Concomitant Staphylococcus aureus bacteriuria is associated with poor clinical outcome in adults with S. aureus bacteraemia

Abstract

A retrospective cohort study was undertaken to determine the prognostic significance of Staphylococcus aureus bacteriuria in patients presenting to our hospital with S. aureus bacteraemia between January 2000 and December 2003. A total of 378 patients had at least one positive blood culture for S. aureus, of whom 221 had urine cultured within 24 h of presentation. For this group, 206 case records could be retrieved for review. Of these patients, all had meticillin-susceptible S. aureus bacteraemia and 35 (17%) had S. aureus cultured in urine. Logistic regression analysis was used to control for age, genitourinary tract status and comorbidity. Concomitant S. aureus bacteriuria persisted as a significant risk factor for ICU admission [risk ratio (RR): 2.5; 95% confidence interval (CI): 1.06-4.36; P = 0.04] and in-hospital mortality (RR: 2.18; 95% CI: 1.05-3.57; P = 0.04). Other findings were that cerebrovascular disease in males and increasing age in both sexes were associated with in-hospital and one-year mortality. Prospective studies are warranted exploring the link between S. aureus bacteriuria and clinical outcome in patients with S. aureus bacteraemia. © 2008 The Hospital Infection Society.