title: Characteristics of Drug-Susceptible and Drug-ResistantStaphylococcus aureusPneumonia in Patients with HIV.
abstract: OBJECTIVE
  To examine predictors and outcomes ofStaphylococcus aureusPneumonia (SAP) in people with HIV compared withStreptococcus pneumoniaePneumonia (SPP), and to compare Methicillin-ResistantS. aureus(MRSA) with Methicillin-SensitiveS. aureus(MSSA) pneumonias in this population.
  
  
  METHODS
  We conducted a retrospective case-control study of HIV-infected patients admitted to a single center with culture-provenS. aureusorS. pneumoniaepneumonia. We identified patients through a computerized database, conducted structured chart reviews, and performed bivariate and multivariate analyses using logistic regression.
  
  
  RESULTS
  We compared 47 SAP episodes in 42 patients with 100 SPP episodes in 93 patients. Use of any antibiotics prior to admission (OR=3.5, p=0.02), a co-morbid illness (OR=4.2, p=0.04), and recent healthcare contact (OR=12.0, p<0.001) were significant independent predictors of SAP. Patients with SAP were more likely to require intensive care (OR=2.7, p=0.02) and mechanical ventilation (OR=3.1, p=0.02), but not to die. MRSA was more common (57% of cases) than MSSA, but outcomes were not significantly worse.
  
  
  CONCLUSIONS
  Patients with HIV and SAP have worse outcomes than those with SPP. Clinicians should consider empiric antibiotic coverage for MRSA in patients admitted with HIV and pneumonia, given the high prevalence of MRSA. Further studies are warranted to examine morbidity differences between HIV-associated MSSA and MRSA pneumonia.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, Box 0841, San Francisco, CA, USA.
authors.forename: Charles K
authors.initials: CK
authors.lastname: Everett
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Maryland, 655 West Baltimore Street, Baltimore, MD 21201, USA.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Subramanian
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, Box 0841, San Francisco, CA, USA.
authors.forename: Leah G
authors.initials: LG
authors.lastname: Jarisberg
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Group Health Bellevue Medical Center, 11511 NE 10th St # 3, Bellevue, WA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Fei
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, Box 0841, San Francisco, CA, USA ; Division of HIV/AIDS, University of California, San Francisco, San Francisco General Hospital, Ward 84, 995 Potrero Avenue, San Francisco, CA 94110, USA.
authors.forename: Laurence
authors.initials: L
authors.lastname: Huang
keywords: AIDS; HIV; MRSA Streptococcus pneumonia; Pneumococcal pneumonia; Pneumonia; Staphylococcal pneumonia; Staphylococcus aureus