Urinary Tract Infections Caused by Staphylococcus Saprophyticus: Recurrences and Complications

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Abstract
S. saprophyticus is a coagulase-negative, novobiocin-resistant Staphylococcus that causes acute urinary tract infections [UTI] in young women. The kidney may be involved in such infections. Of 57 randomly selected women with UTI caused by S. saprophyticus, clinical symptoms suggestive of renal involvement were reported by 29, 20 of whom had renal tenderness on examinatin. The renal concentrating capacity in 9 of 16 patients studied with the pitressin tannate test was reduced during the course of infection. All patients regained the concentrating capacity on follow-up after antibiotic treatment. In the 57 women studied, 38 had a history of recurrent urinary tract infection before entering the study. Recurrent UTI occurred in 17 patients during follow-up of 6-12 mo., with S. saprophyticus in 10 and gram-negative rods in 7. Twelve other women who received treatment with nalidixic acid had persistent UTI with S. saprophyticus on follow-up. Three patients with renal calculi had persistent growth of S. 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 S. saprophyticus. The characteristic appearance of urine sediment from patients with UTI caused by S. saprophyticus is reported, i.e., aggregates of staphylococcal cells and cocci adhered to epithelial cells and hyaline and cellular casts.