[Risk factors of nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus]. / Factores de riesgo de neumonía nosocomial por Staphylococcus aureus resistente a meticilina.
Med Clin (Barc)
; 138(3): 99-106, 2012 Feb 18.
Article
em Es
| MEDLINE
| ID: mdl-22032820
ABSTRACT
BACKGROUND AND OBJECTIVE:
To include a specific antibiotic in the empiric therapy, it is necessary to predict when a nosocomial pneumonia (NP) is caused by methicillin-resistant Staphylococcus aureus (MRSA). We have developed a model for the prediction of the probability of a NP being caused by MRSA, when the carrier status and the microbiological diagnosis are unknown. PATIENTS ANDMETHODS:
A retrospective case-control study (1999-2005) was designed. A univariate and multivariate logistic regression was performed to identify the risk factors for suffering a NP due to MRSA. Demographic factors, related to hospitalization, immunosuppression or neutropenia, to medication and severity were included.RESULTS:
Three hundred and sixty three patients (121 cases and 242 controls) were studied. The final model of multivariate logistic regression included an age>14 years (OR 7.4, CI 95% 1.5-37.4, P<.015), NP appearance>6 days after admittance (OR 4.1, CI 95% 2.4-7,1, P<.001), NP development excluding summers (OR 2.5, CI 95% 1.2-5.2, P<.015), respiratory diseases (OR 4.9, CI 95% 1.5-15.8, P<.007) and multilobar involvement (OR 4, CI 95% 2.3-7.2, P<.001).The probability of developing a pneumonia due to MRSA was studied for each of the possible combinations and subsequently classified in minor and major criteria.CONCLUSIONS:
MRSA coverage should be included in the empirical treatment of NP when a) an adult patient (>14 years old) presents, at least, 2 major criteria or 1 major criterion together with 2 minor criteria, and b) a patient <14 years-old has 2 major criteria as well as 2 minor criteria.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumonia Estafilocócica
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Infecções Estafilocócicas
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Infecção Hospitalar
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Técnicas de Apoio para a Decisão
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Staphylococcus aureus Resistente à Meticilina
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
Es
Revista:
Med Clin (Barc)
Ano de publicação:
2012
Tipo de documento:
Article