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Complications Related to Neurogenic Bladder Dysfunction I
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
Two of the most persistent species are Escherichia coli and Providencia stuartii. Providencia stuartii is rarely found outside the long-term catheterized urinary tract and may use the catheter itself as a niche.16,17
Complications related to neurogenic bladder dysfunction I: Infection, lithiasis, and neoplasia
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
Most bacteriuria in short-term catheterization is of a single organism, whereas patients catheterized for longer than a month will usually show a polymicrobial flora caused by a wide range of gram-negative and gram-positive bacterial species.15 Such specimens commonly have two to four bacterial species, each at concentrations of 105 cfu/mL or more.16 Some may have up to six to eight species at that concentration. This phenomenon is due to an incidence of new episodes of bacteriuria approximately every 2 weeks and the ability of these strains to persist for weeks and months in the catheterized urinary tract.17 Two of the most persistent species are Escherichia coli and Providencia stuartii. Providencia stuartii is rarely found outside the long-term catheterized urinary tract and may use the catheter itself as a niche.18,19
Fleroxacin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Enterobacteriaceae are generally very susceptible, with mean MIC90 values of less than 2 µg/ml for the majority of species. Providencia stuartii is less susceptible than other Enterobacteriaceae, with mean MIC90 than 4 µg/ml. Serratia marcescens may be relatively resistant, with a mean MIC90 of 2 µg/ml noted (Chin et al., 1986; Hirai et al., 1986; Manek et al., 1986; Bremner et al., 1988; Georgopoulos et al., 1988; Paganoni et al., 1988; Barry and Fuchs, 1991; Arman et al., 1994; Prosser and Beskid, 1995; Gargallo-Viola et al., 2001). Fleroxacin may have useful activity against Enterobacteriaceae resistant to aminoglycosides or extended-spectrum cephalosporins (Araque and Velazco, 1998). Other Gram-negative bacteria, such as Haemophilus, Moraxella, Neisseria, Aeromonas, Bordetella, Acinetobacter, Vibrio, and Legionella spp., Brucella melitensis, and Plesiomonas shigelloides, are usually susceptible (Bremner et al., 1988; Georgopoulos et al., 1988; Paganoni et al., 1988; Pohlod et al., 1988a; Yourassowsky et al., 1988; Prosser and Beskid, 1995; Carbone et al., 1999; Gargallo-Viola et al., 2001). Quinolone-resistant strains of Neisseria gonorrhoeae with mutations in the gyrA and parC genes are fleroxacin-resistant, with MIC90 values > 2 µg/ml (Deguchi et al., 1997). Campylobacter spp. are less susceptible (MIC90 = 1–2 µg/ml), while Alcaligenes spp. are resistant (MIC90 = 4–8 µg/ml). Helicobacter pylori is resistant (MIC90 = 4 µg/ml) (Hupertz et al., 1988; Simor et al., 1989). Compared with ciprofloxacin, fleroxacin has relatively poor activity against Pseudomonas aeruginosa, with many reports of MIC90 values > 8 µg/ml. Similarly, most other Pseudomonas spp. and Xanthomonas maltophilia are often resistant (Hohl et al., 1987; Le Saux et al., 1987; Abeck et al., 1988; Aoyama et al., 1988; Paganoni et al., 1988; Hoppe and Simon, 1990; Barry and Fuchs, 1991; Bongaerts and Hoogkamp-Korstanje, 1993; Rice and Knapp, 1994; Prosser and Beskid, 1995; Gargallo-Viola et al., 2001).
Chronic canaliculitis with canaliculoliths due to Providencia stuartii infection
Published in Orbit, 2023
Jenny Lin, Victoria S. North, Christopher Starr, Kyle J. Godfrey
To the best knowledge of the authors, this represents the first reported case of canaliculitis caused by P. stuartii. Providencia stuartii is a gram-negative bacillus of the Morganellaceae family commonly found in soil, water, and animal reservoirs.5 It has been described as an opportunistic pathogen in hospitalized patients and is associated with urinary tract infections in patients with indwelling catheters due to fimbriae that allow for adherence.6 It can grow in anaerobic environments and notably produces urease, which plays an important role in the pathogenesis of urolithiasis and urinary tract infections.5,6 Bacterial urease catalyzes the hydrolysis of urea to form ammonia and carbon dioxide, producing alkaline urine that serves as a favorable environment for the formation of urinary tract stones.5,6 Urea is also found in the lacrimal glands, providing a possible mechanism for the formation of canalicular stones described in the present case.7