March 10, 1999: A Guest Editorial by Paul Fugazzotto

In the processing of 25,000 clinic pelvic disorder specimens, it has occurred to us that the medical lab directors and practitioners have lost sight of their Med School indoctrination in the cardinal rules of microbiology.

Rule 1: Concept of Infection. This has been characterized by the ancient Romans (about 500AD) and defined in Latin by the clinical signs of tumor, rubor & fruor. This trilogy has been well authenticated for centuries and passed on to medical schools for indoctrination and training of medical students. With this trilogy of symptoms, there is no need for the laboratory to test for presumed evidence of infection. The trilogy is evidence in itself.

Rule 2: Etiologic Agent. In modern times, the works of Koch, Pasteur, Bordet, Ehrlich, Zinnser and many other scientists in the field have established that every microbial disease entity has its specific etiologic agent, the laboratory finding of which identifies the disease. As detective agency for the medical profession, the laboratory is obligated first and above all to find that agent by authentic pure-culture technology. There is no other approach capable of resolving this matter. At the Cystitis Research Center, by the above clinical studies, we have found strains of Gram-positive cocci as etiologic agents in 99% of the cases, responding to specific antibiotics.

Rule 3: Saprophyte Contaminants: Normal intestinal gram-negative bacilli survive on dead organic matter. They do not penetrate and destroy living tissue. When present in the area of infection, their survival is enhanced by the availability of dead tissue cells engendered by the invasive pathogen.

In this regard, I am particularly concerned about Dr. Uthman's comments on my work as noted in a recent issue of "Urology Times" that "a single contaminant, even one organism, is going to give him (me) positive results." This is distinctly a high-school concept of bacteriology. In cases of infection, one can under appropriate professional technology, expect a substantial emergence of the respective etiologic agent --- even among contaminants. E.coli (and related gram negative bacillary strains) are saprophytes: as such, they have no quality for penetrating live tissue, a basic medical school concept. Regardless of numbers as accepted by his understanding of infection, they produce only hygienic discomfort, not infection

Regardless of the conventional accepted colony count, my indoctrination in Medical School (Univ. of Michigan) has been and still is, after sixty years of diagnostic research behind the bunsen burner, that infection is due to pathogens; not to large numbers of sprophytic "normal" bacteria. Also, contrary to Dr. Uthman's comments, I have reported only strains of well recognized pathogenic Gram-positive cocci, as agents of PD, not simply gram positive organisms. Dr. Uthman should certainly know the difference.

The situation in society today is an estimated million victims of pelvic disorder (urinary tract, prostatitis) forced to visit many successive providers with little or no relief for years. The conventional diagnostic procedure embraced by the medical profession is focused on elementary tests of raw urine, which contain metabolic wastes, antibiotics, and/or other medications antagonistic to recovery of known pathogens. At CRC, we purge all urine of these components for direct isolation of known pathogens as above. Is there anyone out there in doctor offices, and medical labs, aware that raw urines are not suitable test specimens? These must first be purged of their chemical wastes, before they can be properly processed for microbial diagnostic purposes. All urines do harbor wastes that are antagonistic to the recover of respective etiologic agents. Failure to purge these wastes before testing is irresponsible medical proactive anywhere and at all times. The CRC purges all specimens before processing as a matter of routine.

Furthermore, in the lab, we are the detective agency for the medical profession. As in police work, it is not sufficient to find evidence of a disorder. We are obligated to find the "culprit" or "cause." Analogous to the practice at the airport, everyone is screened for all strains of microbial agents present whereby, with appropriate subsequent technology, the respective pathogen can be isolated and identified. That is the substance of PD diagnosis: that no stones shall be left unturned to find the causes.

At the CRC, we consider any and all reported research outside of direct isolation for the causative agent, as studies on the byproducts of infection. These are of academic interest only and are superfluous relative to benefit of the patient. E-coli is not a valid diagnosis! In otherwise normal individual, the profession must first and above all focus on resolution of infection and turn to possible other abberrent conditions later. In the authentic scientific world of the medical laboratory, there is no valid cost-sparing "short-cut" to the truth. The cardinal rules of thousands of years certainly supercede the few decades of high school level microbial "science."

Paul Fugazzotto

Cystitis Research Center