MP35-11: Comparative Analysis of the Microbiome of Chronic Prostatitis, Acute Cystitis and Asymptomatic Healthy Subjects: The Key to Interpretation of Next Generation Sequencing Urine Reports

Saturday, September 11, 2021 11:30 PM to Sunday, September 12, 2021 1:30 AM


Authors: J. Curtis Nickel, Craig D. Tipton, Caleb D. Phillips, Rick Martin, E. David Crawford

Introduction: Complex next generation sequencing (NGS) analyses reports from urine specimens being submitted from men diagnosed with chronic prostatitis (CP) are difficult to interpret.  To better understand the clinical implications of NGS reports from CP patients, we present a comparative analysis of clinical NGS urine specimens from a large urinary microbiome data base (MicroGenDX, n=71,737) which includes male patients with a physician diagnosis of CP, acute cystitis (AC) in males and a smaller cohort of asymptomatic healthy male controls (HC).

Methods: The urinary microbiome of patients with CP (n=2,404) were compared to male subjects with AC (n=334), and HC with no urological pain or infection (n=105). Differences in each group’s microbiome were investigated from the perspectives of differential taxa abundance, beta and alpha diversity, using ANCOM, Permanova (ADONIS) and Kruskal Wallis test, respectively.

Results: Overall 531 genera were detected with 95 genera found to be differentially abundant across the diagnoses. The top five most abundant genera were identified as Staphylococcus, Escherichia, Streptococcus, Enterococcus, and Corynebacterium.  Alpha diversity was found to be non-randomly distributed by group (Kruskal-Wallis; p < 0.001). Pairwise tests show the healthy cohort had the highest diversity, followed by CP and then lowest was AC (Figure 1a). Microbiome composition was also associated to diagnostic group (Permanova; p = 0.001; Figure 1b), though the effect was small and diagnosis only explained approximately 1% of variation among diagnostic groups.

Conclusions: There is considerable overlap between the microbial composition and diversity with chronic prostatitis associated with an intermediate microbiome state between healthy controls and acute cystitis states.  This suggests that a subset of chronic prostatitis may be related to bacterial infection.  More specific prostate sampling (eg post prostate massage urine) and outcome studies evaluating the potential benefits of NGS directed antibiotic therapy will determine the clinical implications of NGS testing in men diagnosed with chronic prostatitis.

Source of Funding: MicroGenDX

Therapeutic Area