title: Comparison of methicillin-resistant Staphylococcus aureus community-acquired and healthcare-associated pneumonia.
abstract: OBJECTIVE
  Methicillin-resistant Staphylococcus aureus (MRSA) is recognized as an important cause of not only healthcare-associated pneumonia (HCAP) but also community-acquired pneumonia (CAP). We determined the impact of MRSA on differences in clinical characteristics, courses, and outcomes between CAP and HCAP.
  
  
  METHODS
  We conducted a retrospective observational study on 78 adult patients admitted with MRSA pneumonia at a university-affiliated tertiary hospital between January 2008 and December 2011. We compared baseline characteristics, chest radiographs, treatment outcomes, and drug resistance patterns between the CAP and HCAP groups.
  
  
  RESULTS
  Of the 78 patients with MRSA pneumonia, 57 (73.1%) were HCAP and 21 (26.9%) were CAP. MRSA infection history in the previous year (29.8% vs. 14.3%, p=0.244) tended to be more common in HCAP than in CAP. Despite similar Pneumonia Severity Index scores (151 in CAP vs. 142 in HCAP), intubation rates (38.1% vs. 17.5%; p=0.072) and intensive care unit admission (42.9% vs. 22.8%; p=0.095) tended to be higher in the CAP group, while 28-day mortality was higher in the HCAP group (14.3% vs. 26.3%; p=0.368), although without statistical significance. All patients showed sensitivity to vancomycin and linezolid; meanwhile, HCAP patients showed greater resistance to gentamicin than CAP patients (58.3% vs. 16.6%; p=0.037). The median total hospital charges were 6899 American dollars for CAP and 5715 American dollars for HCAP (p=0.161).
  
  
  CONCLUSIONS
  MRSA pneumonia showed significantly differences in baseline characteristics, chest radiographs, treatment outcomes, and medical expenses between HCAP and CAP groups.
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea.
authors: Ah Young
authors: AY
authors: Leem
authors: Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors: Won Jai
authors: WJ
authors: Jung
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea.
authors: Young Ae
authors: YA
authors: Kang
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
authors: Seon Cheol
authors: SC
authors: Park
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea.
authors: Young Jae
authors: YJ
authors: Kim
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea.
authors: Eu Dong
authors: ED
authors: Hwang
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea.
authors: Eun Young
authors: EY
authors: Kim
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea.
authors: Kyung Soo
authors: KS
authors: Jung
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea.
authors: Moo Suk
authors: MS
authors: Park
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea.
authors: Song Yee
authors: SY
authors: Kim
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea.
authors: Young Sam
authors: YS
authors: Kim
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea.
authors: Se Kyu
authors: SK
authors: Kim
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea.
authors: Joon
authors: J
authors: Chang
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea. STOPYES@yuhs.ac.
authors: Ji Ye
authors: JY
authors: Jung
mesh_terms: D000368:Aged; D017714:Community-Acquired Infections / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000472:pathogenicity*; D008875:Middle Aged; D011014:Pneumonia / Q000382:microbiology*; D012189:Retrospective Studies
keywords: Pneumonia; community-acquired pneumonia; healthcare-associated pneumonia; methicillin-resistant Staphylococcus aureus