From the Guidelines
For the treatment of Providencia Stuartii urinary tract infections (UTIs), a combination of amoxicillin plus an aminoglycoside or a second-generation cephalosporin plus an aminoglycoside is recommended, as per the European Association of Urology guidelines 1. When considering treatment options, it's crucial to prioritize the management of any urological abnormality and/or underlying complicating factors 1. The use of ciprofloxacin and other fluoroquinolones for empirical treatment of complicated UTI is not recommended unless the local resistance rate is <10% and specific conditions are met, such as the entire treatment being given orally, the patient not requiring hospitalization, and the patient having anaphylaxis to beta-lactam antimicrobials 1. Key considerations in the treatment of Providencia Stuartii UTIs include:
- The potential for resistance to multiple drugs, necessitating susceptibility testing to guide antibiotic therapy
- The importance of removing or replacing urinary catheters when possible to prevent bacterial biofilm formation
- The need for patients to complete the full course of antibiotics even if symptoms improve
- Maintaining adequate hydration to help flush bacteria from the urinary tract Given the potential for resistance and the complexity of treating Providencia Stuartii UTIs, it is essential to follow the strongest recommendations, which emphasize the use of combination therapies and the management of underlying complicating factors 1.
From the Research
Providencia Stuartii UTI
- Providencia stuartii is a common cause of polymicrobial catheter-associated urinary tract infections (CAUTIs) 2
- The bacteria can colonize the skin and urine drainage bags of patients with condom catheter urinary drainage systems, making them a reservoir for the bacteria 3
- Providencia stuartii is often resistant to multiple antibiotics, making treatment challenging 4
Risk Factors
- Patients with urinary devices, such as catheters, are at increased risk of developing Providencia stuartii UTIs 3, 5, 6
- Diabetes is a common comorbidity among patients with Providencia stuartii UTIs 6
- The use of indwelling urinary catheters is a significant risk factor for developing Providencia stuartii UTIs 6
Treatment and Prevention
- Effective infection control and antibiotic stewardship policies are necessary to prevent the development of further antibiotic resistance 6
- The use of antibiotics such as piperacillin-tazobactam, cefepime, imipenem, gentamicin, and colistin may be recommended for the empirical treatment of UTIs caused by Providencia stuartii 4
- Segregating infected and colonized patients from other patients who require urinary catheters can help prevent the spread of the bacteria 3