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Staphylococcus saprophyticus
📖 About
- Staphylococcus saprophyticus is a coagulase-negative staphylococcus of generally low pathogenicity, but it is a classic cause of urinary tract infections (UTIs) in young women.
🔬 Characteristics
- Gram-positive cocci in clusters; aerobic or facultative anaerobe.
- 🧪 Catalase positive → distinguishes from Streptococcus.
- 🧪 Coagulase negative → distinguishes from S. aureus.
- 🧪 Novobiocin resistant → key test (vs. S. epidermidis, which is sensitive).
- Non-haemolytic; colonies are white to slightly yellow on blood agar.
🏠 Source
- Part of the normal female genitourinary flora (especially vaginal tract).
- Also found in GI tract and perineal area.
⚠️ Pathogenicity
- 🚻 Causes 10–20% of acute uncomplicated UTIs in sexually active young females.
- Typically nitrite-negative on urine dipstick (vs. E. coli which is usually nitrite-positive).
- Rare: prostatitis in men, other GU infections.
- Advice: micturition post-intercourse may reduce recurrence risk.
🔎 Investigations
- Culture: White/yellow colonies, non-haemolytic.
- Coagulase test: Negative (rules out S. aureus).
- Novobiocin resistance: Diagnostic hallmark of S. saprophyticus.
- DNAse test: Negative (vs. S. aureus, which is positive).
💊 Management
- First-line: Nitrofurantoin or trimethoprim-sulfamethoxazole for uncomplicated UTIs.
- Alternatives: Fosfomycin or fluoroquinolones (depending on local resistance patterns).
- Hydration & post-coital voiding can help prevent recurrence.
- Follow-up if symptoms persist/return (resistance patterns vary).
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