The clinical significance of concurrent Staphylococcus aureus bacteriuria in patients with S. aureus bacteremia.
OBJECTIVE
To investigate the clinical significance of Staphylococcus aureus bacteriuria (SABU) in patients with S. aureus bacteremia (SAB).


METHODS
We reviewed clinical data for 203 patients with SAB from January 2006 to July 2007 in a tertiary care hospital. In all patients, blood and urine cultures were performed concurrently. Among these cases, we compared clinical data between patients with and without SABU. To rule out mere colonization of S. aureus through indwelling urinary catheters (IDUC), we excluded patients using IDUC and then repeated the analyses.


RESULTS
Concurrent SABU was observed in 31 of 203 patients (15.3%). In patients without an IDUC, 25 of 128 (19.5%) were positive for SABU. Concurrent SABU was associated with methicillin-susceptible, community-onset SAB, urinary tract obstruction/surgery, urinary tract infection, and vertebral osteomyelitis in patients with SAB. In patients without an IDUC, methicillin-susceptible SAB, urinary tract obstruction, urinary tract infection, and vertebral osteomyelitis were associated with concurrent SABU. Finally, concurrent SABU was not associated with the severity and fatality of SAB.


CONCLUSIONS
We found that SABU was not a result of colonization via IDUC, but instead is a frequent concomitant of SAB. In septic conditions, especially without IDUC, SABU may indicate SAB with foci of infection in the urinary tract or the vertebral column.
Choi
Seong-Ho
SH
Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Medical Center, 224-1 Heukseok-dong Dongjak-gu, Seoul, Republic of Korea.
Lee
Sang-Oh
SO
Choi
Jae-Phil
JP
Lim
Seung Kwan
SK
Chung
Jin-Won
JW
Choi
Sang-Ho
SH
Jeong
Jin-Yong
JY
Woo
Jun Hee
JH
Kim
Yang Soo
YS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis*; D001437:Bacteriuria / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000302:isolation & purification