An additional infection of the urinary tract that is associated with biofilm formation is chronic bacterial prostatitis in men. The most commonly encountered bacteriological agent in prostatitis is E. coli, followed by other members of the Enterobacteriaceae (Proteus and Klebsiella) and coagulase-negative Staphylococci (Domingue and Hellstrom 1998). These infections are notoriously difficult to treat with antibiotic therapy. Studies by Nickel and Costerton demonstrated that prostate biopsy samples from chronically infected patients contained exopolysaccharide-encased microcolonies that were attached to the walls of the prostate ducts (Nickel and Costerton 1993). In chronic staphylococcal prostatitis, biofilm-like microcolonies were attached to the prostate in patients that were refractory to antibiotic therapy (Nickel and Costerton 1992). Finally, in a recent study, a total of 377 E. coli isolates obtained from a variety of urinary tract infections (cystitis, pyelonephritis, and prostatitis) were examined for biofilm-forming abilities by standard crystal violet staining of cells grown in microtiter wells. The isolates from prostatitis cases exhibited significantly greater biofilm formation than other isolates (Kanamaru et al. 2006).
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