Primary Staphylococcus aureus urinary tract infection: the role of undetected hematogenous seeding of the urinary tract

Abstract

Staphylococcus aureus (SA) bacteriuria may accompany SA bacteremia, but primary SA urinary tract infection (UTI) may also occur. Our clinical observation of SA UTIs following intravenous catheter-related phlebitis lead us to review hematogenous and ascending route-related risk factors in patients with primary SA UTIs. The charts from all patients with SA UTIs over a 1.5-year period were reviewed for concurrent or recent hospitalization, intravenous catheterization, and for known UTI risk factors. Patients with concurrent SA bacteremia were excluded. Patients with Escherichia coli UTIs during the same period were included as controls. Twenty cases of primary SA UTI were compared with 43 E. coli UTI cases and they did not differ in age, diabetes mellitus, prostatic hypertrophy, previous UTI, or other urinary tract (UT) abnormality. However, cases were more likely than controls to have had recent or concurrent hospitalization, UT catheterization, and history of recent phlebitis. In multivariate analysis, UT catheterization and recent hospitalization retained significant association with SA UTI. Similar results were shown for the methicillin-resistant SA UTI subgroup. Even though UT catheterization is the main predisposing factor for primary SA UTI, some cases may be mediated through unrecognized preceding bacteremia related to intravascular device exposure or other healthcare-related factors.

Catheterization alters bladder ecology to potentiate Staphylococcus aureus infection of the urinary tract

“…It is, however, an emerging cause of complicated UTIs, including infected kidney stones (11,(47)(48)(49) and CAUTIs (4,8,9,12,21). Here we resolve this paradox by demonstrating that MRSA exploits the presence of Fg that is released as part of an inflammatory response induced by the presence of a foreign body.…”

“…The most significant risk factor for developing complicated MRSA UTI is urinary catheterization (4,8,9,12,21). Recent studies have highlighted that in contrast to catheter-associated UTI (CAUTI) caused by other bacteria, MRSA dissemination to bacteremia following bacteriuria occurs more frequently (5 vs. 20%, respectively) and manifests rapidly, typically within 2 d of a urine positive culture (4,12,22).…”

In vitro antibacterial and time-kill evaluation of phosphanegold(I) dithiocarbamates, R3PAu[S2CN(iPr)CH2CH2OH] for R = Ph, Cy and Et, against a broad range of Gram-positive and Gram-negative bacteria

“…and Bacillus spp. cause urinary tract infection, nosocomial infection and bacteraemia [35][36][37], L. monocytogenes causes listeriosis and meningitis [38] and S. pyogenes causes bacteraemia and meningitis [39]. Furthermore, the MIC values obtained for 4 were relatively lower than the MIC values for the aforementioned Ph 3 PAu[SC(OR)=N(tol-p)], for R = Me, Et and iPr [29], series of compounds against B. cereus (MIC=1-4 μg/ml), S. aureus (MIC=37 μg/ml), E. faecalis (MIC= 4 μg/ml) and E. faecium (MIC = 37 μg/ml), and gold sulfanylcarboxylates [10] against S. aureus (MIC=6.…”

Agreement between Parallel Canine Blood and Urine Cultures: Is Urine Culture the Poor Man's Blood Culture?

“…Urinary tract infections may reflect bloodstream infections via two distinct routes: urosepsis, in which the infection originates within the genitourinary tract and spreads systemically, or hematogenous seeding of the urinary tract, including the kidneys and prostate (17,18). Bacteremia secondary to bacteriuria has been reported in 3% of humans hospitalized with UTIs (19).…”