Thymine-requiring bacteria associated with co-trimoxazole therapy

Incidence of thymidine-dependent enterococci detected on Mueller-Hinton agar with low thymidine content

It was observed that 10% of urine culture isolates of enterococci tested for antimicrobial susceptibility failed to grow on commercially prepared Mueller-Hinton agar with low levels of thymidine and thymine. All strains could utilize exogenous thymidine and thymine and required only low levels (0.4-microgram disk) to support growth. All thymidine-thymine-requiring strains were resistant to trimethoprim-sulfamethoxazole.

Renal stones and urinary infection: a study of antibiotic treatment

Twenty-two patients in whom renal calculi and urinary infection were closely associated were studied over two to five years. Four patients had previously had stones surgically removed, and five underwent pyelolithotomy during the course of the study. Urinary infection was treated with an appropriate antibacterial agent, and treatment was followed by long-term prophylaxis, usually with cotrimoxazole. A sterile urine was maintained for long periods in all these patients. In four patients, however, apparent stone growth occurred while the urine was sterile. On entering the study 21 of the 22 patients complained of symptoms. After treatment 19 of the 20 patients who were still attending were symptom-free. Six of the 22 patients entered the study with raised levels of serum creatinine; levels fell in four and remained raised in two. This antibacterial regimen, either alone or after surgery, will usually relieve symptoms and may prevent deterioration of renal function.