William Stokes1, Michael D Parkins1,2, Elizabeth C T Parfitt3, Juan C Ruiz1, Gerry Mugford4, Daniel B Gregson1,2,5,6. 1. Department of Medicine, Immunology and Infectious Diseases, University of Calgary, Alberta. 2. Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Alberta. 3. Department of Medicine, Royal Inland Hospital, Kamloops, British Columbia. 4. Department of Clinical Epidemiology, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador. 5. Department of Pathology and Laboratory Medicine, University of Calgary, Alberta, Canada. 6. Calgary Laboratory Services, Alberta, Canada.
Abstract
BACKGROUND: Staphylococcus aureus bacteriuria (SABU) may represent multiple processes ranging from asymptomatic colonization to a marker of S. aureus bacteremia (SAB). Our objective was to describe SABU at a population-based level and determine patient characteristics associated with SAB. METHODS: A retrospective study was performed using electronic databases. All urine cultures positive for S. aureus between 2010 and 2013 within the Calgary Health Zone were included. Patient characteristics were compared among patients with and without SAB and risk factors identified using multiple logistic regression modeling. RESULTS: A total of 2540 urine cultures positive for S. aureus from 2054 patients were analyzed. The incidence of SABU was greatest among geriatric males with multiple comorbidities. SAB occurred in 175 (6.9%) of SABU patients. Those with SAB were more likely to be hospitalized, male, have a recent urinary procedure, have pure S. aureus culture in urine, and have laboratory findings suggesting systemic infection. Patients with isolated SABU were more likely to be ≥65 years, have dementia, and have abnormal urinalyses with pyuria and urine nitrites. In-hospital mortality in patients with SABU and SABU+SAB was 9.2% and 17.5%, respectively. Patients with SABU detected ≥48 hours before SAB had the highest risk of death. CONCLUSIONS: Less than 7% of patients with SABU have or will develop SAB. Characteristics associated with SABU were identified that established higher risk for systemic infection. Investigating SABU patients with these characteristics for systemic infection is warranted because a delay in diagnosis is associated with increased mortality.
BACKGROUND:Staphylococcus aureus bacteriuria (SABU) may represent multiple processes ranging from asymptomatic colonization to a marker of S. aureus bacteremia (SAB). Our objective was to describe SABU at a population-based level and determine patient characteristics associated with SAB. METHODS: A retrospective study was performed using electronic databases. All urine cultures positive for S. aureus between 2010 and 2013 within the Calgary Health Zone were included. Patient characteristics were compared among patients with and without SAB and risk factors identified using multiple logistic regression modeling. RESULTS: A total of 2540 urine cultures positive for S. aureus from 2054 patients were analyzed. The incidence of SABU was greatest among geriatric males with multiple comorbidities. SAB occurred in 175 (6.9%) of SABUpatients. Those with SAB were more likely to be hospitalized, male, have a recent urinary procedure, have pure S. aureus culture in urine, and have laboratory findings suggesting systemic infection. Patients with isolated SABU were more likely to be ≥65 years, have dementia, and have abnormal urinalyses with pyuria and urine nitrites. In-hospital mortality in patients with SABU and SABU+SAB was 9.2% and 17.5%, respectively. Patients with SABU detected ≥48 hours before SAB had the highest risk of death. CONCLUSIONS: Less than 7% of patients with SABU have or will develop SAB. Characteristics associated with SABU were identified that established higher risk for systemic infection. Investigating SABUpatients with these characteristics for systemic infection is warranted because a delay in diagnosis is associated with increased mortality.
Authors: Sara Grillo; Guillermo Cuervo; Jordi Carratalà; Immaculada Grau; Mariona Llaberia; José María Aguado; Luis Eduardo Lopez-Cortés; Antonio Lalueza; Rafael Sanjuan; Ana Sanchez-Batanero; Carmen Ardanuy; Dolors García-Somoza; Cristian Tebé; Miquel Pujol Journal: Open Forum Infect Dis Date: 2020-06-06 Impact factor: 3.835
Authors: Kathrin Rothe; Christoph D Spinner; Birgit Waschulzik; Christian Janke; Jochen Schneider; Heike Schneider; Krischan Braitsch; Christopher Smith; Roland M Schmid; Dirk H Busch; Juri Katchanov Journal: PLoS One Date: 2020-10-22 Impact factor: 3.240