Staphylococcus saprophyticus

• A 23-year-old woman presents to her primary care physician due to pain with urination. Her symptoms are associated with lower abdominal pain, increased urinary frequency, and urinary urgency. She is currently sexually active with a recent partner, both of whom received sexually transmitted infection testing, for which both of them were negative. Physical examination is notable for suprapubic tenderness to palpation. A urinalysis is remarkable for being leukocyte esterase positive and urine culture demonstrates gram-positive, coagulase-negative cocci in clusters that are novobiocin resistant.

Introduction

• Classification
  • gram-positive, catalase-positive, coagulase-negative, and urease-positive cocci in clusters that are novobiocin resistant  
• Epidemiology
  • incidence
    • second most common cause of uncomplicated urinary tract infections in young women 
      • Escherichia coli is the most common cause
• Reservoir
  • female genital tract and perineum
• Pathogenesis
  • microorganisms adhere to the uroepithelial cells, where they ascend from the urethra and cause infection
    • this strong ability to adhere to the uroepithelial cells are believed to be due to its lactosamine residue
• Associated conditions
• urinary tract infections

Presentation

• Urinary tract infection
  • symptoms
    • dysuria
    • urinary frequency
    • urinary urgency
  • physical exam
• suprapubic pain

Differential

• Other causes of urinary tract infections
  • differentiating factors
    • E. coli
• gram-negative rod

Treatment

• Medical
  • trimethoprim-sulfamethoxazole
    • indication
• treatment of choice for urinary tract infections caused by S. saprophyticus

Complications

• Pyelonephritis