WBR0945

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Author [[PageAuthor::William J Gibson (Reviewed by Yazan Daaboul, M.D.)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Microbiology
Sub Category SubCategory::Genitourinary
Prompt [[Prompt::A sexually active 22-year-old woman presents to her primary care physician with complaints of burning sensation on urination for the past 2 days. Urine culture demonstrates colonies of catalase-positive, coagulase-negative, gram-positive cocci with novobiocin resistance. Which of the following pathogen's is most likely responsible for this patient's condition?]]
Answer A AnswerA::''Escheria coli''
Answer A Explanation AnswerAExp::While ''E. coli'' is the leading cause of urinary tract infections among sexually active women, ''E.coli'' is a gram-negative rod.
Answer B AnswerB::''Staphylococcus aureus''
Answer B Explanation AnswerBExp::While ''S. aureus'' is a catalase-positive, gram-positive coccus, it is coagulase-positive.
Answer C AnswerC::''Staphylococcus epidermidis''
Answer C Explanation [[AnswerCExp::S. epidermidis is a catalase-positive, coagulase-negative, gram-positive coccus with novobiocin sensitivity. S. epidermidis is a component of the normal skin flora but can become pathogenic typically by infecting prosthetic devices. It is a common cause of endocarditis among patients with artificial valves.]]
Answer D AnswerD::''Staphylococcus saprophyticus''
Answer D Explanation AnswerDExp::''S. Saprophyticus'' is a catalase-positive, coagulase-negative, gram-positive coccus with novobiocin resistance. It is the second most common cause of urinary tract infections among sexually active women, following ''E. coli''.
Answer E AnswerE::''Streptococcus agalactiae''
Answer E Explanation AnswerEExp::''S agalactiae'' is a catalase-negative, beta-hemolytic, gram-positive coccus with bacitracin resistance. It is alternatively referred to as Group B streptococci and is a common cause of neonatal meningitis.
Right Answer RightAnswer::D
Explanation [[Explanation::The patient in this vignette has a urinary tract infection caused by Staphylococcus saprophyticus. S. saprophyticus is a catalase-positive, coagulase-negative, gram-positive coccus with novobiocin resistance. It is the second most common cause of urinary tract infections among sexually active women (10-20%) following E. coli.

Educational Objective: S. Saprophyticus is a catalase-positive, coagulase-negative, gram-positive coccus with novobiocin resistance. It is the second most common cause of urinary tract infections among sexually active women.
References: Hovelius, Birgitta, and Per-Anders Mardh. Staphylococcus saprophyticus as a common cause of urinary tract infections. Review of Infectious Diseases. 1984; 6(3):328-337.
First Aid 2015 page 174.]]

Approved Approved::Yes
Keyword WBRKeyword::Bacteria, WBRKeyword::Staphylococcus saprophyticus, WBRKeyword::Gram positive, WBRKeyword::Gram positive bacteria, WBRKeyword::UTI, WBRKeyword::Urinary tract infection, WBRKeyword::Laboratory classification, WBRKeyword::Catalase, WBRKeyword::Novobiocin, WBRKeyword::Coagulase
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