title: Liver Cirrhosis and Diabetes Mellitus Are Risk Factors for Staphylococcus aureus Infection in Patients with Healthcare-Associated or Hospital-Acquired Pneumonia.
abstract: BACKGROUND
  The risk factors for Staphylococcus aureus (S. aureus) pneumonia are not fully identified. The aim of this work was to find out the clinical characteristics associated with S. aureus infection in patients with healthcare-associated pneumonia (HCAP) and hospital-acquired pneumonia (HAP), which may be applicable for more appropriate selection of empiric antibiotic therapy.
  
  
  METHODS
  From July 2007 to June 2010, patients who were admitted to the intensive care unit with severe HCAP/HAP and severe sepsis were enrolled in this study. Lower respiratory tract sample was semiquantitatively cultured. Initial broad-spectrum antibiotics were chosen by Taiwan or American guidelines for pneumonia management. Standard bundle therapies were provided to all patients according to the guidelines of the Surviving Sepsis Campaign.
  
  
  RESULTS
  The most frequently isolated pathogens were Pseudomonas aeruginosa, S. aureus, Acinetobacter baumannii, Klebsiella pneumoniae, and Escherichia coli. Patients with positive isolation of S. aureus in culture had significantly higher history of liver cirrhosis and diabetes mellitus, with odds ratios of 3.098 and 1.899, respectively. The S. aureus pneumonia was not correlated with history of chronic obstructive pulmonary disease, hypertension, and hemodialysis.
  
  
  CONCLUSIONS
  Liver cirrhosis and diabetes mellitus may be risk factors for S. aureus infection in patients with severe HCAP or HAP.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, 222 Maijin Road, Anle District, Keelung 20401, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Huang-Pin
authors.initials: HP
authors.lastname: Wu
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, 222 Maijin Road, Anle District, Keelung 20401, Taiwan.
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Chu
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, 222 Maijin Road, Anle District, Keelung 20401, Taiwan.
authors.forename: Chun-Yao
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, 222 Maijin Road, Anle District, Keelung 20401, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Chung-Chieh
authors.initials: CC
authors.lastname: Yu
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, 222 Maijin Road, Anle District, Keelung 20401, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Chung-Ching
authors.initials: CC
authors.lastname: Hua
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, 222 Maijin Road, Anle District, Keelung 20401, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Teng-Jen
authors.initials: TJ
authors.lastname: Yu
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, 222 Maijin Road, Anle District, Keelung 20401, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Yu-Chih
authors.initials: YC
authors.lastname: Liu
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000209:etiology*; D048909:Diabetes Complications / Q000150:complications*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D011023:Pneumonia, Staphylococcal / Q000188:drug therapy / Q000209:etiology*; D011446:Prospective Studies; D013211:Staphylococcus aureus
chemical_list: D000900:Anti-Bacterial Agents