Bacterial Urinary Isolates Associated with Prostate Cancer and Their Relationship to Gleason Score

Abstract

Introduction: Prostate cancer ranks as the second cancer among men all over the world. Prostate cancer in Iraq is about 4.08% of all male cancers however after age 50 the incidence has been observed to rise significantly. Prostate cancer has been proposed to be caused by bacteria prostatitis and chronic inflammation. The gram-negative bacteria, particularly Escherichia coli, are commonly implicated in UTI and prostatitis, and can also facilitate the development of inflammatory microenvironment, associated with cancer development. Purpose: This research attempt was designed to isolate and identify bacterial species in urine specimens of patients having prostate cancer and to determine their distribution in terms of Gleason grade, age and other clinical risk factors. Methods: The study was a descriptive cross-sectional one, which was carried out between November 2021 and April 2022. Fifty prostate cancer patients aged between 35 and 80 years who were attending Imam Hussain Center of Oncological and Hematological Diseases, Kerbala, Iraq were recruited. Midstream urine of 10 mL was collected in sterile samples and placed under MacConkey and Blood agar culture. Bacterial identification was done through the traditional biochemical tests and then the VITEK-2 Compact System. The statistical analysis has been conducted using SPSS; Chi-square test and Pearson correlation have been implemented, and the level of significance has been set to p ≤ 0.05. Findings: In 42% of the urine samples, there was significant growth of bacteria. The most common isolate was Escherichia coli (81 percent of the positive cultures), then Enterobacter cloacae (14.3%) and Klebsiella pneumoniae (4.7%). Most of the patients were aged between 70 and 79 years (46%). The most common was Gleason score 8-10 (50%). Forty eight percent of patients were found to smoke. Gleason score of 8 -10 showed the highest E. coli isolate growth (56%). There was no statistically significant difference between age groups and bacterial isolates (p > 0.05), no statistically significant difference in mean age between Gleason score groups (p = 0.689). Conclusion: The most frequent category among prostate cancer patients was Gleason score 8-10. Escherichia coli was the bacterial isolate that was detected to be most common. The risk factors were identified as older age (70-79 years) and smoking. The results were in line with the expectation of the possible role of the long-term presence of bacteria in the inflammatory process involving prostate cancer.