1213
A Clinical
Study
on Patients with Coagulase-Negative
Urinary Tract Staphylococci
Infection
Due to
Shuji TOKUNAGA, Mitsuo OHKAWA,Takao NAKASHIMA,Kazuyou YAMAGUCHI, Tadayuki NISHIKAWA,Yoshiyuki ISHIURA, Tadahiro KOBAYASHI and Haruo HISAZUMI Department ofUrology, SchoolofMedicine, Kanazawa University Shinichi FUJITA CentralClinicalLaboratory, Kanazawa University Hospital (Received: March4, 1992) (Accepted: May7, 1992) Key words: urinary tract infection (UTI), coagulase-negative staphylococci (CNS)
Abstract To tract
assess
the
infection
studied.
(10.4%)
had
infections. the
UTI
patients)
These colonization certain
Of fever Six
patients
significance
the
uncomplicated were
clinical
(UTI),
of
with
results
the of
rather
from
38•Ž
these
or
whom UTI
than
were
patients,
95
isolated
which
was
strongly
by
indwelling
UTI
were
which
pathogens,
indwelling
young hitherto
can urinary
also
staphylococci of
117
women have cause
catheterization
(106
urinary
(89.6%)
and
had
to
complicated and
be
typical
with UTI
of 105 or no
due
to On
more
genitourinary the
other of
ml 11
tract hand,
acute
active
all
of
cystitis. or
chemotherapy
in sexually
11 per
while
contaminants
requiring
cystitis
urinary
patients,
symptoms
symptoms mere
UTI acute
from
catheters.
considered
patients
counts
suffered
urinary
in
complicated
colony
suspected
been
(CNS)
patients
at
patients
managed
CNS,
true as
CNS
were
uncomplicated
such
of a total
greater,
patients
that
of coagulase-negative
characteristics
complicated
suggest
conditions
clinical
benign under women.
Introduction
With the widespread use of antimicrobial agents which possess strong antibacterial activity to gramnegative rods, gram-positive staphylococci have been increasingly frequently isolated from urine specimens. Of the staphylococci, coagulase-positive Staphylococcus,S. aureus, has attracted particular attention because this organism easily becomes resistant to methicillins and cephems (methicillin-resistant S. aureus: MRSA). However, the incidence of S. aureus in the urinary tract has been reported to be significantly less than that of CNS1,2)and its clinical significance including its pathogenicity have been suggested to be minor in the urinary tract3). In our previous study, however, the incidence of CNS isolated from urine specimens was relatively high and, in particular, the incidence in uncomplicated UTI was 15% which ranked second to that of Escherichia coli4>.Recently, several authors have reported the emergence of CNS as a pathogen in the urinary tract1,5,6and, furthermore, as a major causative organism of urosepsis in compromised hosts7). To better define the clinical significance of CNS in UTI patients, we studied the clinical characteristics of patients with CNS UTI. 別 刷 請 求 先 二(〒920)金
沢 市 宝 町13-1
金 沢 大 学 医学 部 泌 尿器 科 学 教 室 徳永 平成4年9月20日
周二
1214
Shuji TOKUNAGA et al
Subjects A
total
between
of
isolated
(Nissui,
and
The
samples by by
negative
Gram
egg
blood
of pyuria.
Statistical
and
identified
as
CNS
at 1 ,500
CNS
were
analysis
was the
was
rpm
for
identified
only
only
or
the
. The
blood
cell
by
in
the
and
pyuria
bacteria
on
of CNS
were
(CLED)
Salt
cocci
which by
judged
York showed
a
when •† _10
and
cfu/ml
Agar
microscopy
present
patients
of •†105
agar(R) cocci
Egg
determined
was UTI
ml
Gram-positive
gram-positive
complicated
per
.
plated
were
Hospital
more
Deficient hours.
was
counts
presence
chi-square
105 or
inpatients
18-24
cocci
10 minutes,
predominant
by
for
CNS
field
62
University
of
Electrolyte
incubated
gram-positive
Kanazawa counts
and
Lactose
. White
power
performed
Cysteine
identify
high
of
colony
outpatients
and
of the to
per
UTI
technique
hours
sediment
CNS
of
Urology
at urinary
of 55
40
observed
of
CNS
plates
a colony
for
were
were
ones8).
split loop
37•Ž
of the
cells
uncomplicated presence
at
reaction
centrifugation
white
on
stain,
Department
whom consisted
quantitative
Tokyo)
yolk
from
patients
plated
the
the
1991
117
were
Tokyo)
Base (R)Nissui,
consulting
March
studied.
screened
after
patients
1988
were
Urine
were
117
April
and Methods
when •†
_5 in of the
regardless
isolated.
test
, Fisher's
exact
probability
test
or
student's
t-test.
Results The
117
CNS
uncomplicated differences
with
(p