Staphylococcus aureus bacteriuria: implications and management

Abstract

Background Staphylococcus aureus is isolated in around 0.2%–4% of positive urinary cultures, more commonly in the contexts of long-term care, urological abnormalities and procedures, male sex, older age and comorbidities. Isolation may represent contamination, colonization, urinary tract infection or bacteraemic seeding from another site, and may be linked to S. aureus bacteraemia. However, there is little guidance on investigation and management of S. aureus bacteriuria. We performed a retrospective analysis of cases in our service, including clinical characteristics, investigations and treatment. Methods Data were collected on all urine samples taken from adult patients over a 5-year period from which S. aureus was isolated. Detailed analysis including investigations and management was conducted in those collected over a 1-year period. Results From 511 patients, 668 urine cultures positive for S. aureus were identified; 6.5% of cases were positive for MRSA. Of 93 patients who had blood cultures taken, there were 6 cases of S. aureus bacteraemia, 4 of which were associated with urological instrumentation. Of 94 cases analysed in detail, 57% were treated with antibiotics, and 49% had repeat urine cultures. Factors associated with recurrence were urinary catheterization, urological abnormality, diabetes and inpatient status. Conclusions Our experience does not support the routine taking of blood cultures or treatment of asymptomatic bacteriuria in well patients with S. aureus bacteriuria in this setting. However, repeat urine culture, and investigation and treatment of higher risk patients, for example, prior to bladder instrumentation, may be warranted. We propose a simple algorithm to guide clinicians.

The Effect of Honey on Bacteria Isolated from Urinary Tract Infections among Patients Attending Ruhengeri Referral Hospital

“…Current results differ from those reported by Loubet et al, that S. aureus is an uncommon isolate in urine cultures contributing to only 0.5-6% of positive urine cultures, except in patients with risk factors for urinary tract colonization 1 . This discrepancy might possibly be explained by poor collection of urine specimens leading to contamination 15 .…”

Medical Device-Associated Biofilm Infections and Multidrug-Resistant Pathogens

“…The presence of MRSA complicates the situation, extending the length of hospital stay [268]. This pathogen causes approximately 0.2-4% of UTIs and is more often found in patients in long-term care and with long-term catheters [269]. Several studies have shown the implication of S. aureus in CA-UTIs [267,270,271].…”

Perfil de Resistência de Bactérias Isoladas em Pacientes Hospitalizados Portadores de Neoplasia

“…Há diversos fatores de risco para aquisição de infecções, como neutropenia, cateterismo de longo prazo e uso extensivo de dispositivos médicos, como cateteres venosos centrais 3 . Entre as possíveis infecções em pacientes com câncer, destacam-se as infecções do trato urinário, sendo causadas por uma diversidade de bactérias, sendo Enterobacterales as mais prevalentes, com destaque para os gêneros Escherichia, Klebsiella, Enterobacter e Citrobacter, contudo, bactérias Gram-positivas dos gêneros Staphylococcus e Enterococcus também vêm apresentando alta prevalência 5,6 . O surgimento de bactérias Gram-negativas e Gram-positivas multirresistentes a vários antimicrobianos na atualidade que causam infecções no trato urinário tornou-se uma preocupação séria, especialmente em pacientes imunocomprometidos 4,5 .…”