Concomitant Staphylococcus aureus bacteriuria is associated with complicated S. aureus bacteremia

Summary Objectives To identify factors associated with complicated Staphylococcus aureus  bacteremia (SAB) in adults. Methods Prospective observational multicenter study during 2 years in Nice University Hospital and during 6 months in the Hôpital Européen Georges Pompidou, Paris, including all adul...

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Bibliographic Details
Published in:The Journal of infection 2009-10, Vol.59 (4), p.240-246
Main Authors: Pulcini, Céline, Matta, Matta, Mondain, Véronique, Gaudart, Alice, Girard-Pipau, Fernand, Mainardi, Jean-Luc, Dellamonica, Pierre
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Bacteremia
Bacteremia - complications
Bacteremia - diagnosis
Bacterial diseases
Bacterial diseases of the urinary system
Bacteriuria
Bacteriuria - etiology
Biological and medical sciences
Comorbidity - trends
Endocarditis
Female
General aspects
Human bacterial diseases
Humans
ID physician
Infectious Disease
Infectious diseases
Male
Medical sciences
Middle Aged
Prospective Studies
Sepsis
Staphylococcal Infections - complications
Staphylococcal Infections - diagnosis
Staphylococcal infections, streptococcal infections, pneumococcal infections
Staphylococcus aureus
Staphylococcus aureus - isolation & purification
Young Adult
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Summary:Summary Objectives To identify factors associated with complicated Staphylococcus aureus  bacteremia (SAB) in adults. Methods Prospective observational multicenter study during 2 years in Nice University Hospital and during 6 months in the Hôpital Européen Georges Pompidou, Paris, including all adult inpatients with SAB assessed by an Infectious Diseases (ID) specialist. Results We included 104 SAB (79 in Nice and 25 in Paris), of which 45 were complicated, including 18 endocarditis and 23 bone and joint infections. A concomitant urine sample was performed in 65% of the cases, showing S. aureus bacteriuria 23/68 (34%) times. Blood cultures were drawn 48–96 h after an appropriate antibiotic therapy had been started in 70 of the 104 cases (67%) and were positive in 28 cases (40%). Conclusions The 3 following factors were found to be associated with complicated SAB in univariate analysis: community acquisition (56% vs 26%, P = 0.002), concomitant bacteriuria (47% vs 19%, P = 0.016) and persistent bacteremia (55% vs 26%, P = 0.016). This last factor was associated with endocarditis, but not with other complications such as bone and joint infections.
ISSN:0163-4453
1532-2742
DOI:10.1016/j.jinf.2009.08.001