Most common Bacteria causing UTI in sexually active young women?
Ans. a (Staph, saprophyticus), (Ref. Microbiology by Ananthnarayan, 7th/l 86 & Harrison 17th ed. Table 282-1)COAGULASE NEGATIVE STAPHYLOCOCCI# Staph, epidermidis - Stitch abscess, implanted foreign body infection, cystitis, endocarditis in drug addicts.# Staph, saprophyticus - UTI (urinary tract infection) in sexually active young women.- Treat with Nalidixic acid.ConditionCharacteristic PathogensMitigating CircumstancesRecommended Empirical treatmentAcute uncomplicated cystitis in womenEscherichia coli,Staphylococcus saprophyticus, Proteus mirabilis,Klebsiella pneumoniaeNoneDiabetes, symptoms for >7d, recent UTI, use of diaphragm, age >65 years Pregnancy3-Day regimens: oral TMP-SMX, TMP quinolone; 7-day regimen: macrocrystalline nitrofurantoin"Consider 7-day regimen: oral TMP-SMX, TMP, quinolone" consider 7-day regimen: oral amoxicillin, macrocrystalline nitrofurantion, cefpodoxime proxetil, of TMP-SMXAcute uncomplicated pyelonephritis in womenE. coli, P. mirabilis, S. saprophyticusMild to moderate illness, no nausea or vomiting; out patient therapySevere illness or possible urosepsis: hospitalization requiredOral quinolone for 7-14 d (initial dose gisven IV if desired); or single-dose cefriaxone (1 g) or gentamicin (3-5 mg/kg) IV followed by oral TMP SMX for 14 dParenteral quinolone, gentamicin (+ ampicillin), cefriaxone, or aztreonam until defervescence; then oral quinolone, cephalosporin, or TMP-SMX for 14 dComplicated UTI in men and womenE.coli, proteus, klebsiella, Pseudomonas, serraria, enterococci, staphylococciMild to moderate illness, no nausea or vomiting: out patient therapyOral quinolone for 10-14 dSevere illness or possible urosepsis: hospitalization requiredParenteral ampicillin and gentamicin, quinolone, ceftriaxone, aztreonam, ticarcillin/clavulanate, or imipenem cilastatin until defervescence; then oral qinolone or TMP-SMX for 10-21 dAlso remember:Features distinguishing the major species of StaphylococciCharacteristicsS. AureusS. epidermidisS. saprophyticusCoagulase+--Novobiocin sensitivitySSRAcid from mannitol anaerobically+/---Phosphatase++.
Staph, saprophyticus
Staph, aureus
Staph, epidermidis
Staph, citrus
Staphylococci