Prevalence and risk factors for bacteremia in patients with Staphylococcus aureus bacteriuria: A retrospective cohort study

https://doi.org/10.1016/j.ijid.2020.07.022Get rights and content
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Highlights

  • Staphylococcus aureus bacteriuria can point towards an underlying bacteremia.

  • 26.9% of patients with S. aureus bacteriuria have a concomitant bacteremia in a hospital-based population.

  • C-reactive protein >10 mg/dl can help to identify patients with S. aureus bacteremia.

Abstract

Objectives

Staphylococcus aureus bacteriuria (SABU) is rare but can be an indicator of S. aureus bacteremia (SAB). The objective of this study was to assess the proportion of SAB in patients with SABU and identify risk factors in a hospital-based population.

Methods

We used electronic databases to identify eligible patients to be enrolled in a retrospective cohort study. Inclusion criteria were (i) SABU, (ii) ≥18 years of age, and (iii) ≥1 blood culture sampled ±3 months of SABU. Patients with missing values for demographic (e.g., age, sex) or clinical characteristics (e.g., comorbidities) and laboratory analyses were excluded.

Results

In total, 245 patients attending the University Hospital Münster, Germany, between 1 January 2012 and 31 December 2019 met the inclusion/exclusion criteria. Of the 245 patients with SABU, 66 had a concomitant SAB (26.9%). Elevated C-reactive protein (CRP) levels were associated with SAB. Other parameters (e.g., leukocytes, comorbidities) were not associated with SAB in a multivariate analysis.

Conclusion

The frequency of SAB in patients with SABU was high and warrants active screening for bloodstream infections in hospitalized patients, particularly if CRP levels are elevated.

Keywords

Staphylococcus aureus
Bacteremia
Bacteriuria
Risk factors
Blood culture
Urine culture

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