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Staphylococcus saprophyticus

Background:

>Staphylococcus Coagulase-negative species:
     1] Staph epidermidis
     2] Staph. haemolyticus
     3] Staph lugdunensis
     4] Staph saprophyticus led
     5] Staph hominis
     6] Staph capitis

Staphylococcus saprophyticus:
  • gram positive and coagulase-negative species of Staphylococcus bacteria.
  • Often implicated in urinary tract infections (10-20% of UTIs).
  • In females between the ages of about 17-27 it is the second most common causative agent of acute UTIs, after Escherichia coli.
  • Phosphatase-negative, urease- and lipase-positive.
  • Source: http://en.wikipedia.org/wiki/Staphylococcus_saprophyticus
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Therapy:

Important considerations:  The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions.   Generally, the most common agents/regimens are listed first.   Listed dosages may need to be adjusted for renal dysfunction.
 
  1. Bactrim DS (TMP-SMX)  po bid
  2. Cephalexin 500mg orally every 6 hours
  3. Augmentin 875/125 mg orally twice daily
  4. Levofloxacin 500 mg IV/PO once daily
  5. Ciprofloxacin 250-500 mg orally or 200-400mg IV  q12h.
  6. Norfloxacin 400mg orally twice daily.


Reference(s)


Infectious Disease Section References:

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  2. Arnold FW, LaJoie AS, Brock GN, Peyrani P, Rello J, Menéndez R, et al. Improving outcomes in elderly patients with community-acquired pneumonia by adhering to national guidelines: Community-Acquired Pneumonia Organization International cohort study results. Arch Intern Med. Sep 14 2009;169(16):1515-24.
  3. Baden LR, Eisenstein BI.Impact of Antibiotic Resistance on the Treatment of Gram-negative Sepsis. Curr Infect Dis Rep. 2000 Oct;2(5):409-416.
  4. Bartlett JG et al. Community-acquired pneumonia in adults: guidelines for management. Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 1998;26:811-38.
  5. Bartlett JG: Empirical therapy of community-acquired pneumonia: macrolides are not ideal choices. Semin Respir Infect 1997 Dec; 12(4): 329-33
  6. Bartlett JG.1998 Pocket Book of Infectious Disease Therapy., Ninth Edition. Baltimore,MD: Williams&Wikins,1998.
  7. Bernstein JM: Treatment of community-acquired pneumonia--IDSA guidelines. Infectious Diseases Society of America. Chest 1999 Mar; 115(3 Suppl): 9S-13S
  8. Brown SM, Jones BE, Jephson AR, Dean NC. Validation of the Infectious Disease Society of America/American Thoracic Society 2007 guidelines for severe community-acquired pneumonia. Crit Care Med. Dec 2009;37(12):3010-6.
  9. CDC. Update to CDC's sexually transmitted diseases treatment guidelines, 2006. fluoroquinolones no longer recommended for treatment of gonococcal infections. MMWR Morb Mortal Wkly Rep. Apr 13 2007;56(14):332-6.
  10. CDC. Centers for Disease Control and Prevention. 2010 STD Treatment Guidelines. http://www.cdc.gov/std/treatment/2010/default.htm
    Accessed: 4-15-2012.
  11. Cunha BA. Antibiotic Essentials 8th.ed. Jones & Bartlett Learning, 2009.
  12. Ewig S et al. Pneumonia acquired in the community through drug-resistant Streptococcus pneumoniae. Am J Respir Crit Care Med. 1999;159:1835-42.
  13. Fang WF, Yang KY, Wu CL, Yu CJ, Chen CW, Tu CY, et al. Application and comparison of scoring indices to predict outcomes in patients with healthcare-associated pneumonia. Crit Care. Jan 19 2011;15(1):R32.
  14. File TM Jr. Community-acquired pneumonia: recent guidelines for therapy. J Respir Dis. 1999;20:534-41.
  15. Gilbert DN, Moellering Jr RC, Eliopoulos GM, et al ed. The Sanford Guide to Antimicrobial Therapy, 40th ed. Sperryville, VA: Antimicrobial Therapy; 2010.
  16. Gold HS, Moellering RC. Antimicrobial-drug resistance. N Engl J Med. 1996;335:1445-1453.
  17. Gonzales R, Sande M: What will it take to stop physicians from prescribing antibiotics in acute bronchitis? Lancet 1995 Mar 18; 345(8951): 665-6
  18. Hooton TM, Stamm WE. Diagnosis and treatment of uncomplicated urinary tract infection. Infect Dis Clin North Am 1997;11:551-581.
  19. Lacy CF, Armstrong LL, Goldman MP, Lance LL. Drug Information Handbook. 20th ed. Hudson, OH: Lexi-Comp, Inc; 2011.
  20. Lipsky BA, Berendt AR.Principles and practice of antibiotic therapy of diabetic foot infections. Diabetes Metab Res Rev. 2000 Sep-Oct;16 Suppl 1:S42-6.
  21. Mandell LA , Wunderink RG , Anzueto A , et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults . Clin Infect Dis . 2007;44(suppl 2):S27–S72.
  22. Mufson MA.Pneumococcal Pneumonia. Curr Infect Dis Rep. 1999 Apr;1(1):57-64.
  23. Nabel EG, Federman DD. Infectious Diseases: The Clinician's Guide to Diagnosis, Treatment, and Prevention. Jackson, WY: Teton Data Systems, 2010.
  24. Phua J, See KC, Chan YH, Widjaja LS, Aung NW, Ngerng WJ, et al. Validation and clinical implications of the IDSA/ATS minor criteria for severe community-acquired pneumonia. Thorax. Jul 2009;64(7):598-603.
  25. Pirracchio R, Mateo J, Raskine L, Rigon MR, Lukaszewicz AC, Mebazaa A, et al. Can bacteriological upper airway samples obtained at intensive care unit admission guide empiric antibiotherapy for ventilator-associated pneumonia?. Crit Care Med. Sep 2009;37(9):2559-63.
  26. Reese RE, Betts RF: A Practical Approach to Infectious Diseases. 4th ed. Boston: Little, Brown, and Company; 1996: 251
  27. Runyon B. Ascites and spontaneous bacterial peritonitis. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Vol 2. 8th ed. Philadelphia, Pa: Saunders; 2006:1935-64.
  28. Rybak MJ, Lomaestro BM, Rotschafer JC, et al: Therapeutic monitoring of vancomycin in adults: summary of consensus recommendations from the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Pharmacotherapy 2009; 29:1275-1279.
  29. Stefani SD, Cadore LP, Villaroel RU, Azevedo S, Machado AL. Antibiotic Selection in the Treatment of Febrile Neutropenia: Current Approach and New Directions.
    Braz J Infect Dis. 1998 Jun;2(3):109-117.
  30. Stamm WE, Hooton TM. Management of urinary tract infections in adults. N Engl J Med 1993;329:1328-1334.
  31. Tan J, et al. Expert Guide to Infectious Diseases 2nd ed. Philadelphia: ACP Press/American College of Physicians, 2008.
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  33. Wiggins KJ, Craig JC, Johnson DW, Strippoli GF. Treatment for peritoneal dialysis-associated peritonitis. Cochrane Database Syst Rev. Jan 23 2008;CD005284.
  34. Workowski KA, Berman S. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. Dec 17 2010;59:1-110.






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