The clinical significance of concomitant bacteriuria in patients with Staphylococcus aureus bacteremia. A review and meta-analysis

Infect Dis (Lond). 2018 Sep;50(9):648-659. doi: 10.1080/23744235.2018.1445280. Epub 2018 Feb 28.

Abstract

Background: Staphylococcus aureus bacteriuria (SABU) concomitant to S. aureus bacteremia (SAB) has been associated with deep-seated infections and worse prognosis. However, the relevant studies were small and inconsistent. Here, we aim to provide a review of the relevant literature, and a meta-analysis of these studies.

Methods: We searched PubMed and Scopus for studies comparing patients with SAB and concomitant SABU to patients with SAB without SABU.

Results: Nine relevant studies were identified, involving 1429 patients with SAB, of whom 18.5% (n = 265) had concomitant SABU. Pooling the results of those studies, SABU was significantly associated with endocarditis, bone/joint infection and septic embolism. SABU was also associated with persistent SAB, and higher mortality.

Conclusions: Although SABU may be a useful marker of complicated SAB, the current literature has several limitations. Larger prospective studies are required to clarify the value of SABU in clinical decision making.

Keywords: Bacteremia; Bacteriuria; Diagnosis; Meta-analysis; Prognosis; Staphylococcus aureus.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Bacteremia / complications
  • Bacteremia / diagnosis
  • Bacteremia / epidemiology*
  • Bacteremia / urine*
  • Bacteriuria / complications
  • Bacteriuria / diagnosis
  • Bacteriuria / epidemiology*
  • Humans
  • Prognosis
  • Sensitivity and Specificity
  • Staphylococcal Infections / diagnosis*
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / mortality
  • Staphylococcus aureus / isolation & purification
  • Urine / microbiology