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

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.