Urinary tract infections in young adult women caused by Staphylococcus saprophyticus

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Abstract
Eighty-one urinary tract infections (UTI) with S. saprophyticus occurring in 72 college women with Escherichia coli UTI were evaluated and compared. During the 14-mo. study period, S. saprophyticus was the second most common cause of UTI, accounting for 11% of the total. S. saprophyticus infections occurred more frequently during the late summer and early fall. Age, history of previous UTI, signs and symptoms of infection, and findings on urinalysis were similar in patients with S. saprophyticus and E. coli infections. Nine (41%) of 22 S. saprophyticus infections were localized to the upper urinary tract by the antibody-coated bacteria technique compared with 18 (16%) of 115 infections with E. coli (P = 0.01). Rectal, vaginal and urethral colonization with S. saprophyticus was associated with UTI caused by these organisms, suggesting that their pathogenesis resembles that of E. coli UTI. In vitro susceptibility testing showed almost uniform sensitivity of S. saprophyticus to most antimicrobials used to treat UTI, but recurrent infections occurred in 6 of the 72 women despite adequate therapy. Physicians and microbiologists must be aware that S. saprophyticus is an important cause of UTI in young women.