PTU - Polskie Towarzystwo Urologiczne
list of articles:

Ligase chain reaction (LCR) used for detection of subclinical prostate infection caused by Chlamydia trachomatis
Article published in Urologia Polska 2005/58/1.


Rościsław Bielecki 1, Bożena Zdrodowska-Stefanow 2, Iwona Ostaszewska-Puchalska 3, Marek Baltaziak 4, Małgorzata Skawrońska 5, Robert Kozłowski 1
1 Oddział Urologii SP ZOZ Wojewódzkiego Szpitala Zespolonego im. J. Śniadeckiego w Białymstoku
Ordynator oddziału: dr n. med. Robert Kozłowski
2 Klinika Dermatologii i Wenerologii Akademii Medycznej w Białymstoku
Kierownik kliniki: prof. dr hab. Bożena Chodynicka
3 Ośrodek Diagnostyczno-Badawczy Chorób Przenoszonych Drogą Płciową w Białymstoku
Kierownik ośrodka: dr n. med. Katarzyna Puciło
4 Zakład Patomorfologii Ogólnej Akademii Medycznej w Białymstoku
Kierownik zakładu: prof. dr hab. Andrzej Kemona
5 Zakład Medycyny Sšdowej Akademii Medycznej w Białymstoku
Kierownik zakładu: prof. dr hab. Jerzy Janica


prostate, Chlamydia trachomatis, prostatitis, ligase chain reaction, prostate biopsy


Prostatitis is a common urological problem affecting men at every age. The evidence of bacterial infection could be demonstrated only in 5 to 10% of cases. Chlamydia trachomatis (Ch. trachomatis) infection is rarely diagnosed in chronic prostatitis.
aim of the study
Our goal was to analyze the frequency of subclinical Ch. trachomatis infection among sexually active men undergoing prostate biopsy due to prostate cancer suspicion.
material and methods
We evaluated 30 men in whom prostate cancer was excluded and evidence of prostatic inflammation was found in histology preparations. Sera samples were tested for anti-chlamydial IgG and anti-chlamydial IgA antibodies. The number of polymorphonuclear leukocytes (PMN) in urethral smears and expressed prostatic secretions (EPS) was assessed. Urethral smears and biopsy tissue specimens were tested for chlamydial DNA by ligase chain reaction (LCR) method. The NIH Chronic Prostatitis Symptom Index score was obtained for every patient.
Two out of 30 men were tested positive for chlamydial DNA in biopsy tissue specimens with LCR. None of them had positive history of prostatitis. Their sera samples were negative for anti-chlamydial antibodies. The inflammatory changes on histology preparations were estimated low and high according to CPCRN and IPCN classification. The urethral smears of both men and EPS of one were negative for PMN. The EPS of one patient was positive for PMN.
In the case of asymptomatic prostatitis, the presence of subclinical Ch. trachomatis infection should be considered. Molecular methods could be helpful in the diagnostic process due to their high sensitivity and specificity.


  1. Roberts RO, Lieber M, Bostwick D, Jacobsen S: A review of clinical and pathological prostatitis syndromes. Urology 1997; 49; 809-821.
  2. Schaeffer AJ: Epidemiology and demographics of prostatitis. Andrologia 2003; 35; 252-257.
  3. McNaughton Collins M, Stafford R, O´Leary M, Barry M: How common is prostatitis? A national survey of physician visits. J Urol 1998; 149; 1224-1228.
  4. Moon TD: Questionnaire survey of urologists and primary care physicians diagnostic and treatment practices for prostatitis. Urology 1997; 50; 543-547.
  5. Weidner W, Ludwig M: Common organism in urogenital infections with special impact on prostatitis. Eur Urol 2003; Suppl 2; 15-18.
  6. Bergmann B, Wedren H, Holm SE: Staphylococcus saprohyticus in males with symptoms of chronic prostatitis. Urology 1989; 34; 241-245.
  7. Nickel JC, Costerton JW: Coagulase-negative staphylococcus in chronic prostatitis. J Urol 1992; 147; 398-400.
  8. Weidner W, Schiefer HG, Krauss H, Jantos C, Friedrich HJ, Altmannsberger M: Chronic prostatitis, a thorough search for etiologically involved microorganisms in 1461 patients. Infection 1991; 19; 119-125.
  9. Centers for Disease Control and Prevention. Chlamydia Prevalence Monitoring Project Annual Report 2002. In: Sexually Transmitted Disease Survicillance 2002 (Suppl), Atlanta, GA, USA, October 2003.
  10. Krieger JN, Takahashi S, Riley DE: Chronic prostatitis: Role of uncommon organisms. Eur Urol 2003; Suppl 2; 19-22.
  11. Nickel JC, Nyberg LM, Hennefent M: Research guidelines for chronic prostatitis consensus report from First National Institutes of Health International Prostatitis Collaborative Network. Urology 1999; 54; 229-233.
  12. Meares EM, Stamey TA: Bacteriologic localization patterns in bacterial prostatitis and urethritis. Invest Urol 1968; 5; 492-518.
  13. Krieger JN, Riley DE, Roberts MC, Berger RE: Prokaryotic DNA sequences in patients with chronic idiopathic prostatitis. J Clin Microbiol 1996; 34; 3120-3128.
  14. Guo H, Lu G, Zhang Q, Xiong X: Detection of Chlamydia trachomatis by polymerase chain reaction assay in nonbacterial prostatitis. Chin Med J 1997; 110; 177-179.
  15. Ostaszewska I, Zdrodowska-Stefanow B, Badyda J, Puciło K, Trybuła J, Bułhak V: Chlamydia trachomatis - probable cause of prostatitis. Int J STD AIDS 1998; 9; 350-353.
  16. Walsh S, Metzger DA, Higucki R: Chelex-100 as a medium for simple extraction of DNA for PCR-based typing from forensic material. Biotechniques 1991; 10; 506-513.
  17. Nickel JC, True LD, Krieger JN, Berger RE, Boag AH, Young ID and participating members of the North American Chronic Prostatitis Research Network and the International Prostatitis Collaborative Network: Consensus development of a histological classification system for chronic prostatic inflammation. Br J Urol Int Int 2001; 87; 797-805.
  18. Gordon FB, Quan AL: Isolation of the trachoma agent in cell culture. Proc Soc Exp Biol Med 1965; 118; 354-359.
  19. Stephens RS, Tam MR, Kuo CC, Nowinski RC: Monoclonal antobodies to Chlamydia trachomatis: antibody specificities and antigen characterization. J Immunol 1982; 128; 1083-1089.
  20. Mumatz G, Mellars BJ, Ridgway GL, Oriel JD: Enzyme immunoassay for the detection of Chlamydia trachomatis antigen in urethral and endocervical swabs. J Clin Pathol 1985; 38; 740-742.
  21. Krieger JN, Riley DE: Prostatitis: what is the role of infection. Int J Antimicrob Agents 2002; 19; 475-479.
  22. Schachter J: DFA, EIA, PCR, LCR and other technologies: what tests should be used for diagnosis of Chlamydia infections? Immunol Invest 1997; 26; 157-161.
  23. Bruce AW, Chadwick P, Willett WS, O´Shaughnessy M: The role of chlamydie in genitourinary disease. J Urol 1981; 126; 625-629.
  24. Dan M, Samra Z, Siegel YI, Korczak D, Lindner A: Isolation of Chlamydia trachomatis from prostatic tissue of patients undergoing transurethral prostatectomy. Infection 1991; 19; 162-163.
  25. Poletti F, Medici MC, Alinovi A et al: Isolation of Chlamydia trachomatis from the prostatic cells in patients affected by nonacute abacterial prostatitis. J Urol 1985; 134; 691-693.
  26. Kadar A, Bucsek M, Kardos M, Corradi G: Detection of Chlamydia trachomatis in chronic prostatitis by in situ hybridization (preliminary methodical report). Orvosi Hetilap 1995; 136; 659-662.
  27. Corradi G, Bucsek M, Panovics J et al: Detection of Chlamydia trachomatis in the prostate by in-situ hybridization and by transmission electron microscopy. Int J Androl 1996; 19; 109-112.
  28. Doble A, Thomas BJ, Walker MM, Harris JRW, Witherow RO`N, Taylor-
  29. -Robinson D: The role of Chlamydia trachomatis in chronic abacterial prostatitis: a study using ultrasound guided biopsy. J Urol 1989; 141; 332-333.
  30. Taylor-Robinson D: Evaluation and comparsion of tests to diagnose Chlamydia trachomatis genital infections. Hum Reprod 1997; 12; 113-120.


Rościsław Bielecki
SP ZOZ Wojewódzki Szpital Zespolony im. Śniadeckiego
Oddział Urologii
ul. Skłodowskiej-Curie 26
15-960 Białystok
tel. (0...85) 748 82 60