Bacteriospermia and male infertility: A method for increasing the sensitivity of semen culture

Objective-To test a method for increasing the sensitivity of semen culture. Design-Prospective and transverse. Setting-Andrology clinic at a tertiary care health institution in Mexico City. Patients-65 infertile patients with abnormal semen, bacteriospermia detected on Gram stain and at least two pr evious negative semen cultures (<3 months) were included to test routine se men culture and a method including centrifugation of semen at 10,00 rpm for 20 minutes. Localization cultures were also carried out in all patients. M ain outcome measure-Bacterial isolation in semen samples. Results-Routine s emen culture was positive in 22% of patients, while centrifuged aliquots of the same semen sample were positive in 52% of patients (chi(2) = 6.60, P < .01). Enterococcus was isolated in 43% of patients, E, coli in 24%, coagula se-negative Staphylococcus in 19%, and U. urealyticum in 14%. Ninety percen t of isolates corresponded to specimens from the urethra and the prostato-v esicular region. Conclusion-Sensitivity of semen culture increased with cen trifugation of semen samples. Localization pattern and type of isolates sug gest that these patients had chronic prostatitis and that episodic eliminat ion of bacteria might also explain false negative semen cultures in patient s with chronic asymptomatic infection of the accessory sex glands.