The identification of spread factors, control measures and treatment in patients suffering from staphylococal infections in Zambia

Until as recently as twenty-five years ago, the CNS were regarded as mere contaminants when they were ob¬served to be present in infected specimens. They were, till then, overshadowed by the more pathogenic and better studied S. aureus. In the course of the; last twenty-five years, however, the CNS were found to be important uro-pathogens causing urinary tract infections. The present study was initiated with a view to determining how results of CNS activity in urinary tract infections in sexually active out-patient females in Zambia compared with similar results published in Europe and the United States.A total of 519 urine samples of young, sexually active females sent to the diagnostic microbiology laboratory of the University Teaching Hospital in Lusaka were examined for the presence of significant bacteriuria. Of these, 157 urine samples (30.25%) were found to be cases of significant bacteriuria, among which thirty-nine urine samples (24.84%) were infected with the CNS. The identification of the isolates of CNS present in the urine in these thirty-nine cases was achieved using the Staph-Ident System, a product of the Analytab Laboratories in New York. After identification, the antibiotic susceptibility pattern in each case was investigated, using the Agar Dilution Technique.This investigation revealed that S.epidermidis accounted for 30.8% of the CNS identified, S.haemolyticus for 23.1%, while 5.saprophyticus was the third most frequently en¬countered species of CNS. Gross pyuria was not a common finding in the urine samples infected by the CNS. The majority of these samples showed an intermediary pyuria.
It turned out that among the seven antibiotics in common use in the University Teaching Hospital in Lusaka, cepha-lothin was the only effective antibiotic for the blind treatment of CNS associated urinary tract infection. In the case of penicillin, erythromycine, cloxacillin, chloramphenicol and co-trimexazole it was found to be necessary that an antibiogram be carried out prior to treatment. Tetracycline, on the other hand, was found not to be an effective drug in the treatment of UTI caused by the CNS.The results obtained present significant contrasts with the published results of similar investigations conducted elsewhere,and would necessarily influence the approach to the treatment of UTI in Zambia.