Prevalence and risk factors for bacteremia in patients with Staphylococcus aureus bacteriuria: a retrospective cohort study

Abstract Objectives Staphylococcus aureus bacteriuria (SABU) is rare but can be an indicator for S. aureus bacteremia (SAB). The objective of this study was to assess the proportion of SAB in patients with SABU and to identify risk factors in a hospital-based population. Methods We used electronic databases to identify eligible patients to be included in a retrospective cohort study. Inclusion criteria were (i) SABU, (ii) ≥18 years of age and (iii) ≥1 blood culture sampled ±3 months of SABU. Patients with missing values for demographic (e.g. age, sex) or clinical characteristics (e.g. comorbidities) and laboratory analyses were excluded. Results In total, 245 patients attending the University Hospital Munster, Germany between 1 January 2012 and 31 December 2019 met the inclusion/exclusion criteria. Of the 245 patients with SABU, 66 had a concomitant SAB (26.9%). Elevated C-reactive protein (CRP) levels were associated with SAB. Other parameters (e.g. leukocytes, comorbidities) were not associated with SAB in a multivariate analysis. Conclusion The frequency of SAB in patients with SABU was high and warrants active screening for bloodstream infections in hospitalized patients, particularly if CRP levels are elevated.