Staphylococcus aureus Bacteremia (SAB) With Associated S-aureus Bacteriuria (SABU) as a Predictor of Complications and Mortality

BACKGROUND AND OBJECTIVES: Staphylococcus aureus (SA) bacteremia (SAB) is associated with a high rate of complications, most of which are related to hematogenous seeding into deep tissues or prosthetic material. SA bacteriuria (SABU) has been described in association with SAB, but has not been evaluated as a predictor for complicated bacteremia, which was the objective of our study. METHODS (DESIGN, SETTING, AND PATIENTS): We conducted a retrospective study of patients admitted to the hospital with SAB. The 118 patients included in the study were divided in 2 cohorts: a group with SABU and a group without SA in the urine. We followed the 2 cohorts for an average of 8 months and evaluated the differences in complications and mortality. RESULTS: SABU was found in 28 of 118 patients with SAB. Eighteen patients (64%) in this group had complications from the bacteremia, while in the group without SABU only 33% (30/90 patients) had complications (P = 0.004). The SABU group also had more deaths (32% vs. 14%; P = 0.036). CONCLUSIONS: In this population of hospitalized patients with SAB, the presence of SABU was associated with an increased risk of early complications, including septic shock, and with higher mortality. A routine urine culture in search of SABU may be a helpful tool for detection of those patients with SAB who are at increased risk of complications and death. Journal of Hospital Medicine 2010;5:208-211. (C) 2010 Society of Hospital Medicine.