Staphylococcus saprophyticus
| Staphylococcus saprophyticus | ||||||||||||||
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| Staphylococcus saprophyticus (Fairbrother 1940) Shaw et al. 1951 |
Staphylococcus saprophyticus is a coagulase-negative species of Staphylococcus bacteria (which are catalase-positive). S. saprophyticus is often implicated in urinary tract infections. S. saprophyticus is resistant to the antibiotic Novobiocin, a characteristic that is used in laboratory identification to distinguish it from S. epidermitis, which is also coagulase- negative.
The organism is rarely found in healthy humans but is commonly isolated from animals and their carcasses.
It is implicated in 10-20% of urinary tract infections (UTI). In females between the ages of ca. 17-27 it is the second most common cause of UTIs. It may also reside in the urinary tract and bladder of sexually active females. S. saprophyticus is phosphatase-negative, urease and lipase positive.
Some of the symptoms of this bacteria are burning sensation when passing urine, the urge to go to the toilet more often than usual, the 'dripping effect' after urination, weak bladder, bloated feeling with sharp razor pains in the lower abdomen around the bladder and ovary areas and razor-like pains during sexual intercourse.
Quinolones are commonly used in treatment of S. saprophyticus urinary tract infections.
Treatment
Antimicrobial therapy
- Urinary tract infection
- Acute uncomplicated urinary tract infection (cystitis-urethritis) in females
- Preferred regimen : Cephalosporin PO OR Amoxicillin-Clavulanate 625 mg PO OR Trimethoprim-Sulfamethoxazole-DS bid for 3 days; if sulfa allergy, Nitrofurantoin 100 mg po bid for 5 days OR Fosfomycin 3 gm po as a single dose AND Pyridium.
- Alternative regimen (in sulfa allergy): then 3 days of Ciprofloxacin 250 mg bid OR Ciprofloxacin-Erythromycin 500 mg q24h OR Levofloxacin 250 mg q24h OR Moxifloxacin 400 mg q24h OR Nitrofurantoin 100 mg bid OR Fosfomycin single 3 gm dose AND Phenazopyridine Pyridium 200 mg po tid times 2 days.
- Note (1): Pyridium non-prescription—may relieve dysuria. Hemolysis if G6PD deficient.
- Note (2): >7-day treatment recommended in pregnancy [discontinue or do not use sulfonamides (Trimethoprim-Sulfamethoxazole) near term (2 weeks before EDC) because of potential increase in kernicterus]. If failure on 3-day course, culture and treat for 2 weeks.
- Recurrent urinary tract infection in postmenopausal women
- Preferred regimen : Trimethoprim-Sulfamethoxazole-DS bid for 3 days; if sulfa allergy, Nitrofurantoin 100 mg po bid for 5 days OR Fosfomycin 3 gm po as a single dose AND Pyridium.
- Alternative regimen (in sulfa allergy): then 3 days of Ciprofloxacin 250 mg bid OR Ciprofloxacin-Erythromycin 500 mg q24h OR Levofloxacin 250 mg q24h OR Moxifloxacin 400 mg q24h OR Nitrofurantoin 100 mg bid OR Fosfomycin single 3 gm dose AND Phenazopyridine Pyridium 200 mg po tid times 2 days.
- Note (1): Recurrent urinary tract infection definition is ≥3 culture and symptomatic urinary tract infection in 1 year or 2 urinary tract infection in 6 months. Evaluate for potentially correctable urologic factors like (1) cystocele (2) incontinence (3) increased residual urine volume (≥50 mL).
- Note (2): Nitrofurantoin more effective than vaginal cream in decreasing frequency, but adverse effect is pulmonary fibrosis with long-term Nitrofurantoin treatment.
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