MP37-06: Antimicrobial Resistance and Microbial Patterns within the Chronic Prostatitis Urobiome compared to Asymptomatic Healthy Controls

J. Curtis Nickel*, Kingston, Canada, Niccole Diaz, Craig D. Tipton, Lubbock, TX, E. David Crawford, San Diego, CA, Rick Martin, Caleb D. Phillips, Lubbock, TX

Introduction: We present a comparative analysis of the urobiome and its antimicrobial resistance patterns from urine specimens submitted by patients with a clinical diagnosis of chronic prostatitis (CP) and asymptomatic healthy control males.

Methods: The urobiome of 763 subjects with a confirmed physician diagnosis of CP (from data base of 2,397 with CP ICD-10 code) were compared to 92 healthy males with no urological pain or infection. Microbiome and antibiotic resistance gene data were analyzed by NGS and qPCR respectively (MicroGenDx).  Differences in each group’s urinary microbiome were investigated from perspectives of compositional differences and antibiotic resistance patterns.

Results: In respect to alpha diversity, CP cohort had similar number of species (richness; p = 0.1: Fig 1a) but higher Shannon Diversity (richness and evenness of species abundances; F = 5, p = 0.03, R2 = 0.6%: Fig 1b) compared to healthy controls. Escherichia coli and Streptococcus agalactiae had significantly higher incidence rate in CP (p = 0. 04) and controls (p = 0.002) respectively. Diagnosis of CP vs controls explained a significant proportion of overall compositional dissimilarity (F = 5.51. p = 0.001, R2 = 0.64%).  Five species E. coli, C. acnes, K. pneumoniae, C. glucuronolyticum and P. harei had higher average abundance in CP (Fig 1c); present in 50% of CP but only 16% of controls. While frequency of beta lactam (TEM) resistance was higher in CP (p=0.059), no significant differences in resistance patterns were identified for beta latam SHV (p=0.62) aminoglycosides (antia or alph3; p=0.4-0.81), macrolides (emB; p=0.84), methicillin (mecA: p=0.31), quinolones (qnr; p=0.15), tetracycline (tetB or tetM; p=0.37-1.0) or vancomycin (vanA; p=1.0).

Conclusions: CP is associated with significantly different species incidence rates and relative abundances (notably E. coli, K. pneumoniae, C. acnes and C. glucuronolyticum), and with small but statistically significant components of variation in both alpha and beta diversity, but no clinically significant difference in antibiotic resistance patterns compared to healthy controls. The clinical relevance of detecting potential uropathogens with their associated resistance data in CP management needs to be addressed.

Source of Funding: MicroGenDx