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Comparison of Methicillin-Resistant Staphylococcus aureus Community-Acquired and Healthcare-Associated Pneumonia

Authors
 Ah Young Leem  ;  Won Jai Jung  ;  Young Ae Kang  ;  Seon Cheol Park  ;  Young Jae Kim  ;  Eu Dong Hwang  ;  Eun Young Kim  ;  Kyung Soo Jung  ;  Moo Suk Park  ;  Song Yee Kim  ;  Young Sam Kim  ;  Se Kyu Kim  ;  Joon Chang  ;  Ji Ye Jung 
Citation
 YONSEI MEDICAL JOURNAL, Vol.55(4) : 967-974, 2014 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2014
MeSH
Aged ; Community-Acquired Infections/microbiology* ; Female ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus/pathogenicity* ; Middle Aged ; Pneumonia/microbiology* ; Retrospective Studies
Keywords
Pneumonia ; community-acquired pneumonia ; healthcare-associated pneumonia ; methicillin-resistant Staphylococcus aureus
Abstract
PURPOSE: Methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an important cause of not only healthcare-associated pneumonia (HCAP) but also community-acquired pneumonia (CAP). We determined the impact of MRSA on differences in clinical characteristics, courses, and outcomes between CAP and HCAP. MATERIALS AND METHODS: We conducted a retrospective observational study on 78 adult patients admitted with MRSA pneumonia at a university-affiliated tertiary hospital between January 2008 and December 2011. We compared baseline characteristics, chest radiographs, treatment outcomes, and drug resistance patterns between the CAP and HCAP groups. RESULTS: Of the 78 patients with MRSA pneumonia, 57 (73.1%) were HCAP and 21 (26.9%) were CAP. MRSA infection history in the previous year (29.8% vs. 14.3%, p=0.244) tended to be more common in HCAP than in CAP. Despite similar Pneumonia Severity Index scores (151 in CAP vs. 142 in HCAP), intubation rates (38.1% vs. 17.5%; p=0.072) and intensive care unit admission (42.9% vs. 22.8%; p=0.095) tended to be higher in the CAP group, while 28-day mortality was higher in the HCAP group (14.3% vs. 26.3%; p=0.368), although without statistical significance. All patients showed sensitivity to vancomycin and linezolid; meanwhile, HCAP patients showed greater resistance to gentamicin than CAP patients (58.3% vs. 16.6%; p=0.037). The median total hospital charges were 6899 American dollars for CAP and 5715 American dollars for HCAP (p=0.161). CONCLUSION: MRSA pneumonia showed significantly differences in baseline characteristics, chest radiographs, treatment outcomes, and medical expenses between HCAP and CAP groups.
Files in This Item:
T201401908.pdf Download
DOI
10.3349/ymj.2014.55.4.967
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, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Young Jae(김영재)
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
Hwang, Eu Dong(황의동)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99021
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