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Shaw et al. 1951
Staphylococcus saprophyticus is a Gram-positive, coagulase-negative bacterium belonging to the Staphylococcus genus. S. Saprophyticus is a common cause of community-acquired urinary tract infections.
Staphylococcus saprophyticus was not recognized as a cause of urinary tract infections until the early 1970s, more than ten years after its original demonstration in urine specimens. Prior to this, the presence of coagulase-negative staphylococci (CoNS) in urine specimens was dismissed as contamination.
Epidemiology and pathogenesis
In humans, S. saprophyticus is found in the normal flora of the female genital tract and perineum. It has been isolated from other sources too including meat and cheese products, vegetables, the environment, and human and animal gastrointestinal tracts. S. saprophyticus causes 10–20% of urinary tract infections (UTIs). In females 17–27 years old, it is the second most common cause of community-acquired UTI, after Escherichia coli. Sexual activity increases the risk of S. saprophyticus UTI because bacteria are displaced from the normal flora of the vagina and perineum into the urethra. Most cases occur within 24 hours of sex, earning this infection the nickname "honeymoon cystitis". S. saprophyticus has the capacity to selectively adhere to human urothelium. The adhesin for S. saprophyticus is a lactosamine structure. S. saprophyticus produces no exotoxins.
Patients with urinary tract infections caused by S. saprophyticus usually present with symptomatic cystitis. Symptoms include a burning sensation when passing urine, the urge to urinate more often than usual, a 'dripping effect' after urination, weak bladder, a bloated feeling with sharp razor pains in the lower abdomen around the bladder and ovary areas, and razor-like pains during sexual intercourse. Signs and symptoms of renal involvement are also often registered.
The urine sediment of a patient with a S. saprophyticus urinary tract infection has a characteristic appearance under the microscope. Chemical screening methods for bacteriuria do not always detect S. saprophyticus infection because, even when such an infection occurs above the neck of the bladder, low numbers of colony-forming units (less than 105 cfu/ml) are often present.
S. saprophyticus is identified as belonging to the Staphylococcus genus using the Gram stain and catalase test. It is identitified as a species of coagulase negative staphylococci (CoNS) using the coagulase test. Lastly, S. saprophyticus is differentiated from S. epidermidis, another species of pathogenic CoNS, by testing for susceptibility to the antibiotic novobiocin. S. saprophyticus is novobiocin-resistant, whereas S. epidermidis is novobiocin-sensitive.
There are many supposed home remedies or natural treatments for urinary tract infections that are not proven to be very effective, such as cranberry juice, alkalinization and herbs and spices. Although some may show promise in other situations, such as to effect the formation of biofilms on surfaces or medical equipment, or in other in vitro situations, this does not translate into their use in the treatment of an active infection. 
Two subspecies of S. saprophyticus exist: S. saprophyticus subsp. bovis and S. saprophyticus subsp. saprophyticus, the latter more commonly found in human UTIs. S. saprophyticus subsp. saprophyticus is nitrate reductase negative and pyrrolidonyl arylamidase negative while S. Saprophyticus subsp. bovis is nitrate reductase positive and pyrolidonyl arylamidase negative.
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