title: Association between microbial characteristics and poor outcomes among patients with methicillin-resistant Staphylococcus aureus pneumonia: a retrospective cohort study.
abstract: BACKGROUND
  Methicillin-resistant S. aureus (MRSA) pneumonia is associated with poor clinical outcomes. This study examined the association between microbial characteristics and poor outcomes among patients with methicillin-resistant Staphylococcus aureus pneumonia.
  
  
  RESULTS
  This retrospective cohort study included 75 patients with MRSA pneumonia who were admitted to two large tertiary care medical centers during 2003-2010. Multivariable models were created using Cox proportional hazards regression and ordinal logistic regression to identify predictors of mortality or increased length of stay (LOS). None of the microbial characteristics (PFGE type, agr dysfunction, SCCmec type, and detection of PVL, ACME, and TSST-1) were significantly associated with 30-day mortality or post-infection hospital length of stay, after adjusting for gender, age, previous hospital admission within 12 months, previous MRSA infection or colonization, positive influenza test, Charlson Comorbidity Index score, and treatment (linezolid or vancomycin).
  
  
  CONCLUSIONS
  Large prospective studies are needed to examine the impact of microbial characteristics on the risk of death and other adverse outcomes among patients with MRSA pneumonia.
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA USA ; Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA USA ; Iowa City Veterans Affairs Health Care System, Iowa City, IA USA.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: McDanel
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA USA ; Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA USA ; Iowa City Veterans Affairs Health Care System, Iowa City, IA USA.
authors.forename: Eli N
authors.initials: EN
authors.lastname: Perencevich
authors.affiliation: Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA USA ; Department of Pathology, Carver College of Medicine, University of Iowa, Iowa City, IA USA ; Clinical Quality, Safety, and Performance Improvement, University of Iowa Hospitals and Clinics, Iowa City, IA USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Diekema
authors.affiliation: Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA USA ; Iowa City Veterans Affairs Health Care System, Iowa City, IA USA.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Winokur
authors.affiliation: Department of Pathology, University of Maryland School of Medicine, Baltimore, MD USA.
authors.forename: J Kristie
authors.initials: JK
authors.lastname: Johnson
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA USA ; Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA USA ; Clinical Quality, Safety, and Performance Improvement, University of Iowa Hospitals and Clinics, Iowa City, IA USA.
authors.forename: Loreen A
authors.initials: LA
authors.lastname: Herwaldt
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA USA ; Present address: Department of Biostatistics, Environmental Health Sciences, and Epidemiology, Kent State University, Kent, OH USA.
authors.forename: Tara C
authors.initials: TC
authors.lastname: Smith
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Chrischilles
authors.affiliation: Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Dawson
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA USA ; Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA USA ; Iowa City Veterans Affairs Health Care System, Iowa City, IA USA.
authors.forename: Marin L
authors.initials: ML
authors.lastname: Schweizer
keywords: Accessory Gene Regulator; MRSA pneumonia; Panton-Valentine leukocidin; length of stay; mortality