Details:

Alternative Title:
BMC Infect Dis
Publisher's site:
http://dx.doi.org/10.1186/1471-2334-10-225
Personal Author:
Chihara, Shingo ; Popovich, Kyle J ; Weinstein, Robert A ; Hota, Bala
Chihara, Shingo ; Popovich, Kyle J ; Weinstein, Robert A ; Hota, Bala Less -
Description:
Background

When Staphylococcus aureus is isolated in urine, it is thought to usually represent hematogenous spread. Because such spread might have special clinical significance, we evaluated predictors and outcomes of S. aureus bacteriuria among patients with S. aureus bacteremia.

Methods

A case-control study was performed at John H. Stroger Jr. Hospital of Cook County among adult inpatients during January 2002-December 2006. Cases and controls had positive and negative urine cultures, respectively, for S. aureus, within 72 hours of positive blood culture for S. aureus. Controls were sampled randomly in a 1:4 ratio. Univariate and multivariable logistic regression analyses were done.

Results

Overall, 59% of patients were African-American, 12% died, 56% of infections had community-onset infections, and 58% were infected with methicillin-susceptible S. aureus (MSSA). Among 61 cases and 247 controls, predictors of S. aureus bacteriuria on multivariate analysis were urological surgery (OR = 3.4, p = 0.06) and genitourinary infection (OR = 9.2, p = 0.002). Among patients who died, there were significantly more patients with bacteriuria than among patients who survived (39% vs. 17%; p = 0.002). In multiple Cox regression analysis, death risks in bacteremic patients were bacteriuria (hazard ratio 2.9, CI 1.4-5.9, p = 0.004), bladder catheter use (2.0, 1.0-4.0, p = 0.06), and Charlson score (1.1, 1.1-1.3, p = 0.02). Neither length of stay nor methicillin-resistant Staphylococcus aureus (MRSA) infection was a predictor of S. aureus bacteriuria or death.

Conclusions

Among patients with S. aureus bacteremia, those with S. aureus bacteriuria had 3-fold higher mortality than those without bacteriuria, even after adjustment for comorbidities. Bacteriuria may identify patients with more severe bacteremia, who are at risk of worse outcomes.


Subject:
[+]
Adult
Bacteremia
Bacteriuria
Case-Control Studies
Female
Humans
Male
Middle Aged
Prognosis
Research Article
Staphylococcal Infections
Staphylococcus Aureus
Treatment Outcome

Source:
BMC Infect Dis. 2010; 10:225.
Pubmed ID:
20667139
Pubmed Central ID:
PMC2920260
Document Type:
Journal Article
Funding:
5U01CI000327/CI/NCPDCID CDC HHS/United States
Collection(s):
Emerging Infectious Diseases
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:d1e9a872d719be618a32afe8e6d10672551d2d5575b008079347787a599bc795
File Type:

Supporting Files

• 	1471-2334-10-225-1.gif	gif
  	1471-2334-10-225-1.jpg	jpeg
  	1471-2334-10-225.nxml	txt
  	license.txt	txt

More +