Association of Escherichia coli Infection and fimh Virulence With Benign Prostatic Hyperplasia in Ghanaian Patients

Abstract

Background: Benign prostatic hyperplasia (BPH) is the most common urological disorder of the prostate in aged men. Oxidative stress and environmental factors have been associated with BPH. However, information on infectious agents asso ciation with BPH remains scarce. This study aims to determine Escherichia coli (E. coli) infection and virulence gene association with BPH in patients. Methods: A case–control study was conducted with 61 BPH patients and 52 controls. Prostate volume (PV) was estimated for diagnosis of BPH using abdominal ultrasound. Serum malondialdehyde (MDA) levels were measured, and data on alcohol intake and physical exercise were obtained with questionnaire. E. coli DNA was extracted from urine samples, and targeted 16S rRNA and fimH gene primers were used for PCR amplifications. Results: Mean difference of PV between patients (55.10 ± 27.37) and controls (26.33 ± 6.37) was statistically significant (p < 0.01). Serum MDA was significantly and positively correlated with PV (p < 0.001). Exercise correlate inversely with prostate volume. Intriguingly, alcohol intake significantly and inversely correlated with PV (p < 0.05). E. coli infection, but not virulence, was associated with an almost 12‐fold increased risk of PV (p < 0.01). No fimH gene sequence variation was observed in isolates from patients and controls. However, Ghanaian isolates displayed sequence diversity when compared with isolates from other countries. Conclusion: Escherichia coli infection, particularly variant carrying the fimH virulence gene, was more frequent among the BPH patients. These findings suggest that E. coli infection should be considered as a key factor in the management of BPH