Healthcare-associated pneumonia with positive respiratory methicillin-resistant Staphylococcus aureus culture: Predictors of the true pathogenicity
Healthcare-associated pneumonia with positive respiratory methicillin-resistant Staphylococcus aureus culture: Predictors of the true pathogenicity
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DOI：
10.1111/ggi.12739
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发表时间：
2017-03-01
影响因子：
3.3
通讯作者：
Suda, Takafumi
中科院分区：
文献类型：
--
作者：
Enomoto, Yasunori;Yokomura, Koshi;Suda, Takafumi
目的：尽管耐甲氧西林金黄色葡萄球菌 (MRSA) 通常从医疗相关肺炎 (HCAP) 的呼吸道标本中分离出来，但由于污染/定植的可能性，很难确定致病病原体。本研究旨在确定 HCAP 中 MRSA 真正致病性的临床预测因子。方法：纳入 2009 年至 2014 年日本滨松 Seirei Mikatahara 综合医院收治的痰液或气管内抽吸物中 MRSA 培养呈阳性的 HCAP 患者。根据所使用的药物和治疗结果，识别出真性 MRSA 肺炎（MP）患者和 MRSA 污染/定植患者（假 MP）。比较各组之间的基线特征，并通过逻辑回归分析评估真 MP 的临床预测因素。结果：总共 93 名患者（平均年龄 78.7 +/- 12.6 岁）被识别并分为真 MP (n = 16) 或假 MP (n = 77) 组。尽管各组之间的基线特征大致相似，但真正的 MP 组具有 PaO2 的患者明显更多
Aim: Although methicillin-resistant Staphylococcus aureus (MRSA) is commonly isolated from respiratory specimens in healthcare-associated pneumonia (HCAP), it is difficult to determine the causative pathogen because of the possibilities of contamination/colonization. The present study aimed to identify clinical predictors of the true pathogenicity of MRSA in HCAP.Methods: Patients with HCAP with positive MRSA cultures in the sputum or endotracheal aspirates who were admitted to Seirei Mikatahara General Hospital, Hamamatsu, Japan, from 2009 to 2014 were enrolled. According to the administered drugs and the treatment outcomes, patients with true MRSA pneumonia (MP) and those with contamination/colonization of MRSA (false MP) were identified. Baseline characteristics were compared between groups, and clinical predictors of true MP were evaluated by logistic regression analyses.Results: A total of 93 patients (mean age 78.7 +/- 12.6 years) were identified and classified into the true MP (n = 16) or false MP (n = 77) groups. Although baseline characteristics were broadly similar between groups, the true MP group had significantly more patients with PaO2