Prior studies have described clinical features associated with MRSA CAP, such as hemodialysis, influenza infection, hemoptysis, multifocal or cavitary infiltrates, and recent antibiotic use. Īlthough current guidelines from the Infectious Diseases Society of America (IDSA) and American Thoracic Society (ATS) do not recommend routine empirical anti-MRSA antibiotics for CAP, addition of vancomycin or linezolid to standard therapy is recommended if MRSA pneumonia is clinically suspected. Nonetheless, clinicians often use vancomycin or linezolid empirically to treat adults with CAP due to concerns about the potential of MRSA pneumonia. Although the prevalence of MRSA among acute cases of CAP has not been fully elucidated, recent studies suggest MRSA is an uncommon cause of CAP in the United States. aureus (MRSA) as a cause of severe pneumonia that leads to critical illness and death. The clinical presentation of MRSA CAP overlapped substantially with pneumococcal CAP, highlighting the challenge of accurately targeting empirical anti-MRSA antibiotics with currently available clinical tools and the need for new diagnostic strategies.ĭuring the past decade, several reports described the emergence of community-acquired pneumonia (CAP) caused by Staphylococcus aureus and, specifically, methicillin-resistant S. aureus and, specifically, MRSA, nearly one-third of adults hospitalized with CAP received anti-MRSA antibiotics. Patients with MRSA CAP had more severe clinical outcomes than those with pneumococcal CAP, including intensive care unit admission (86.7% vs 34.8%) and in-patient mortality (13.3% vs 4.4%).Ĭonclusions. Otherwise, clinical features at admission were similar, including concurrent influenza infection, hemoptysis, multilobar infiltrates, and prehospital antibiotics. Chronic hemodialysis use was more common among patients with MRSA (20.0%) than pneumococcal (2.6%) and all-cause non- S. Vancomycin or linezolid was administered to 674 (29.8%) patients within the first 3 days of hospitalization. aureus identified, including 15 (0.7%) with MRSA and 22 (1.0%) with MSSA 115 (5.1%) had Streptococcus pneumoniae. Among 2259 adults hospitalized for CAP, 37 (1.6%) had S. aureus CAP (per respiratory or blood culture) with those of pneumococcal (per respiratory or blood culture or urine antigen) and all-cause non- S. We compared the epidemiologic, radiographic, and clinical characteristics of S. aureus (MRSA) and methicillin-susceptible S. Using a multicenter, prospective surveillance study of adults hospitalized with CAP, we calculated the prevalence of methicillin-resistant S. Prevalence of Staphylococcus aureus community-acquired pneumonia (CAP) and its clinical features remain incompletely understood, complicating empirical selection of antibiotics.
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