Prevalence of genotoxic bacteria in men undergoing biopsy for prostate cancer

John Lee, Brian L. Wickes, Jianmin Fu, Nohelli E. Brockman, Harshit Garg, Christian Jobin, Teresa Johson-Pais, Robin J Leach, Zhao Lai, Michael A. Liss

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: New evidence suggests that bacteria-produced DNA toxins may have a role in the development or progression of prostate cancer. To determine the prevalence of these genes in a noninfection (i.e., colonized) state, we screened urine specimens in men before undergoing a biopsy for prostate cancer detection. Methods: We developed a multiplex polymerase chain reaction using three of the most described bacterial genotoxin gene primers: Colibactin (polyketone synthase [pks] gene island: clbN and clbB), cytotoxic necrotizing factor (cnf1) toxin, and cytolethal distending toxin B (cdtB) represented gene islands. After calibration on Escherichia coli samples of known genotypes, we used a training and validation cohort. We performed multiplex testing on a training cohort of previously collected urine from 45 men undergoing prostate biopsy. For the validation cohort, we utilized baseline urine samples from a previous randomized clinical trial (n = 263) with known prostate cancer outcomes. Results: The prevalence of four common bacterial genotoxin genes detected in the urine before prostate biopsy for prostate cancer is 8% (25/311). The prevalence of pks island (clbN and clbB), cnf1, and cdt toxin genes are 6.1%, 2.4%, and 1.7%, respectively. We found no association between urinary genotoxins and prostate cancer (p = 0.83). We did identify a higher proportion of low-grade cancer (92% vs. 44%) in those men positive for urinary genotoxin and higher-grade cancer in those genotoxin negative (8% vs. 56%, p = 0.001). Conclusions: The prevalence of urinary genotoxins is low and does not correspond to a prostate cancer diagnosis. The urine was taken at one point in time and does not rule out the possibility of previous exposure.

Original languageEnglish (US)
Pages (from-to)663-669
Number of pages7
Issue number7
StatePublished - May 15 2023


  • E. coli
  • genotoxin
  • prostate cancer
  • urinary microbiome

ASJC Scopus subject areas

  • Oncology
  • Urology


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