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1509. Clinical Significance of Staphylococcus aureus Bacteriuria

BACKGROUND: The clinical significance of Staphylococcus aureus bacteriuria (SABU) is unclear and often presumed to represent hematogenous spread of occult S. aureus bacteremia (SAB). The aim of this study was to evaluate the clinical significance of SABU by assessing factors associated with the deve...

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Autores principales: Masel, Jennifer, Kamau, Edwin, Brooks, Dan, Gleeson, Todd
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253858/
http://dx.doi.org/10.1093/ofid/ofy210.1338
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author Masel, Jennifer
Kamau, Edwin
Brooks, Dan
Gleeson, Todd
author_facet Masel, Jennifer
Kamau, Edwin
Brooks, Dan
Gleeson, Todd
author_sort Masel, Jennifer
collection PubMed
description BACKGROUND: The clinical significance of Staphylococcus aureus bacteriuria (SABU) is unclear and often presumed to represent hematogenous spread of occult S. aureus bacteremia (SAB). The aim of this study was to evaluate the clinical significance of SABU by assessing factors associated with the development of invasive S. aureus disease and 12-month mortality. We also describe the proportion of patients with methicillin-resistant S. aureus (MRSA), symptomatic urinary tract infection (UTI), asymptomatic bacteriuria, concomitant SAB, and calculate Charlson comorbidity scores. METHODS: This is a retrospective cohort study of all SABU isolates in a tertiary care hospital from 1 January 2007 to 31 December 2016. Cases were identified by screening specimens processed in the microbiology laboratory with records in the Phoenix/BG data system. Demographic data, Charlson comorbidity score, antimicrobial susceptibility profiles, urinary catheter use, residence in a long-term care facility, and UTI symptoms were obtained through chart review. RESULTS: A total of 356 patients with SABU were identified and 237 met inclusion criteria. Seventeen patients had concurrent invasive S. aureus infections and 220 patients had SABU without invasive infection or SAB. Of the 220 patients with SABU and no invasive S. aureus infection, none developed invasive disease. The 12-month mortality rate was 6.8% in those without concurrent SAB and 52.9% in those with invasive infection. In those without concurrent invasive S. aureus infection, male sex (P = 0.033), MRSA (P = 0.008), collection of blood cultures (P = 0.005), and Charlson comorbidity score (P ≤ 0.001) were identified as risk factors for 12-month mortality. Race, inpatient status, specimen type, pyuria, UTI symptoms, and urologic instrumentation were not significantly associated with mortality. CONCLUSION: Patients without evident invasive S. aureus infection at the time of urine culture were not observed to present with invasive disease in the following year. Mortality increases with Charlson score and invasive infection in patients with SABU. Clinicians may consider isolated UTI, contamination, and colonization before embarking on extensive searches for occult staphylococcal infection in patients who present without obvious invasive infection, particularly in those without comorbid disease. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-62538582018-11-28 1509. Clinical Significance of Staphylococcus aureus Bacteriuria Masel, Jennifer Kamau, Edwin Brooks, Dan Gleeson, Todd Open Forum Infect Dis Abstracts BACKGROUND: The clinical significance of Staphylococcus aureus bacteriuria (SABU) is unclear and often presumed to represent hematogenous spread of occult S. aureus bacteremia (SAB). The aim of this study was to evaluate the clinical significance of SABU by assessing factors associated with the development of invasive S. aureus disease and 12-month mortality. We also describe the proportion of patients with methicillin-resistant S. aureus (MRSA), symptomatic urinary tract infection (UTI), asymptomatic bacteriuria, concomitant SAB, and calculate Charlson comorbidity scores. METHODS: This is a retrospective cohort study of all SABU isolates in a tertiary care hospital from 1 January 2007 to 31 December 2016. Cases were identified by screening specimens processed in the microbiology laboratory with records in the Phoenix/BG data system. Demographic data, Charlson comorbidity score, antimicrobial susceptibility profiles, urinary catheter use, residence in a long-term care facility, and UTI symptoms were obtained through chart review. RESULTS: A total of 356 patients with SABU were identified and 237 met inclusion criteria. Seventeen patients had concurrent invasive S. aureus infections and 220 patients had SABU without invasive infection or SAB. Of the 220 patients with SABU and no invasive S. aureus infection, none developed invasive disease. The 12-month mortality rate was 6.8% in those without concurrent SAB and 52.9% in those with invasive infection. In those without concurrent invasive S. aureus infection, male sex (P = 0.033), MRSA (P = 0.008), collection of blood cultures (P = 0.005), and Charlson comorbidity score (P ≤ 0.001) were identified as risk factors for 12-month mortality. Race, inpatient status, specimen type, pyuria, UTI symptoms, and urologic instrumentation were not significantly associated with mortality. CONCLUSION: Patients without evident invasive S. aureus infection at the time of urine culture were not observed to present with invasive disease in the following year. Mortality increases with Charlson score and invasive infection in patients with SABU. Clinicians may consider isolated UTI, contamination, and colonization before embarking on extensive searches for occult staphylococcal infection in patients who present without obvious invasive infection, particularly in those without comorbid disease. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6253858/ http://dx.doi.org/10.1093/ofid/ofy210.1338 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Masel, Jennifer
Kamau, Edwin
Brooks, Dan
Gleeson, Todd
1509. Clinical Significance of Staphylococcus aureus Bacteriuria
title 1509. Clinical Significance of Staphylococcus aureus Bacteriuria
title_full 1509. Clinical Significance of Staphylococcus aureus Bacteriuria
title_fullStr 1509. Clinical Significance of Staphylococcus aureus Bacteriuria
title_full_unstemmed 1509. Clinical Significance of Staphylococcus aureus Bacteriuria
title_short 1509. Clinical Significance of Staphylococcus aureus Bacteriuria
title_sort 1509. clinical significance of staphylococcus aureus bacteriuria
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253858/
http://dx.doi.org/10.1093/ofid/ofy210.1338
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