title: [Clinical features and outcome of community-acquired methicillin-resistant Staphylococcus aureus pneumonia].
abstract: BACKGROUND
  The aim of this study is to describe the epidemiological and clinical features, treatment and prognosis of community-acquired pneumonia (CAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) in two different geographic regions where community-acquired MRSA (CA-MRSA) infections have different frequencies.
  
  
  METHODS
  Observational study of patients admitted to two hospitals (one in Argentina, the other in Spain) between March 2008 and June 2012.
  
  
  RESULTS
  We documented 16 cases of CAP caused by MRSA. MRSA accounted for 15 of 547 (2.7%) cases of CAP in Hospital Rodolfo Rossi and 1 of 1258 (0,08%) cases at the Hospital Universitari de Bellvitge (P ≤ .001). Most patients were young and previously healthy. Multilobar infiltrates, cavitation and skin and soft tissue involvement were frequent. All patients had positive blood cultures. Five patients required admission to the intensive care unit. Early mortality (≤ 48 hours) was 19%, and overall mortality (≤ 30 days) was 25%.
  
  
  CONCLUSIONS
  CAP caused by MRSA causes high morbidity and mortality rates. It should be suspected in areas with a high prevalence of CA-MRSA infections, and especially in young and healthy patients who present with multilobar pneumonia with cavitation. Mortality is mainly related to septic shock and respiratory failure and occurs early in most cases.
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Rodolfo Rossi, La Plata, Argentina.
authors.forename: Mora
authors.initials: M
authors.lastname: Obed
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge-IDIBELL, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España; REIPI (Red Española de Investigación en Patología Infecciosa), Instituto de Salud Carlos III, Madrid, España. Electronic address: carolgv75@hotmail.com.
authors.forename: Carolina
authors.initials: C
authors.lastname: García-Vidal
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Rodolfo Rossi, La Plata, Argentina.
authors.forename: Pedro
authors.initials: P
authors.lastname: Pessacq
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Rodolfo Rossi, La Plata, Argentina.
authors.forename: Analia
authors.initials: A
authors.lastname: Mykietiuk
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge-IDIBELL, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España; REIPI (Red Española de Investigación en Patología Infecciosa), Instituto de Salud Carlos III, Madrid, España.
authors.forename: Diego
authors.initials: D
authors.lastname: Viasus
authors.affiliation: Laboratorio de Microbiología, Hospital Rodolfo Rossi, La Plata, Argentina.
authors.forename: Laura
authors.initials: L
authors.lastname: Cazzola
authors.affiliation: REIPI (Red Española de Investigación en Patología Infecciosa), Instituto de Salud Carlos III, Madrid, España; Servicio de Microbiología, Hospital Universitario de Bellvitge, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: M Angeles
authors.initials: MA
authors.lastname: Domínguez
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Rodolfo Rossi, La Plata, Argentina.
authors.forename: Anibal
authors.initials: A
authors.lastname: Calmaggi
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge-IDIBELL, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España; REIPI (Red Española de Investigación en Patología Infecciosa), Instituto de Salud Carlos III, Madrid, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Carratalà
mesh_terms: D000328:Adult; D000368:Aged; D017714:Community-Acquired Infections / Q000175:diagnosis; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D011023:Pneumonia, Staphylococcal / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011446:Prospective Studies; D012189:Retrospective Studies
keywords: Community-acquired pneumonia; Methicillin-resistant Staphylococcus aureus; Neumonía adquirida en la comunidad; Staphylococcus aureus resistente a la meticilina; Vancomicina; Vancomycin