We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Predictors of P seudomonas and methicillin-resistant S taphylococcus aureus in hospitalized patients with healthcare-associated pneumonia.
- Authors
Metersky, Mark L.; Frei, Christopher R.; Mortensen, Eric M.
- Abstract
Background and objective Patients with healthcare-associated pneumonia ( HCAP) are at high risk of infection with multidrug-resistant ( MDR) pathogens. Factors discriminating infection with MDR Gram-negative ( MDR-GN) organism from infection with methicillin-resistant S taphylococcus aureus ( MRSA) are not well understood and patients are often treated for both organisms. This study was performed to determine risk factors predicting pneumonia due to P seudomonas versus MRSA. Methods Veterans age ≥65 hospitalized with HCAP between 2002 and 2012 were identified from the Veterans Affairs administrative databases. Patients were identified with P seudomonas pneumonia, MRSA pneumonia or neither according to the International Classification of Diseases, 9th Revision, Clinical Modification codes. We assessed unadjusted and adjusted associations of patient characteristics and HCAP due to P seudomonas or MRSA. Results Of the 61 651 patients with HCAP, 1156 (1.9%) were diagnosed with P seudomonas pneumonia, 641 (1.0%) with MRSA pneumonia and 59 854 (97.1%) with neither. MRSA pneumonia was positively associated with male gender, age >74, diabetes, chronic obstructive pulmonary disease ( COPD), recent nursing home or hospital stay, recent exposure to fluoroquinolone or antibiotics treating Gram-positive organisms, and severe pneumonia. MRSA pneumonia was negatively associated with complicated diabetes. P seudomonas pneumonia was positively associated with recent hospital stay, immunocompromise, COPD, hemiplegia, recent exposure to inhaled corticosteroids, β-lactam/cephalosporin/carbapenem antibiotics, antibiotics against Gram-positive organisms, 'other antibiotics' and severe pneumonia. P seudomonas pneumonia was negatively associated with age >84, higher socioeconomic status, drug abuse and diabetes. Conclusions Patient characteristics may assist in identifying patients at risk for HCAP due to P seudomonas or MRSA.
- Subjects
RISK factors of pneumonia; MULTIDRUG resistance in bacteria; GRAM-negative bacteria; GRAM-negative bacterial diseases; LENGTH of stay in hospitals; METHICILLIN-resistant staphylococcus aureus; OBSTRUCTIVE lung diseases
- Publication
Respirology, 2016, Vol 21, Issue 1, p157
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.12651