Molecular detection of Staphylococcus aureus in urine in patients with S. aureus bacteremia: an exploratory study.

Bibliographic Details
Title: Molecular detection of Staphylococcus aureus in urine in patients with S. aureus bacteremia: an exploratory study.
Authors: Schuler, Franziska, Kaasch, Achim J., Schaumburg, Frieder
Source: European Journal of Clinical Microbiology & Infectious Diseases; Jan2025, Vol. 44 Issue 1, p37-43, 7p
Subject Terms: NUCLEIC acid amplification techniques, SURGICAL swabs, MEDICAL sciences, BLOOD collection, BACTEREMIA
Abstract: Purpose: Staphylococcus aureus bacteremia (SAB) is associated with a 90-day mortality of 28–34%. Many SAB-patients (7.8–39%) have a secondary S. aureus bacteriuria (SABU) mainly without symptoms of a urinary tract infection. Due to high morbidity and mortality, there is an interest in rapid detection of S. aureus bacteremia. Here, we compared a rapid nucleic acid amplification test (NAAT) with conventional culture to detect S. aureus in urine and to identify cases with increased risk for SAB. Methods: In a cross-sectional study, we assessed urine samples (mid-stream, clean catch and catheter urine) of patients with SAB and bacteremia other than SAB (non-SAB). Urine samples were collected ± 3 days to the collection of the positive blood culture and were cultured on a set of selective and non-selective agar plates. NAAT was performed using a commercial test (Xpert® SA Nasal Complete G3, Cepheid) from a sterile swab soaked in urine. Results: We included samples from 100 patients (68% male, median age: 67.4 years) with SAB and 20 patients (75% male, median age: 65.84 years) with non-SAB. The sensitivity of detecting SAB from urine samples was 47% (specificity: 90%) for NAAT, when applying a Ct-value of ≤ 37.4 for positive results. Urine culture had a sensitivity of 25% and a specificity of 95%. Molecular and culture methods showed a moderate agreement (80%, Cohens kappa: 0.55). Conclusion: NAAT from urine has a higher sensitivity than culture in patients with SAB and could potentially identify cases with increased risk for SAB. Future studies should investigate whether this characteristic could translate into a clinical benefit through rapid detection of SAB. [ABSTRACT FROM AUTHOR]
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Database: Complementary Index
More Details
ISSN:09349723
DOI:10.1007/s10096-024-04969-7
Published in:European Journal of Clinical Microbiology & Infectious Diseases
Language:English