Prevalence of bacteremia and infective endocarditis in patients with Staphylococcus aureus ; Étude des bactériuries à Staphylococcus aureus et prévalence de l'association à une bactériémie et une endocardite infectieuse

Introduction. Isolation of S. aureus in urine culture (S. aureus bacteriuria, SABU) is a rare event. Given the low tropism of S. aureus for the urinary and digestive epithelia, primary staphylococcal urinary tract infection is less probable than a haematogenous mechanism, i.e. S. aureus bacteremia (SAB) and infective endocarditis (IE). We aimed to determine to what extent SAB and endocarditis were associated with SABU. Patients and Methods. We conducted a retrospective, observational and single-centre study at the Grenoble Alpes University Hospital, Grenoble, France. Medicals records of all patients who had presented urine culture yielding S. aureus between the 1st January 2007 and 31th December 2014 were reviewed. Results. Six-hundred eighty-four patients were included. Blood culture was performed for 408 (59.6%), in whom a SAB was diagnosed in 122 cases (29.9%). For these 122 patients, echocardiography was performed in 85 (69.7%). Forty-seven IE were diagnosed (55.3%) (22 definite, 28 possible). Among patients with blood culture, those with SAB had significantly higher C-reactive protein and creatinine blood levels and less urinary tract catheterization than those without SAB. Among patients with bacteremia, those with an infective endocarditis has less urological comorbidities, and had received less frequently a recent urological surgery than those without IE. Conclusion. Among the patients with S. aureus bacteriuria, bacteremia is detected in 29.9% of patients who had blood culture, and diagnosis of definite/probable IE is made in 55.3% of cases if sought. Blood cultures and (if positive) echocardiography should be systematically performed in case of SABU. ; Introduction. L'isolement d'un Staphylococcus aureus dans les urines (SABU) est rare. Du fait du faible tropisme de S. aureus pour les épithéliums urinaire et digestif, une infection urinaire primitive est moins probable qu’une diffusion par une bactériémie à S. aureus (SAB) et une endocardite infectieuse (EI). Nous avons cherché à déterminer dans quelle ...