Grillo, SaraCuervo, GuillermoCarratalà, JordiGrau, ImmaculadaLlaberia, MarionaAguado, José MaríaLopez-Cortés, Luis EduardoLalueza, AntonioSanjuan, RafaelSanchez-Batanero, AnaArdanuy, CarmenGarcía-Somoza, DolorsTebé, CristianPujol, Miquel2022-04-212022-04-212020-06-06Grillo S, Cuervo G, Carratalà J, Grau I, Llaberia M, Aguado JM, Lopez-Cortés LE, Lalueza A, Sanjuan R, Sanchez-Batanero A, Ardanuy C, García-Somoza D, Tebé C, Pujol M. Characteristics and Outcomes of Staphylococcus aureus Bloodstream Infection Originating From the Urinary Tract: A Multicenter Cohort Study. Open Forum Infect Dis. 2020 Jun 6;7(7):ofaa216http://hdl.handle.net/10668/3554Background Staphylococcus aureus bloodstream infection (SABSI) arising from a urinary tract source (UTS) is poorly understood. Methods We conducted a retrospective analysis in 3 major teaching hospitals in Spain of prospectively collected data of hospitalized patients with SABSI. SABSI-UTS was diagnosed in patients with urinary tract symptoms and/or signs, no evidence of an extra-urinary source of infection, and a urinary S. aureus count of ≥105 cfu/mL. Susceptibility of S. aureus strains and patient mortality were compared between SABSI from UTS (SABSI-UTS) and other sources (SABSI-other). Results Of 4181 episodes of SABSI, we identified 132 (3.16%) cases of SABSI-UTS that occurred predominantly in patients who were male, had high Charlson comorbidity scores, were dependent for daily life activities, and who had undergone urinary catheterization and/or urinary manipulation before the infection. SABSI-UTS was more often caused by MRSA strains compared with SABSI-other (40.9% vs 17.5%; P < .001). Patients with SABSI-UTS caused by MRSA more often received inadequate empirical treatment compared with those caused by susceptible strains (59.7% vs 23.1%; P < .001). The 30-day case fatality rate was lower in patients with SABSI-UTS than in those with SABSI-other (14.4% vs 23.8%; P = .02). Factors independently associated with mortality were dependence for daily activities (aOR, 3.877; 95% CI, 1.08–13.8; P = .037) and persistent bacteremia (aOR, 7.88; 95% CI, 1.57–39.46; P = .012). Conclusions SABSI-UTS occurs predominantly in patients with severe underlying conditions and in those who have undergone urinary tract manipulation. Moreover, it is frequently due to MRSA strains and causes significant mortality.enAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/BacteremiaStaphylococcus aureusUrinary devicesUrinary tract infectionStaphylococcal InfectionsBacteriemiaInfecciones urinariasInfecciones estafilocócicasMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Check Tags::MaleMedical Subject Headings::Organisms::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Staphylococcaceae::Staphylococcus::Staphylococcus aureus::Methicillin-Resistant Staphylococcus aureusMedical Subject Headings::Organisms::Bacteria::Gram-Positive Bacteria::Bacillales::Staphylococcaceae::Staphylococcus::Staphylococcus aureusMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Retrospective StudiesMedical Subject Headings::Geographical Locations::Geographic Locations::Europe::SpainMedical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::BacteremiaMedical Subject Headings::Anatomy::Urogenital System::Urinary TractMedical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Staphylococcal InfectionsMedical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Urinary Tract Infectionsresearch article32665958open access10.1093/ofid/ofaa2162328-8957PMC7341555