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Risk of infective endocarditis and complicated infection in Staphylococcus aureus bacteremia – a retrospective cohort study on the role of bacteriuria

Bergenman, Oskar ; Nilson, Bo LU orcid and Rasmussen, Magnus LU (2024) In European Journal of Clinical Microbiology and Infectious Diseases
Abstract

Purpose: S. aureus bacteremia (SAB) is a common and severe infection with high mortality and morbidity. The clinical relevance of the finding of concurrent S. aureus bacteriuria (SABU) is debated. The goal of this study was to analyze whether a concurrent SABU is associated with complicated SAB, infective endocarditis (IE) and mortality. Methods: We conducted a retrospective cohort study, reviewing medical charts of all episodes of SAB in patients > 18 years in the region of Skåne, Sweden, between 1st of January and 31st of June 2020. Episodes where a concurrent urine culture was performed were included for analysis. An episode was considered as complicated SAB if there was either attributable mortality, recurrent infection, embolic... (More)

Purpose: S. aureus bacteremia (SAB) is a common and severe infection with high mortality and morbidity. The clinical relevance of the finding of concurrent S. aureus bacteriuria (SABU) is debated. The goal of this study was to analyze whether a concurrent SABU is associated with complicated SAB, infective endocarditis (IE) and mortality. Methods: We conducted a retrospective cohort study, reviewing medical charts of all episodes of SAB in patients > 18 years in the region of Skåne, Sweden, between 1st of January and 31st of June 2020. Episodes where a concurrent urine culture was performed were included for analysis. An episode was considered as complicated SAB if there was either attributable mortality, recurrent infection, embolic stroke, or occurrence of a complicated focus of infection. Results: During the study period, there were 279 episodes of SAB. 154 episodes met the eligibility criteria, of whom 37 (24%) had concurrent SABU. In 78 episodes (51%), the patients had a complicated SAB. There was a significantly lower proportion of complicated SAB for episodes with concurrent SABU (32%), compared to episodes without concurrent SABU (56%), p-value 0.014. Moreover, in the cohort there were 11 episodes (7.1%) of IE and a 30 days mortality rate of 16%, with no difference between the groups with or without SABU. Conclusions: There is an association between concurrent SABU and a decreased risk for complicated SAB among patients with SAB. This study found no significant association between SABU and neither IE nor mortality for patients with SAB.

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Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Complicated Staphylococcus aureus bacteremia, Infective endocarditis, Staphylococcus aureus, Staphylococcus aureus bacteremia, Staphylococcus aureus Bacteriuria
in
European Journal of Clinical Microbiology and Infectious Diseases
publisher
Springer
external identifiers
  • scopus:85193719992
  • pmid:38771404
ISSN
0934-9723
DOI
10.1007/s10096-024-04850-7
language
English
LU publication?
yes
id
05a088ec-6ec5-428f-a9ba-19adee3e2bce
date added to LUP
2024-06-14 15:28:27
date last changed
2024-07-26 19:52:36
@article{05a088ec-6ec5-428f-a9ba-19adee3e2bce,
  abstract     = {{<p>Purpose: S. aureus bacteremia (SAB) is a common and severe infection with high mortality and morbidity. The clinical relevance of the finding of concurrent S. aureus bacteriuria (SABU) is debated. The goal of this study was to analyze whether a concurrent SABU is associated with complicated SAB, infective endocarditis (IE) and mortality. Methods: We conducted a retrospective cohort study, reviewing medical charts of all episodes of SAB in patients &gt; 18 years in the region of Skåne, Sweden, between 1st of January and 31st of June 2020. Episodes where a concurrent urine culture was performed were included for analysis. An episode was considered as complicated SAB if there was either attributable mortality, recurrent infection, embolic stroke, or occurrence of a complicated focus of infection. Results: During the study period, there were 279 episodes of SAB. 154 episodes met the eligibility criteria, of whom 37 (24%) had concurrent SABU. In 78 episodes (51%), the patients had a complicated SAB. There was a significantly lower proportion of complicated SAB for episodes with concurrent SABU (32%), compared to episodes without concurrent SABU (56%), p-value 0.014. Moreover, in the cohort there were 11 episodes (7.1%) of IE and a 30 days mortality rate of 16%, with no difference between the groups with or without SABU. Conclusions: There is an association between concurrent SABU and a decreased risk for complicated SAB among patients with SAB. This study found no significant association between SABU and neither IE nor mortality for patients with SAB.</p>}},
  author       = {{Bergenman, Oskar and Nilson, Bo and Rasmussen, Magnus}},
  issn         = {{0934-9723}},
  keywords     = {{Complicated Staphylococcus aureus bacteremia; Infective endocarditis; Staphylococcus aureus; Staphylococcus aureus bacteremia; Staphylococcus aureus Bacteriuria}},
  language     = {{eng}},
  publisher    = {{Springer}},
  series       = {{European Journal of Clinical Microbiology and Infectious Diseases}},
  title        = {{Risk of infective endocarditis and complicated infection in Staphylococcus aureus bacteremia – a retrospective cohort study on the role of bacteriuria}},
  url          = {{http://dx.doi.org/10.1007/s10096-024-04850-7}},
  doi          = {{10.1007/s10096-024-04850-7}},
  year         = {{2024}},
}