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Introduction: To evaluate the clinical significance of the isolation of Staphylococcus aureus in urine samples., Methods: A retrospective study was performed on adult patients identified from a microbiology database in a 200-bed general hospital between the years 2000 and 2009. The demographic data, comorbidities, and risk factors, were reviewed, particularly those associated with the concomitant isolation of S.aureus in blood cultures., Results: The frequency of S.aureus found in urine samples was 0.63%. A total of 43 patients (mean age 68.7 years [SD±16], and 58.1% males) were identified in the database. A Charlson comorbidity index >3 was observed in 20.9%. Concurrent bacteremia was seen in 48.8%. Two groups of patients were distinguished: with concomitant bacteremia (n=21) or without (n=22). Intervention in the urinary tract significantly predicted (P=.00004) bacteriuria without bacteremia (81.8%), compared to bacteremia cases (19%). The attributable mortality was 47.6% in patients with bacteremia compared to non-bacteremia (no deaths), even though the appropriate antibiotic treatment was more frequent among patients with bacteremia (92% and 60%, respectively)., Conclusion: The presence of S.aureus in urine was accompanied by bacteremia in half of the cases, but in patients without previous urinary tract intervention such a possibility increased to 81%. Concomitant bacteremia predicts a worse prognosis even with appropriate treatment., (Copyright © 2012 Elsevier España, S.L. All rights reserved.)

Campylobacter is an important agent of illness in human beings. Bacteremia occurs principally in the immunocompromissed host and is frequently due to C. fetus. Nevertheless bacteremia also has been observed in patients with enteritis due to C. jejuni. We refer two cases of patients with severe enteritis and bacteremia, both of them with immunosupressive concomitant diseases such as nephrotic syndrome and chronic cirrotic hepatopathy. Both patients presented hemathemesis.

Bacteremia is associated with high morbidity and mortality. Nosocomial bacteremia is associated with an attributable mortality of 35%. In order to characterize the etiological agent of bacteremia cases during two time periods, 6605 patients were studied as follows: 1) from 1980 to 1982 (n = 2401) and 2) from 1988 to 2000 (n = 4204). A total of 596 cases of bacteremia were detected. The most frequent agents were Staphylococcus aureus, negative coagulase (CNS) Staphylococcus, Klebsiella pneumoniae and Escherichia coli. In the second period, an increase in the frequency of bacteremia caused by gram positive bacteria, particularly gram-positive cocci, was noted. Conversely, gram negative bacteria diminished significantly in the second period, specially enterobacterial species. Methicillin-resistant S. aureus and CNS were significantly more frequently isolated in the second period. Infrequent agents of endocarditis, such as Actinobacillus actinomycetemcomitans, Haemophilus aphrophilus, and Corynebacterium urealyticum, were isolated.

The incidence of severe infections caused by Lactobacillus spp. is very low. This paper reports a case of a liver abscess and bacteremia due to Lactobacillus rhamnosus. The patient is a 73 year-old woman with antecedent of diabetes mellitus. She has undergone surgery and received antimicrobial therapy (ampicillin plus gentamicin). The clinical outcome was favorable.