Title: Staphylococcus saprophyticus: Which beta-lactam? - ScienceDirect
Headings: Staphylococcus saprophyticus
: Which beta-lactam?

International Journal of Infectious Diseases
Short Communication
Staphylococcus saprophyticus: Which beta-lactam?
Highlights
Abstract
Background
Methods
Results
Conclusions
Keywords
Introduction
Methods
Results
Discussion
Conflict of interest/funding
References

Content: The high proportion of pyelonephritis (33.3%) that was recorded in the present study suggests that this clinical feature should be considered. MSSS is often considered as usually susceptible to most antibiotics ( Chen, 2014 ). However, some natural resistance to the antibiotics commonly used for empirical antimicrobial therapy in UTIs, such as cefixime and fosfomycin trometamol, is known for this pathogen. In this study, 60% of cystitis and 25% of pyelonephritis due to MSSS was treated with an ineffective empirical antimicrobial therapy (cefixime, fosfomycin, or amoxicillin). Of the 56 urine samples with Gram-positive cocci observed on direct examination, 50% were treated with an empirical antibiotic therapy that is ineffective against MSSS, underlining the fact that despite suggestive results on direct examination, the hypothesis of MSSS resistance had not been taken into account for empirical treatment. Ceftriaxone is used in the treatment of UTI, mainly where there is a suspicion of pyelonephritis. In this study, 12.5% of patients with MSSS pyelonephritis were treated with ceftriaxone. The MIC distribution for ceftriaxone differed greatly between MSSS and MSSA isolates, with higher MIC values for the former than for the latter ( Figure 1, Figure 2 ). In contrast, the MICs of amoxicillin–clavulanic acid were similarly distributed in the two groups of isolates. These observations are discrepant with EUCAST recommendations, which specify that the susceptibility of staphylococci to ceftriaxone must be interpreted following the cefoxitin susceptibility.