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

Won Jung Jung, 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

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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.

Original languageEnglish
Article number370
JournalBMC Infectious Diseases
Volume13
Issue number1
DOIs
Publication statusPublished - 2013 Aug 9

All Science Journal Classification (ASJC) codes

  • Infectious Diseases

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    Jung, W. J., Kang, Y. A., Park, M. S., Park, S. C., Leem, A. Y., Kim, E. Y., Chung, K. S., Kim, Y. S., Kim, S. K., Chang, J., & Jung, J. Y. (2013). Prediction of methicillin-resistant Staphylococcus aureus in patients with non-nosocomial pneumonia. BMC Infectious Diseases, 13(1), [370]. https://doi.org/10.1186/1471-2334-13-370