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

Authors
 Won Jai 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 
Citation
 BMC INFECTIOUS DISEASES, Vol.13 : 370, 2013 
Journal Title
BMC INFECTIOUS DISEASES
Issue Date
2013
MeSH
Aged ; Aged, 80 and over ; Chi-Square Distribution ; Community-Acquired Infections/diagnosis ; Community-Acquired Infections/epidemiology* ; Community-Acquired Infections/microbiology* ; Community-Acquired Infections/mortality ; Cross Infection/diagnosis ; Cross Infection/epidemiology ; Cross Infection/microbiology ; Cross Infection/mortality ; Female ; Hospitalization/statistics & numerical data ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus/isolation & purification* ; Middle Aged ; Pneumonia, Bacterial/diagnosis ; Pneumonia, Bacterial/epidemiology ; Pneumonia, Bacterial/microbiology* ; Pneumonia, Bacterial/mortality ; Pneumonia, Staphylococcal/diagnosis ; Pneumonia, Staphylococcal/epidemiology* ; Pneumonia, Staphylococcal/microbiology* ; Pneumonia, Staphylococcal/mortality ; Radiography, Thoracic ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Statistics, Nonparametric ; Treatment Outcome
Keywords
Pneumonia ; Methicillin-resistant Staphylococcus aureus ; Non-nosocomial ; Risk factors ; Community-acquired pneumonia ; Healthcare-associated pneumonia
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.
Files in This Item:
T201302796.pdf Download
DOI
10.1186/1471-2334-13-370
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Kim, Se Kyu(김세규)
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Eun Young(김은영) ORCID logo https://orcid.org/0000-0002-3281-5744
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Park, Seon Cheol(박선철)
Leem, Ah Young(임아영) ORCID logo https://orcid.org/0000-0001-5165-3704
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Jung, Kyung Soo(정경수) ORCID logo https://orcid.org/0000-0003-1604-8730
Jung, Won Jai(정원재)
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87620
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