Pyelonephritis‐associated Staphylococcus saprophyticus bacteremia in an immunocompetent host: Case report and review of the literature

Abstract

Staphylococcus saprophyticus is a gram-positive, novobiocinresistant, coagulase-negative staphylococcus species. 1 It is the second most frequent causative microorganism in acute uncomplicated urinary tract infections in young, sexually active women. 2 However, it can present with a variety of complicated genitourinary tract infections which include prostatitis, pyelonephritis, and epididymitis. 3 Staphylococcus saprophyticus bacteremia rarely complicates the involvement of the urinary tract, particularly in immunocompetent hosts. 4 The clinical presentation and diagnosis are usually undistinguished S. saprophyticus bacteremia secondary to pyelonephritis from typical uropathogens. 5 Typically, S. saprophyticus is sensitive to most antimicrobials used to treat UTIs. However, there is rising resistance of S. saprophyticus to empirically and commonly used antibiotics to treat cystitis, hence, rendering the management more challenging. 6 Herein, we report an unusual highly resistant case of S. saprophyticus pyelonephritis leading to bacteremia in an otherwise healthy young female patient who was successfully treated with a course of vancomycin and daptomycin. In addition, we reviewed the literature for similar cases.

Isolation and characterization of Staphylococcus saprophyticus responsible for death of two six- banded armadillos (Euphractus sexcinctus)

“…However, more serious liver lesions were observed in mice than that in the armadillos, which may be related to differential effect of the bacterium based on species. Moreover, high bacterial load, tubular epithelial cells necrosis, and in ammatory cell in ltration was found in kidneys of the mice infected with S. saprophyticus, which is in agreement with the kidney lesions reported in humans (Matarneh et al 2021). A previous study reported S. saprophyticus can locate in the kidneys of a urease-induced UTI rat model that exhibited in ammation in the kidneys (Gatermann et al 1989;Kline et al 2010;Matarneh et al 2021).…”

“…Moreover, high bacterial load, tubular epithelial cells necrosis, and in ammatory cell in ltration was found in kidneys of the mice infected with S. saprophyticus, which is in agreement with the kidney lesions reported in humans (Matarneh et al 2021). A previous study reported S. saprophyticus can locate in the kidneys of a urease-induced UTI rat model that exhibited in ammation in the kidneys (Gatermann et al 1989;Kline et al 2010;Matarneh et al 2021). Altogether, these ndings suggest that S. saprophyticus probably infection in two armadillos, but the detailed mechanism needs to be further unmasked.…”

“…The two armadillos exhibited acute septicaemia with enlargement, congestion, and necrosis in the liver and spleen. S. saprophyticus mainly exists in food and water (Hedman et al 1990;Basso et al 2014), it seldom causes serious diseases except when a large number of the bacterium enters the blood (Ishihara et al 2001;Matarneh et al 2021;Ehlers and Merrill 2022). In the current study, no wounds were observed on the two armadillos and there were no changes in their living environment; therefore, the most probable origin of S. saprophyticus was hypothesised to be food.…”

“…S. saprophyticus is an opportunistic pathogen that infects when the host is immunocompromised (Nagy et al 1993; Ehlers and Merrill 2022) and/or during seasonal changes (Kline and Lewis 2016). In young women, S. saprophyticus is a common cause of uncomplicated urinary tract infections (UTIs) (Raz et al 2005), and some complicated infections including acute pyelonephritis (Matarneh et al 2021), renal calculi (Hur et al 2016), and endocarditis (Nishimura et al 2020). Moreover, once S. saprophyticus enters the human body, it can cause sepsis (Jones et al 2019) and pneumonia (Hell et al 1999).…”

Comparative genomics reveals the correlations of stress response genes and bacteriophages in developing antibiotic resistance of Staphylococcus saprophyticus

“…To date, S. saprophyticus has been reported as the second most frequent causative organism of uncomplicated UTIs in women ( 2 ). Infrequently, it is also responsible for several complications including acute pyelonephritis ( 3 , 4 ), bloodstream infection ( 5 ), endocarditis ( 6 ), and nephrolithiasis ( 7 ). In terms of body habitats, S. saprophyticus is present in humans as part of the normal microbiota of the skin and mucosal surfaces in perineum, rectum, urethra, cervix, and gastrointestinal tract ( 2 , 8 ).…”