Polymicrobial prostatitis: microbiological spectrum and antibiotic resistance patterns in a retrospective cohort study

Abstract Background Polymicrobial prostatitis, though less common, presents significant diagnostic and therapeutic challenges due to diverse pathogens and varied resistance patterns. This study aimed to assess the microbiological profile and antibiotic sensitivity in such cases. Results Gram-positive cocci were predominant (93.7%), while Gram-negative bacilli accounted for 6.2% of isolates. The most frequently isolated organisms were coagulase-negative staphylococci (CoNS) (37.5%) and non-grouping streptococci (34.4%), followed by Enterococcus faecalis and Staphylococcus aureus , each representing 6.3% of isolates. Other isolates included Enterococcus faecium , methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae , Escherichia coli , and Streptococcus spp., each accounting for 3.1%. Colony-forming units (CFUs) varied, with the highest observed in MRSA (100,000 CFU). CoNS and non-grouping Streptococci showed CFUs between 3,000 and 50,000. Nitrofurantoin demonstrated 100% sensitivity across all isolates, followed by vancomycin (93.8%), teicoplanin (84.4%), linezolid (81.3%), and fosfomycin (75%). High resistance was observed against ciprofloxacin (100%), erythromycin, imipenem, and tazobactam–piperacillin each of which show (96.9%), meropenem (93.8%), and cephalosporins (75–95%). Conclusions Polymicrobial prostatitis in this exploratory cohort was predominantly caused by Gram-positive organisms. Beta-lactams and Fluroquinolones showed high resistance, while nitrofurantoin and vancomycin emerged as the most effective agents. These preliminary findings underscore the need for targeted therapy based on culture and sensitivity results and serve as a hypothesis-generating basis for future large-scale research.