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Incidence and Outcomes of Staphylococcus aureus Bacteriuria: A Population-based Study.
Clin Infect Dis. 2018 Nov 24;:
Authors: Stokes W, Parkins MD, Parfitt ECT, Ruiz JC, Mugford G, Gregson DB
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 2010-2013 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 modelling.
Results: A total of 2540 urine cultures positive for S. aureus from 2054 patients were analyzed. The incidence of SABU was greatest amongst geriatric males with multiple comorbidities. 175 (6.9%) of the cohort had SAB. Those with concurrent 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 an 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 since a delay in diagnosis is associated with increased mortality.
PMID: 30476003 [PubMed - as supplied by publisher]
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