요로에서 분리된 Methicillin 내성 Staphylococcus aureus의 임상적 의의

Abstract

Purpose: In specific patient populations, Staphylococcus aureus (S. aureus) can be an important primary urinary pathogen. However, the significance of staphylococcal bacteriuria is uncertain. In present study, clinical characteristics of methicillin-resistant Staphylococcus aureus (MRSA) bacteriuria were evaluated. Materials and Methods: We analysed clinical chracteristics of 50 cases with MRSA bacteriuria in Chosun University Hospital from May 2007 to August 2008, retrospectively Results: Among 1209 stains isolated from urine, 50 stains were MRSA showing 5.1%. Of 50 patients, 31 patients (62%) had undergone recent urinary catheterization and 47 patients (94%) were long-term care patients. 28 patients (14%) of patients had symptomatic urinary tract infection at the time of initial isolation of MRSA, and 4 patients (2%) were bacteremic. 23.2% of asymptomatic patients had undergoing MRSA pneumonia or MRSA wound infection treatments. Asymptomatic patients had follow-up culture data; 55.8% of cultures were positive for MRSA (median duration of MRSA bacteriuria, 3.2month). However, nobody had subsequent staphylococcal infections. 20.9% were negative for MRSA at additional cultures. Conclusions: In some cases with MRSA bacteriuria, MRSA was a cause of urinary tract infections that cause some symptoms or bacteremia. MRSA could be isolated by reason of bacteremia from infection of other organs, colonization, or contamination. Therefore, it seems that an active observation of symptoms or repetitive urine cultures should be done, to make a difference.