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 Hopital Europeen 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 48–96h 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.