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Isolation of Methicillin-Resistant Staphylococcus aureus from the Urinary Tract: Clinical Characteristics and Antimicrobial Resistance
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Lim Dong Hoon, Moon Hyoung Yoon, Rho Joon, Kim Cheol Sung
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Korean J Urogenit Tract Infect Inflamm 2008;3(2):210-216. Published online October 31, 2008
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 Abstract
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- "Purpose: In specific patient populations, Staphylococcus aureus can be an important primary urinary pathogen. However, the significance of staphylococcal bacteriuria is uncertain. In present study, clinical characteristics and antimicrobial susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) bacteriuria were evaluated Materials and Methods: We performed antimicrobial susceptibility test of 50 MRSA stains isolated from urine in Chosun University Hospital from May 2007 to August 2008 and analysed clinical chracteristics of 50 cases with MRSA bacteriuria, retrospectively. Results: Among 1209 stains isolated from urine, 50 stains were MRSA showing 5.1%. Of 50 patient, 62% had undergone recent urinary catheterization and 94% was long-term care patients. Forteen of patients had symptomatic urinary tract infection at the time of initial isolation of MRSA, and 2% was bacteremic. 23.2% of asymptomatic patients had undergoing MRSA pneumonia or MRSA wound infection treatments. Asymptomatic patients had follow-up culture data; 55.8% of cultures was positive for MRSA (median duration of MRSA bacteriuria, 3.2months). However, nobody had subsequent staphylococcal infections. 20.9% were negative for MRSA at additional cultures. According to in vitro susceptibility test, habekacin, vancomycin, quinupristin-dalfopristin, trimethoprim-sulfamethoxazole, nitrofurantoin, linezolid, teicoplanin, rifampicin showed relatively higher sensitivity. Conclusions: In some cases with MRSA bacteriuria, MRSA was a cause of urinary tract infections that cause some symptoms or bacteremia. MRSA could be isolated by reason of bacteremia from infection of other organs, colonization, or contamination. Therefore, it seems that an active observation of symptoms or repetitive urine cultures should be done, to make a difference. And antimicrobial susceptibility test is necessary, because the rate of MRSA and the resistance of MRSA are increasing."
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