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

BMC Infectious Diseases

Ji Ye Jung¹  Joon Chang¹  Se Kyu Kim¹  Young Sam Kim¹  Kyung Soo Chung¹  Eun Young Kim¹  Ah Young Leem¹  Seon Cheol Park¹  Moo Suk Park¹  Young Ae Kang¹  Won Jai Jung¹ 

[1] Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea

关键词: Healthcare-associated pneumonia;    Community-acquired pneumonia;    Risk factors;    Non-nosocomial;    Methicillin-resistant Staphylococcus aureus;    Pneumonia;   

Others  :  1146337
DOI  :  10.1186/1471-2334-13-370

 received in 2013-04-15, accepted in 2013-07-29,  发布年份 2013

【 摘 要 】

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.

【 授权许可】

   
2013 Jung et al.; licensee BioMed Central Ltd.

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