URINARY-TRACT INFECTIONS CAUSED BY STAPHYLOCOCCUS-SAPROPHYTICUS - RECURRENCES AND COMPLICATIONS

Staphylococcus saprophyticus is a coagulase-negative, novobiocin-resistant staphylococcus known to cause acute urinary tract infections in young women. We believe that the kidney can be involved in such infections. Of 57 randomly selected women with urinary tract infection caused by Staphylococcus saprophyticus clinical symptoms suggestive of renal involvement were reported by 29, 20 of whom had renal tenderness on examination. In 9 of 16 patients studied with the pitressin tannate test the renal concentrating capacity was reduced during the course of infection. All patients had regained the concentrating capacity on followup after antibiotic treatment. In the 57 women studied 38 had a history of recurrent urinary tract infection before entering the study. Recurrent urinary tract infection occurred in 17 patients during followup of 6 to 12 months, with Staphylococcus saprophyticus in 10 and gram-negative rods in 7. Twelve other women who had received treatment with nalidixic acid had persistent urinary tract infection with Staphylococcus saprophyticus on followup. In addition, 3 patients with renal calculi had persistent growth of Staphylococcus saprophyticus despite treatment with antibiotics to which the organisms were susceptible in vitro. In 1 of these patients urine obtained from the renal pelvis at nephrolithotomy yielded Staphylococcus saprophyticus. The characteristic appearance of urine sediment from patients with urinary tract infection caused by Staphylococcus saprophyticus is reported, that is aggregates of staphylococcal cells and cocci adhered to epithelial cells, and hyaline and cellular casts.