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

A clinical study on patients with urinary tract infection due to coagulase-negative staphylococci.

To assess the clinical significance of coagulase-negative staphylococci (CNS) in patients with urinary tract infection (UTI), the clinical characteris...
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