Effects of azoximer bovgialuronidase on bacterial biofilms in the ejaculate of patients with chronic prostatitis.

Introduction. The use of molecular biological methods in the analysis of bacterial diversity (metataxonomics) of prostate secretion and ejaculate to assess the male microbiota made it possible to identify the bacterial diversity of the microbiota in chronic prostatitis. At the same time, many strains of uropathogens identified in chronic prostatitis show the ability to form biofilms, while there are no generally accepted methods for treating infections caused by bacterial biofilms. Purpose of the study. To study the effect of bovhyaluronidase azoximer in chronic prostatitis, which may be due to the enzymatic action of hyaluronidase on the matrix of bacterial biofilms, which increases the bioavailability of antibiotics, leading to the transition of bacteria into a planktonic state. Material and methods. An electron microscopic study of the ejaculate of 42 patients with chronic prostatitis was performed, of which 32 randomly selected patients received combined antibiotic treatment (4-6 weeks) together with bovhyaluronidase azoxymer (12 weeks) (group I), 10 patients received only antibiotic therapy according to clinical guidelines (group II). On ultrathin sections, the number of bacterial microcolonies and neutrophilic leukocytes per 100 spermatozoa was counted. Results. In the semen of 30 patients, bacterial biofilms with a characteristic morphology were detected: the presence of heterogeneous microorganisms in one microcolony and the presence of a fibrous matrix in which bacteria are immersed. After therapy, in group I, a decrease in the number of bacterial microcolonies, the disappearance of the extracellular matrix, and isolated single bacteria (planktonic state) were detected, in some cases, damage to the bacterial cell wall was detected. In group II quantitative changes in the content of microcolonies and neutrophilic leukocytes were also revealed, however, the morphology of microcolonies in group II did not change. Conclusions. electron microscopy in the study of the ejaculate of patients with chronic prostatitis allows us to reveal the features of the structure of bacterial biofilms. In combined antibiotic therapy together with bovhyaluronidase azoxymer, the biofilm matrix changes and the bacteria transform into a planktonic form.