1321. Evaluation of the Management of Staphylococcus aureus Bacteriuria at an Academic Medical Center
Session: Poster Abstract Session: Clinical Infectious Diseases: Urinary Tract Infections
Friday, October 28, 2016
Room: Poster Hall
Background:

Staphylococcus aureus is a frequent pathogen in healthcare, associated with complications. S. aureus bacteremia (SAB) carries heavy burden if not recognized and treated appropriately. S. aureus is not considered a common uropathogen, and the association between Staphylococcus aureus bacteriuria (SABU) and SAB has been investigated, finding that SABU has been linked to more complicated SAB infections. The objective of this study is to evaluate proper recognition and management of SABU by medical staff at our institution, as well as identify potential complications.

Methods:

This study is a single-center, retrospective chart review of adult patients hospitalized from Aug 2012-Oct 2015 with a positive monomicrobial urine culture for S. aureus. Data was collected for infection markers, presence of urinary symptoms, urinalysis, treatment of SABU, and readmissions for invasive S. aureus disease and its complications. Treatment courses were evaluated for appropriateness.

Results:

During the study period, 133 patients with SABU were included. Of these, 20.3% (n=27) of the patients had concomitant SAB+SABU. The majority of included patients (n=120, 90.2%) received antimicrobials. MRSA was identified in 57% of the patients. Infectious diseases (ID) was consulted in 33% (n=44) of patients, but consulted more in the SAB+SABU cohort than the SABU cohort (19 (70.4%) vs 25 (23.5%), p=0.0001). ID consult had higher rate of obtaining blood cultures (95.5% (n=42/44)) than those without ID consult (68.5% (n=61/89)) (p=0.0003). In the patients with SABU, blood cultures were obtained in 75% (n=79) of patients. Patients with SABU were stratified as being treated appropriately to cover bacteremia (22% (n=23)) or not (78% (n=83)). A total of 12 (9%) of patients had related readmissions. Failure to treat as a bacteremia was not associated with readmission.

Conclusion:

Treatment of SABU as undiagnosed bacteremia was not associated with readmission for infection complications. ID doctors recognize this as a potential marker for bacteremia. If the patients in whom blood cultures were not obtained had the same rate of bacteremia, then there are potentially unrecognized bacteremias that are not being managed appropriately.

Astyn Miller, PharmD1, Katherine Lusardi, PharmD, BCPS-AQ ID1 and Jeremy Ryan Bariola, MD2, (1)Hospital Pharmacy, UAMS Medical Center, Little Rock, AR, (2)Division of Infectious Diseases, UAMS Medical Center, Little Rock, AR

Disclosures:

A. Miller, None

K. Lusardi, None

J. R. Bariola, None

Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.