Coagulase-negative Staphylococci: a rare cause of urinary tract infections in children with consequences on clinical practice

• Published in: European journal of pediatrics 2022-03, Vol.181 (3), p.1099-1104
• Main Author: Megged, Orli
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Child, Preschool; Children; Coagulase; Contamination; Cystitis; Humans; Infant; Infant, Newborn; Male; Males; Medical records; Medicine; Medicine & Public Health; Original Article; Pathogens; Pediatrics; Pyelonephritis; Pyelonephritis - diagnosis; Staphylococcal Infections - complications; Staphylococcal Infections - diagnosis; Staphylococcus; Staphylococcus infections; Staphylococcus saprophyticus; Urinary Tract; Urinary tract infections; Urinary Tract Infections - complications; Urinary Tract Infections - diagnosis; Urogenital system
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-021-04308-4

Isolation of coagulase-negative Staphylococci (CoNS) in urine cultures of children is usually considered a contamination of the sample, except for Staphylococcus saprophyticus in older children. The aim of this study was to describe the characteristics of children in whom CoNS was considered a true urinary pathogen. The medical records of all children aged 0 to 18 years at Shaare Zedek Medical Center between 2013 and 2020 who were diagnosed with CoNS urinary tract infection (UTI) were reviewed for demographic, clinical, and laboratory data. CoNS were identified as the causative organism of UTIs in 30 children, none of whom was bacteremic. Male sex, younger age, and infection with non- S. saprophyticus CoNS were associated with higher risk of pyelonephritis in comparison to cystitis. Eleven (37%) children had previously known or newly diagnosed underlying urinary tract abnormalities. All patients recovered. CoNS were found to be an uncommon urinary pathogen among children but can cause pyelonephritis, especially in young children and in males. Conclusion : The finding of CoNS pyelonephritis requires thorough search for urinary abnormalities. What is Known: • Isolation of most CoNS species in urine cultures in children is usually considered contamination of the sample. • Staphylococcus saprophyticus causes cystitis in teenager females. What is New: • CoNS other than S. saprophyticus can cause pyelonephritis, especially in young children and in males. • CoNS pyelonephritis is associated with underlying urinary tract abnormalities.