THE CHEMOTHERAPY OF UREASE- AND CITRASE- PRODUCING BACTERIA OF THE URINARY TRACT

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Abstract
On the basis of the urease and citrase production, the pathogenic bacteria are classified into 7 profiles. Profile 1 is urease and citrase positive and includes Proteus columbiensis (P. vulgaris, P. rettgeri, P. mirabilis), Proteus OX 2. Profile 2 is urease positive and citrase negative. It includes P. morganii and micrococcus. Profile 3 is urease positive (aerobic) and citrase positive Aerobacter, Klebsiella and Pseudomonas. Profile 4 may or may not produce urease and citrase: Proteus OX 19 and Proteus OX K. Profile 5 is urease negative but citrase may or may not be produced: P. inconstans. Profile 6: produces only citrase: Pseudomonas, Alcaligenes, Salmonella, Vibrio cholerae, Escherichia freurdii and E. intermedia. Profile 7: does not produce citrase and urease: E. coli, E. aurescens, E. typhosa, S. paratyphi, S. pullorum, S. gallinarum, V. El Tor, Micrococcus, Streptococcus pyogenes, Pneumococcus, Shigella. In the treatment of infections caused by urea splitters, the administration of urease blocking agent (chlormerodrin) may change the sensitivity-resistance pattern of the pathogen, thus rendering drug resistant pathogens to become more sensitive. Occasionally, mutation may take place in favor of the pathogen which may become more resistant to drugs. Chlormerodrin is given in doses of one tablet 4 times daily for 4 days in 2 series of patients. In one group of 64 patients, where 43 were thoroughly studied, 18 were cured, 7 were reinfected and 18 failed to respond to chlormerodrin.