Abstract
[Background]Most of the MRSA detected in respiratory specimens were colonization. However pneumonia due to MRSA becomes severe and improvement of outcomes were important.[Methods]Medical records of 11 MRSA pneumonia patients among 106 patients with MRSA detected in respiratory specimens from June 2010 to May 2011 at Kameda Medical Center were reviewed retrospectively. The following variables were studied: patient background, hospitalization, drug susceptibility, outcomes. [Results] Mean age was 73.5 y.o. Eight patients were male, 3 were female. Eight were HAP, 3 were NHCAP (Nursing and healthcare associated pneumonia). Four patients have Chronic kidney disease, 3 have neurological disorder and 2 were under steroid administration. Nine patients (81,8%) were detected through microbial substitution. Period from admission to detection was 41.9 days, period from antimicrobial initiation to detection was 23.1 days, numbers of antimicrobial agents were 2.1 on average. Nine patients (81.8%) have polymicrobial detection. P.aeruginosa, S.maltophilia, K.pneumonia were detected in 4, 3, 2 patients frequently. All of the anti MRSA agents administered were VCM. MIC of VCM were 1 with 2 patients, 0.5 with 1 patients, unexamined with 1 patients in the 4 patients after the introduction of broth microdilution method. Duation of administration was 12.8 days on average. In 9 patients (84.6%) beta-lactam agents were administered in combination. Duration of hospitalization was 124.8 days on average, 5 patients (45.5%) were died.[Conclusions]Most of the MRSA pneumonia were HAP and polymicrobial detection. MRSA caused the prolonged hospitalization and poor prognosis.
- © 2012 ERS
