Urinary tract infections due to Staphylococcus saprophyticus in a child

Staphylococcus (S.) saprophyticus belongs to the coagulase-negative staphylococci and is the cause of urinary tract infections, especially in young women, rarely in children and in elderly men. Probably the real incidence of urinary tract infections due to these organisms is higher than usually accepted. We report on a 11 3/12-year-old girl, who developed symptoms of a urinary tract infection (dysuria, flank pain), but without fever and elevated CRP. In the bladder aspirate we found leukocytes and 5. saprophyticus (cotrimoxazole-resistent). Ultrasound detected intrarenal doubling, but no typical anomalies, disposing for urinary tract infections. The treatment with cefuroxim i.v. and clindamycin p.o. was succesful. Conclusion: Coagulase-negative staphylococci cultivated in urine represent contamination (mostly S. epidermidis - except in patients, who have undergone manipulation or catheterization of the urinary tract) or they are the cause of an urinary tract infection (mostly 5. saprophyticus).