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Indwelling catheterization, renal stones, and hydronephrosis are risk factors for symptomatic Staphylococcus aureus-related urinary tract infection

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Abstract

Purpose

Staphylococcus aureus is a relatively uncommon causative agent of urinary tract infection (UTI). However, the clinical features of S. aureus-related UTI are unclear. Thus, we aimed to clarify how patients with S. aureus bacteriuria develop UTI and determine the features and clinical risk factors of symptomatic S. aureus-related UTI.

Methods

We performed a retrospective study of patients at the Hiroshima University Hospital for whom S. aureus had been isolated from urine culture from January 2010 to December 2017. The characteristics (age, sex, body mass index, indwelling catheterization, renal stones, hydronephrosis, anticancer drug use, diabetes mellitus, steroid use, serum albumin, antibiotic use in the past 1 month, estimated glomerular filtration rate, benign prostate hyperplasia, and neurogenic bladder) of patients with UTI and those without UTI were compared, and the risk factors for S. aureus-related UTI were identified by multiple logistic regression model.

Results

A total of 286 patients with S. aureus bacteriuria were analyzed; 33 patients developed UTI. The causative pathogens were methicillin-sensitive S. aureus and methicillin-resistant S. aureus (MRSA) in 14 and 19 patients, respectively, who developed UTI. This study demonstrated that indwelling catheterization, hydronephrosis, and renal stones are significantly associated with S. aureus-related UTI (p = 0.01, odds ratio = 3.1; and p < 0.01, odds ratio = 7.0; and p = 0.02, odds ratio = 1.2; respectively) and hypoalbuminemia in MRSA-related UTI (p < 0.01).

Conclusion

Paying attention to risk factors, specifically indwelling catheterization, renal stones, and hydronephrosis, will be an effective strategy for prevention of S. aureus-related UTI with persistent staphylococcal bacteriuria.

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Acknowledgments

We gratefully acknowledge the work of past and present members of Infectious Diseases Laboratory, Clinical Practice and Support at Hiroshima University Hospital.

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Authors and Affiliations

  1. Department of Infectious Diseases, Hiroshima University Hospital, Kasumi 1-2-3 Minamiku, Hiroshima City, 734-8551, Japan

    Hiroyuki Kitano, Norifumi Shigemoto, Keitaro Omori & Hiroki Ohge

  2. Department of Urology, Hiroshima University Hospital, Hiroshima City, Japan

    Hiroyuki Kitano, Jun Teishima & Akio Matsubara

  3. Department of Infectious Diseases Laboratory, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan

    Yumiko Koba, Toshinori Hara & Kashiyama Seiya

  4. Department of Urology, Kobe University Hospital, Kobe City, Japan

    Katsumi Shigemura & Masato Fujisawa

Authors
  1. Hiroyuki Kitano
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  2. Norifumi Shigemoto
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  3. Yumiko Koba
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  4. Toshinori Hara
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  5. Kashiyama Seiya
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  11. Hiroki Ohge
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Contributions

HK: protocol, data collection, data analysis, manuscript writing, and editing; NS: data collection; YK: data collection; TH: data collection; KS: data collection; KO: data collection; KS: Protocol, project development, data management, and editing; JT: editing; MF: editing; AM: editing; HO: editing.

Corresponding author

Correspondence to Hiroyuki Kitano.

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The authors declare that they have no conflict of interest.

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The Ethics Committee of Hiroshima University (REB-E-1520 Hiroshima, Japan) approved this retrospective study.

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Kitano, H., Shigemoto, N., Koba, Y. et al. Indwelling catheterization, renal stones, and hydronephrosis are risk factors for symptomatic Staphylococcus aureus-related urinary tract infection. World J Urol 39, 511–516 (2021). https://doi.org/10.1007/s00345-020-03223-x

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  • DOI: https://doi.org/10.1007/s00345-020-03223-x

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