title: Incidence, characteristics and outcomes of patients with severe community acquired-MRSA pneumonia.
abstract: We evaluated the published data for the incidence, characteristics and outcomes of patients with community-acquired pneumonia (CAP) due to methicillin-resistant Staphylococcus aureus (MRSA). The estimated incidence of MRSA CAP is 0.51-0.64 cases per 100,000. We identified 74 articles reporting data on 114 patients. Influenza like symptoms was reported in 41% of patients. Pneumonia improved in 59 (54.1%) out of 109 patients; 49 (44.5%) out of 110 patients died. The duration of hospitalisation was 38.1+/-24.9 and 8.3+/-11.7 days, respectively. The duration of intensive care unit (ICU) stay was 18.9+/-13.6 and 6.8+/-9.7 days, respectively. 76 strains carried the Panton-Valentine leukocidin gene. The univariate analysis showed that multi-organ failure (p<0.001), leukopenia (p<0.001), admission to ICU (p<0.001), mechanical ventilation (p<0.001), use of aminoglycosides after culture results (p<0.001), shock (p = 0.001), acute respiratory distress syndrome (p = 0.001), influenza like symptoms (p = 0.008), disseminated intravascular coagulation (p = 0.042) and rash (p = 0.04) were the factors associated with death.
authors.affiliation: Alfa Institute of Biomedical Sciences, 9 Neapoleos Street, 151 23 Marousi, Greece. m.falagas@aibs.gr
authors.forename: K Z
authors.initials: KZ
authors.lastname: Vardakas
authors.forename: D K
authors.initials: DK
authors.lastname: Matthaiou
authors.forename: M E
authors.initials: ME
authors.lastname: Falagas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001427:Bacterial Toxins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D004211:Disseminated Intravascular Coagulation; D005098:Exotoxins / Q000235:genetics; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007956:Leukocidins / Q000235:genetics; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000378:metabolism*; D008875:Middle Aged; D011023:Pneumonia, Staphylococcal / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D012128:Respiratory Distress Syndrome / Q000150:complications; D016896:Treatment Outcome
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin