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. 2013 Aug 9:13:370.
doi: 10.1186/1471-2334-13-370.

Prediction of methicillin-resistant Staphylococcus aureus in patients with non-nosocomial pneumonia

Won Jai Jung  1 , Young Ae Kang, Moo Suk Park, Seon Cheol Park, Ah Young Leem, Eun Young Kim, Kyung Soo Chung, Young Sam Kim, Se Kyu Kim, Joon Chang, Ji Ye Jung
Affiliations

Prediction of methicillin-resistant Staphylococcus aureus in patients with non-nosocomial pneumonia

Won Jai Jung et al. BMC Infect Dis. .

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an important cause of not only hospital acquired pneumonia, but also non-nosocomial pneumonia. However, the risk factors for non-nosocomial MRSA pneumonia are not clearly defined. Our objective was to identify risk factors at admission that were associated with non-nosocomial MRSA pneumonia.

Methods: We evaluated 943 patients admitted to a university-affiliated hospital with culture-positive bacterial pneumonia developed outside the hospital from January 2008 to December 2011. We compared the clinical characteristics between MRSA and non-MRSA pneumonia, and identified risk factors associated with MRSA pneumonia.

Results: Of 943 patients, MRSA was identified in 78 (8.2%). Higher mortality was observed in MRSA than in non-MRSA patients (33.3% vs. 21.5%; P = 0.017). In a logistic regression analysis, MRSA pneumonia was observed more frequently in patients with a previous history of MRSA infection (OR = 6.05; P < 0.001), a PSI score ≥120 (OR = 2.40; P = 0.015), intravenous antibiotic treatment within 30 days of pneumonia (OR = 2.23; P = 0.018). By contrast, non-MRSA pneumonia was observed more often in patients with a single infiltrate on chest radiography (OR = 0.55; P = 0.029).

Conclusions: Anti-MRSA antibiotics could be considered in hospitalized non-nosocomial patients with several risk factors identified herein. The presence or absence of these factors would provide useful guidance in selecting initial empirical antibiotics.

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References

    1. Rubinstein E, Kollef MH, Nathwani D. Pneumonia caused by methicillin-resistant Staphylococcus aureus. Clin Infect Dis. 2008;46(Suppl 5):S378–385. - PubMed
    1. Hidron AI, Low CE, Honig EG, Blumberg HM. Emergence of community-acquired meticillin-resistant Staphylococcus aureus strain USA300 as a cause of necrotising community-onset pneumonia. The Lancet infectious diseases. 2009;9(6):384–392. doi: 10.1016/S1473-3099(09)70133-1. - DOI - PubMed
    1. Schreiber MP, Chan CM, Shorr AF. Resistant pathogens in nonnosocomial pneumonia and respiratory failure: is it time to refine the definition of health-care-associated pneumonia? Chest. 2010;137(6):1283–1288. doi: 10.1378/chest.09-2434. - DOI - PubMed
    1. Chalmers JD, Taylor JK, Singanayagam A, Fleming GB, Akram AR, Mandal P, Choudhury G, Hill AT. Epidemiology, antibiotic therapy, and clinical outcomes in health care-associated pneumonia: a UK cohort study. Clin Infect Dis. 2011;53(2):107–113. doi: 10.1093/cid/cir274. - DOI - PubMed
    1. Park SC, Kang YA, Park BH, Kim EY, Park MS, Kim YS, Kim SK, Chang J, Jung JY. Poor prediction of potentially drug-resistant pathogens using current criteria of health care-associated pneumonia. Respir Med. 2012;106(9):1311–1319. doi: 10.1016/j.rmed.2012.04.003. - DOI - PubMed

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