title: Multidrug-resistant pathogens in patients with pneumonia coming from the community.
abstract: OBJECTIVE
  Identification of patients with multidrug-resistant (MDR) pathogens at initial diagnosis is essential for the appropriate selection of empiric treatment of patients with pneumonia coming from the community. The term Healthcare-Associated Pneumonia (HCAP) is controversial for this purpose. Our goal is to summarize and interpret the data addressing the association of MDR pathogens and community-onset pneumonia.
  
  
  RESULTS
  Most recent clinical studies conclude that HCAP risk factor does not accurately identify resistant pathogens. Several risk factors related to MDR pathogens, including new ones that were not included in the original HCAP definition, have been described and different risk scores have been proposed. The present review focuses on the most recent literature assessing the importance of different risk factors for MDR pathogens in patients with pneumonia coming from the community. These included generally MDR risk factors, specific risk factors related to methicillin-resistant Staphylococcus aureus or Pseudomonas aeruginosa and clinical scoring systems develop to assess the MDR risk factors and its application in clinical practice.
  
  
  CONCLUSIONS
  Different MDR risk factors and prediction scores have been recently developed. However, further research is needed in order to help clinicians in distinguishing between different MDR pathogens causing pneumonia.
authors.affiliation: aServei de Pneumologia, Hospital de la Santa Creu i Sant Pau; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain bDepartment of Respiratory Medicine, Institute for Advanced Research, Nagoya University, Nagoya University Graduate School of Medicine, Nagoya, Japan cSchool of Medicine and Surgery, University of Milan Bicocca, AO San Gerardo, Monza, Italy dSouth Texas Veterans Healthcare System and University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Oriol
authors.initials: O
authors.lastname: Sibila
authors.forename: Ana
authors.initials: A
authors.lastname: Rodrigo-Troyano
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Shindo
authors.forename: Stefano
authors.initials: S
authors.lastname: Aliberti
authors.forename: Marcos I
authors.initials: MI
authors.lastname: Restrepo
mesh_terms: D018432:Drug Resistance, Multiple; D006801:Humans; D011014:Pneumonia / Q000188:drug therapy; D012307:Risk Factors