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IJCRR - 4(14), July, 2012

Pages: 38-44

Date of Publication: 31-Jul-2012

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ISOLATION AND IDENTIFICATION OF STAPHYLOCOCCUS SAPROPHYTICUS FROM URINE SAMPLES COLLECTED FROM SEXUALLY ACTIVE YOUNG WOMEN SUFFERING FROM SYMPTOMATIC URINARY TRACT INFECTION

Author: R.Sarath babu, T.V.Ramani, G.Indira

Category: General Sciences

Abstract:Staphylococcus saprophyticus may be present on normal human skin and the periurethral area and can cause urinary tract infection, particularly in sexually active young women. In the present study, an attempt
has been made to isolate, identify and to know the antibiotic sensitivity pattern of Staphylococcus saprophyticus from urine samples collected from the same group. In the present study, a total number of
100 urine samples were collected from sexually active young women 15-40yrs of age attending the Gynaecology outpatients department, MIMS General hospital. Out of 100 samples, 88 were culture positive and 12 samples showed no growth. Out of 88 culture positive cases, 18 (20.45%) samples were
positive for Staphylococcus saprophyticus. All the 18 Staphylococcus saprophyticus strains were identified by their
colony morphology, biochemical tests and were subjected to antibiotic sensitivity testing by modified Kirby-bauer disc diffusion method. All the Staphylococcus saprophyticus strains isolated(n=18) were 100% sensitive to Vancomycin, 55.56% to Oxacillin and Ciprofloxacin, 50% to Gentamicin and 38.89% to Tetracycline. The resistance pattern showed by the above strains isolated was 100% to Penicillin, 61.11% to Tetracycline, 50% to Gentamicin, 44.44% to Oxacillin and Ciprofloxacin respectively. In the present study, Staphylococcus saprophyticus is the second most common organism isolated from sexually active young women suffering from symptomatic urinary tract infection which coincided with several other authors who reported the same in their studies. The present study also reveals the need to report Staphylococcus saprophyticus as a pathogen when isolated from sexually active young female outpatients suffering from symptomatic urinary tract infection.

Full Text:

INTRODUCTION
Coagulase negative staphylococci constitute a major component of the normal flora of the human body. In the past, coagulase negative staphylococci were generally considered to be contaminants having little significance. Over the past four decades, these organisms have been recognized as important agents of human disease. Staphylococcus saprophyticus may be present on the normal skin and the periurethral area and can cause urinary tract infection, particularly in sexually active young women. Staphylococcus saprophyticus is uniquely associated with uncomplicated urinary tract infection in humans. Staphylococcus saprophyticus is second only to Escherichia coli as the most frequent causative organism of uncomplicated urinary tract infection in women.

The more severe complications include acute pyelonephritis, septicaemia, nephrolithiasis and endocarditis. The vast majority of infections occur in young sexually active women. Common symptoms of inflammation of the lower urinary tract, such as haematuria and pyuria, were seen more often among patients with colonization of Staphylococcus saprophyticus.

Aim of the present study
1. To isolate and identify Staphylococcus saprophyticus from urine samples collected from sexually active young women(15-40yrs of age) suffering from symptomatic urinary tract infection.

2. To know the antibiotic sensitivity pattern of the Staphylococcus saprophyticus strains isolated.

MATERIALS AND METHODS
A total number of 100 urine samples were collected from sexually active young women(15- 40yrs of age) attending the Gynaecology outpatients department , MIMS General hospital, Nellimarla, Vizianagaram.

Inclusion criteria
1.Young women(15-40yrs of age) with symptomatic urinary tract infection, attending the Gynaecology outpatients department.

2.Fever, increased frequency of micturition, dysuria and pain in the lower abdomen were the main symptoms observed in the patients of above age group.

Exclusion criteria
1. Pregnant mothers and hospitalised women of 15-40yrs of age.

All the samples were inoculated on blood agar and macconkey agar and the plates were incubated overnight at 37ºC. Staphylococcus saprophyticus strains were identified by their 1.Colony morphology.

2.Negative Coagulase test.

3.Gram stain.

4.Novobiocin resistance.

5.Negative phosphatase test.

6.Inability to ferment mannitol.

7.Production of urease.

All the S.saprophyticus strains identified were subjected to antibiotic sensitivity testing by modified Kirby-Bauer disc diffusion method.

The following antibiotics were used bearing the concentrations
1.Penicillin G – 10units / disc.

2.Gentamicin – 10mcg.

3.Vancomycin – 30mcg.

4.Ciprofloxacin – 5mcg.

5.Tetracycline – 30mcg.

All the strains(n=18) of S.saprophyticus isolated were screened for

1. Oxacillin sensitivity on Mueller-Hinton agar with 4% Nacl.

2. Novobiocin resistance on blood agar.

DISCUSSION
Among the coagulase negative staphylococci, Staphylococcus saprophyticus is a true urinary pathogen, causing both upper and lower urinary tract infections, primarily in young women. -Present study coincides with studies by several other authors who reported this organism to be the second most common cause of urinary tract infections after Escherichia coli in young female out patients.

-Urinary tract infections due to Staphylococcus epidermidis and other coagulase negative staphylococci were reported to be usually associated with catheterisation and occur in elderly patients with prior instrumentation of urinary tract or surgery like renal transplantation, urolithiasis or other urological abnormalities. -Several potential virulence factors of Staphylococcus saprophyticus have been examined in recent years. -Invitro studies on the adherence of this species to various cell types have been shown that Staphylococcus saprophyticus adheres to uroepithelial, urethral and periurethral cells in greater numbers than other staphylococci, and does not adhere to other cell types, including skin and buccal mucosal cells. -This uroepithelial tissue tropism may explain the high frequency of urinary tract infections caused by this organism. -In the present study, out of ?88? culture positive samples, ?18?(20.45%) were positive for Staphylococcus saprophyticus. -Out of all the Staphylococcus saprophyticus strains isolated, 100% sensitivity was observed to Vancomycin, followed by 10(55.56%) to Oxacillin, 10(55.56%) to Ciprofloxacin, 09(50%) to Gentamicin and 07(38.89%) to Tetracycline. -All the Staphylococcus saprophyticus strains(n=18) isolated were resistant to Penicillin G(100%), followed by 11 ( 61.11% ) to Tetracycline, 09(50%) to Gentamicin, 08(44.44%) to Oxacillin and 08(44.44%) to Ciprofloxacin. CONCLUSION -Present study coincides with several other studies reporting Staphylococcus saprophyticus (20.45%) as the second most common organism in causing symptomatic urinary tract infection in sexually active young female outpatients. -Among the coagulase negative staphylococci, Staphylococcus saprophyticus is a true urinary tract pathogen, causing both upper and lower urinary tract infections, primarily in young women. -Present study reveals a need to report Staphylococcus saprophyticus as a pathogen causing symptomatic urinary tract infection in sexually active young women.

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List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award

A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award

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