TITLE:
Epidemiology and outcome of methicillin-resistant Staphylococcus aureus health-care associated pneumonia
AUTHORS:
Hadeel Zainah, Syed Hassan, Rasha Nakhleh, Samia Arshad, Marcus Zervos
KEYWORDS:
MRSA; Healthcare-Acquired; Pneumonia; Epidemiology; Outcome
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.2 No.1,
March
25,
2013
ABSTRACT: Objectives:
Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of
health-care-associated pneumonia (HCAP). HCAP confers high morbidity and
mortality. In this study, we evaluated risk factors and clinical outomes of
MRSA-HCAP. Methods: Between 08/2008 and 09/2010
we conducted a retrospective, singlecenter study. Seven hundred and
eighty three patients with MRSA isolated from respiratory cultures were
screened. The primary outcome was 28-day mortality. Results were computed using univariate and multiple logistic regression analysis. Results: The analysis included 63
patients (54.78%) with MRSA HCAP. The mean age (±SD) was 65.95 ± 15.4 years. Thirty seven (58.7%) were males. Fifty six (88.9%) had at least one associated comorbid medical condition. Forty two (66.7%) were treated with vancomycin, 4 (6.3%) with linezolid and the remaining
17 (27%) were switched between the two antimicrobials. Mean APACHE II (±SD)
score was 18.8 (±7.3). Mortality rate was 28.6%. APACHE-II score, chronic obstructive pulmonary disease (COPD) and superinfection were found to be independent risk factors for 28-day mortality.
Conclusions: MRSA is a significant etiology of HCAP which is more prevalent in
the elderly. The associated mortality rate could be high and driven by several
factors including APACHE II score and
preexisting COPD.