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Review
. 2021 Mar 30;8(6):ofab158.
doi: 10.1093/ofid/ofab158. eCollection 2021 Jun.

A Narrative Review on the Role of Staphylococcus aureus Bacteriuria in S. aureus Bacteremia

Franziska Schuler  1 , Peter J Barth  2 , Silke Niemann  1 , Frieder Schaumburg  1
Affiliations
Review

A Narrative Review on the Role of Staphylococcus aureus Bacteriuria in S. aureus Bacteremia

Franziska Schuler et al. Open Forum Infect Dis. .

Abstract

Staphylococcus aureus bacteriuria (SABU) can occur in patients with S. aureus bacteremia (SAB). However, little is known on the (molecular) pathomechanisms of the renal passage of S. aureus. This review discusses the epidemiology and pathogenesis of SABU in patients with SAB and identifies knowledge gaps. The literature search was restricted to the English language. The prevalence of SABU in patients with SAB is 7.8%-39% depending on the study design. The main risk factor for SABU is urinary tract catheterization. SABU in SAB patients is associated with increased mortality. Given present evidence, hematogenous seeding-as seen in animal models-and the development of micro-abscesses best describe the translocation of S. aureus from blood to urine. Virulence factors that might be involved are adhesion factors, sortase A, and coagulase, among others. Other potential routes of bacterial translocation (eg, transcytosis, paracytosis, translocation via "Trojan horses") were identified as knowledge gaps.

Keywords: Staphylococcus aureus; bacteremia; bacteriuria; pathogenesis; renal abscess.

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Figures

Figure 1.
Figure 1.
Translocation of Staphylococcus aureus from blood to urine.
See this image and copyright information in PMC

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