Bacteremic Pneumonia Due to Staphylococcus aureus: A Comparison of Disease Caused by Methicillin-Resistant and Methicillin-Susceptible Organisms

• Published in: Clinical infectious diseases Vol. 29; no. 5; pp. 1171 - 1177
• Main Authors: González, Carmen, Rubio, Margarita, Romero-Vivas, José, González, Miguel, Picazo, Juan J.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.11.1999; University of Chicago Press
• Subjects: Adult; Aged; Antibiotics; Aspiration pneumonia; Bacteremia - drug therapy; Bacterial diseases; Bacterial diseases of the respiratory system; Bacterial pneumonia; Biological and medical sciences; Clinical Articles; Epidemiology; Female; Human bacterial diseases; Humans; Infections; Infectious diseases; Lung diseases; Male; Medical sciences; Methicillin - pharmacology; Methicillin Resistance; Middle Aged; Mortality; Penicillins - pharmacology; Pneumonia; Pneumonia, Staphylococcal - drug therapy; Prospective Studies; Staphylococcal Infections - drug therapy; Staphylococcal pneumonia; Staphylococcus aureus; Staphylococcus aureus - drug effects; Human; Lung disease; Pneumonia; Prognosis; Radiodiagnosis; Respiratory disease; Mortality; β-Lactams; Bacteremia; Infection; Penicillin derivatives; Symptomatology; Risk factor; Bacteriosis; Bacteria; Micrococcales; Complication; Micrococcaceae; Staphylococcal infection; Comparative study; Staphylococcus aureus
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/313440

We performed a prospective study of all patients with bacteremic pneumonia due to Staphylococcus aureus over a period of 6 years during an outbreak of methicillin-resistant S. aureus (MRSA). Patients with bacteremic pneumonia due to MRSA (32 cases) or methicillin-susceptible S. aureus (MSSA; 54 cases) were compared. The patients with MRSA pneumonia were older and were more likely than those with MSSA pneumonia to have predisposing factors for acquisition of the infection. There were no differences in clinical findings, radiological pattern, or complications in clinical evolution among patients with MRSA and MSSA pneumonia. Mortality was significantly higher among MSSA-infected patients treated with vancomycin than among those treated with cloxacillin (47% vs. none; P <.01). Multivariate analysis (stepwise logistic regression method) showed a relationship between mortality and the following variables: septic shock (odds ratio [OR], 61), vancomycin treatment (OR, 14), and respiratory distress (OR, 8).