Characteristics of Drug-Susceptible and Drug-Resistant Staphylococcus aureus Pneumonia in Patients with HIVCharles K. Everett1*, Anuradha Subramanian3, Leah G. Jarlsberg1, Matthew Fei4 and Laurence Huang1,2
- *Corresponding Author:
- Charles K. Everett
Pulmonary and Critical Care Medicine
Box 0841, San Francisco General Hospital
1001 Potrero Avenue, San Francisco, CA 94110, USA
Tel: (415) 206-2487
Fax: (415) 695-1551
E-mail: [email protected]
Received date: April 05, 2013; Accepted date: May 02, 2013; Published date: May 06, 2013
Citation: Everett CK, Subramanian A, Jarlsberg LG, Fei M, Huang L (2013) Characteristics of Drug-Susceptible and Drug-Resistant Staphylococcus aureus Pneumonia in Patients with HIV. Epidemiol 3:122. doi: 10.4172/2161-1165.1000122
Copyright: © 2013 Everett CK, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objectives: To examine predictors and outcomes of Staphylococcus aureus Pneumonia (SAP) in people with HIV compared with Streptococcus pneumoniae Pneumonia (SPP), and to compare Methicillin-Resistant S. aureus (MRSA) with Methicillin-Sensitive S. aureus (MSSA) pneumonias in this population.
Methods: We conducted a retrospective case-control study of HIV-infected patients admitted to a single center with culture-proven S. aureus or S. pneumoniae pneumonia. We identified patients through a computerized database, conducted structured chart reviews, and performed bivariate and multivariate analyses using logistic regression.
Results: We compared 47 SAP episodes in 42 patients with 100 SPP episodes in 93 patients. Use of any antibiotics prior to admission (OR=3.5, p=0.02), a co-morbid illness (OR=4.2, p=0.04), and recent healthcare contact (OR=12.0, p<0.001) were significant independent predictors of SAP. Patients with SAP were more likely to require intensive care (OR=2.7, p=0.02) and mechanical ventilation (OR=3.1, p=0.02), but not to die. MRSA was more common (57% of cases) than MSSA, but outcomes were not significantly worse.
Conclusions: Patients with HIV and SAP have worse outcomes than those with SPP. Clinicians should consider empiric antibiotic coverage for MRSA in patients admitted with HIV and pneumonia, given the high prevalence of MRSA. Further studies are warranted to examine morbidity differences between HIV-associated MSSA and MRSA pneumonia.