[Gram positive microorganisms in urinary tract infections: epidemiology and therapy]

Urinary tract infections are the most frequent hospital acquired infections and represent one of the major problem in general practice. The predominant causative agents are enteric gram-negative bacteria. Nevertheless, the importance of gram-positive bacteria, particularly Staphylococcus aureus and Enterococcus, has progressively increased especially in nosocomial urinary tract infections. Such an increase is probably related to the indiscriminate use of beta-lactam antibiotics or to the growing number of susceptible patients (surgical procedures, immunodeficiency, ecc.) The therapeutic approach of community and hospital infections is different: while in the first case treatment is usually not difficult, the therapy for nosocomial urinary tract infections should be based on the results of antibiotic susceptibility tests since a multiantibiotic resistant microorganism is often involved.