousov II, Gudima IA. Bacterial prostatitis: epidemiology and etiology. Urologiia. 2018 Dec;15(6):144–9. doi: 10.18565/urology.2018.6.144-148.
     Google Scholar
  8. Davis NG, Silberman M. Bacterial Acute Prostatitis. Treasure Island (FL). Stat Pearls Pub. 2020, PMID: 29083799. NBK459257. https://europepmc.org/article/NBK/nbk459257.
     Google Scholar
  9. CA-SFM. « Comité de l’antibiogramme de la société française de Microbiologie ». Paris, France, 2021. http://www.sfmmicrobiologie.org/UserFiles/files/casfm/CASFM_EUCAST_V1_0_2021.pdf.
     Google Scholar
  10. Hung SC, Lai SW, Tsai PY, Chen PC,Wu HC, LinWH, et al. Synergistic interaction of benign prostatic hyperplasia and prostatitis on prostate cancer risk. Br J Cancer. 2013;108(9):1778–83.
     Google Scholar
  11. Silverio F, Gentile V, Pastore A, Voria G, Mariotti G, Sciarra A. Benign prostatic hyperplasia: what about a campaign for prevention? Urol Int. 2004;72:179–88.
     Google Scholar
  12. Abdulkareem WL, Hussein NR,Mohammed AA, Arif SH, Naqid IA. Risk factors association for MRSA nasal colonization in preoperative patients in Azadi teaching HospitalDuhoK, Kurdistan region, Iraq. Sci J Univer Zakho. 2020;8(3):88–91.
     Google Scholar
  13. Assafi MS, Ibrahim NM,Hussein NR, Taha AA, Balatay AA. Urinary bacterial profile and antibiotic susceptibility pattern among patients with urinary tract infection in Duhok city, Kurdistan region, Iraq. Int J Pure Appl Sci Technol. 2015;30(2):54.
     Google Scholar
  14. Stamatiou K, Pierris N. Mounting resistance of uropathogens to antimicrobial agents: a retrospective study in patients with chronic bacterial prostatitis relapse. Investigative Clinic Urol. 2017 Jul 1;58(4):271–80.
     Google Scholar
  15. Turay AA, Obadan AI, Okagun GR, Okadua MA, Okwori AE. Prevalence and association of asymptomatic prostatitis with urinary tract infection among apparently healthy men in Ekpoma, Edo, Nigeria. Int J Basic, Appl Innov Res. 2014;3(3):72-9.
     Google Scholar
  16. Adegoke AO, Bamigbowu OE, Ayodele MB, Blankson CD. Prevalence of asymptomatic bacteriuria in prostatitis subjects attending University of Port Harcourt Teaching Hospital. Afr J Microbiol Res. 2012 Jun 9;6(21):4443–8.
     Google Scholar
  17. Mishra PP, Prakash V, Singh K, Mog H, Agarwal S. Bacteriological profile of isolates from urine samples in patients of benign prostatic hyperplasia and or prostatitis showing lower urinary tract symptoms. J Clin Diagn Res: JCDR. 2016 Oct;10(10):DC16.
     Google Scholar
  18. Lipsky BA. Prostatitis and urinary tract infection in men: what’s new; what’s true? Ameri J Med. 1999 Mar 1;106(3):327–34.
     Google Scholar
  19. Todar K. The Normal Bacterial Flora of Humans. 1st ed. Madison: University of Wisconsin; 2008.
     Google Scholar
  20. Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015;13(5):269.
     Google Scholar
  21. Bublitz DC, Wright PC, Bodager JR, Rasambainarivo FT, Bliska JB, Gillespie TR. Epidemiology of pathogenic enterobacteria in humans, livestock, and peridomestic rodents in rural Madagascar. PLoS One. 2014;9(7):e101456.
     Google Scholar
  22. Sarah A, Saif Q, Ruhi K, Asfia S, Meher R, Shahzad HF. Semen culture in patients with chronic prostatitis syndrome: a valuable diagnostic tool. Int J Curr Microbiol Appl Sci.. 2015(1):236–42. ISSN: 2319–7706.
     Google Scholar
  23. Hussein B, Sbri M, Hssan E. Bacteriological and clinical study of patients with benign prostatic hyperplasia and urinary tract infection. Pain. 2009;33:22.
     Google Scholar
  24. Karami AA, Javadi A, Salehi S, Nasirian N, Maali A, Shadkam MB, et al. Detection of bacterial agents causing prostate infection by culture and molecular methods from biopsy specimens. Iran J Microbiol. 2022;14(2):161.
     Google Scholar
  25. Oshodi AJ,Nwabuisi C, Popoola AA, Edungbola LD, Agbede OO, Akanbi II AA, et al. Bacterial uropathogen among benign prostatic hyperplasia patients at a tertiary hospital in Nigeria. Open J Med Microbiol. 2015 Feb 6;5(01):22.
     Google Scholar
  26. Stamatiou K, Magri V, Perletti G, Rekleiti N, Lacroix R, Moschouris H. Gram-positive microorganisms isolated during Chronic Bacterial Prostatitis investigation. A retrospective study. Hellenic Urol. 2019 Mar 14;30(4).
     Google Scholar
  27. Zhanel GG, Hoban DJ, Karlowsky JA. Nitrofurantoin is active against vancomycin-resistant enterococci. Antimicrob Agents Ch. 2001 Jan 1;45(1):324–6.
     Google Scholar
  28. Butt T, Leghari MJ, Mahmood A. In-vitro activity of nitrofurantoin in enterococcus urinary tract infection. J-Paki MedAssoc. 2004 Sep 1;54:466–8.
     Google Scholar
  29. Das A, Banerjee T, Anupurba S. Susceptibility of nitrofurantoin and fosfomycin against outpatient urinary isolates of multidrugresistant Enterococci over a period of 10 years from India. Microb Drug Resist. 2020 Dec 1;26(12):1509–15.
     Google Scholar