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Methicillin-resistant Staphylococcus aureus bacteriuria.

F L Sapico, J Z Montgomerie, H N Canawati

    The American Journal of the Medical Sciences
    |March 1, 1981
    PubMed
    Summary
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    Methicillin-resistant Staphylococcus aureus (MRSA) bacteriuria occurred in 11 patients, often older, diabetic, or with catheters. Prompt cephalosporin therapy effectively treated most MRSA urinary tract infections.

    Area of Science:

    • Infectious Diseases
    • Urology
    • Microbiology

    Background:

    • Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen.
    • MRSA colonization or infection can lead to various complications, including urinary tract infections.
    • Understanding the characteristics and management of MRSA bacteriuria is crucial for patient care.

    Purpose of the Study:

    • To investigate the incidence and clinical features of MRSA bacteriuria in patients colonized or infected with MRSA.
    • To evaluate the outcomes of antibiotic therapy and spontaneous resolution of MRSA bacteriuria.
    • To assess the in vitro antibiotic resistance patterns of MRSA isolates causing bacteriuria.

    Main Methods:

    • Retrospective analysis of patients with MRSA colonization or infection.

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  • Detection and characterization of MRSA bacteriuria.
  • Evaluation of patient demographics, risk factors, and clinical presentation.
  • Assessment of antibiotic treatment regimens and outcomes.
  • In vitro antimicrobial susceptibility testing of MRSA isolates.

    • Main Results:

    • MRSA bacteriuria was detected in 11 of 41 patients (27%).
    • Patients with bacteriuria were typically older than 40, with comorbidities like diabetes and history of urinary catheterization.
    • Most patients were asymptomatic or mildly symptomatic.
    • Cephalosporin therapy was effective in eradicating bacteriuria in most treated patients.
    • Spontaneous resolution occurred in untreated patients within one month.
    • MRSA isolates were predominantly serotype 83A and resistant to most antibiotics except vancomycin.
    • Cephalothin disc sensitivity testing at 30°C may be unreliable for detecting resistance.

    Conclusions:

    • MRSA bacteriuria can occur in a significant proportion of colonized/infected patients, often without severe symptoms.
    • Prompt treatment with cephalosporins is effective for MRSA bacteriuria.
    • Spontaneous clearance is possible but may take longer.
    • Reliable susceptibility testing methods are essential for guiding MRSA treatment, as standard disc diffusion at 35°C may underestimate resistance.