A retrospective case series of 44 patients with community-acquired Staphylococcus aureus pneumonia

Staphylococcus aureus (S. aureus) community-acquired pneumonia (CAP) is a potentially devastating and life-threatening infection. Early detection and appropriate treatment is important to prevent morbidity and death. The aim of this case series was to investigate the patient demographics, clinical features, antibiotic treatment and complications of cases of community-acquired S. aureus pneumonia occurring in the Wellington region.

The case records of patients with radiographically confirmed community-acquired pneumonia and laboratory evidence to support S. aureus as the causative organism admitted to Wellington Regional Hospital over a 5-year period (2007-2012) were retrospectively reviewed.

A total of 48 presentations in 44 patients met the inclusion criteria. The majority of patients (63.6%) had underlying comorbidities. Although the mean CURB65 score was only one and fever was uncommon, 30% of patients were admitted to ICU and 16% died in hospital. Significant infective complications occurred in 48% with new lung cavitation in 20%.

This series of patients with staphylococcal pneumonia confirms the significant morbidity and mortality of the infection. A low CURB65 score and lack of objective fever should not detract from the possibility of S. aureus. The presence of bacteraemia in patients with S. aureus pneumonia needs to be regarded as a potentially deleterious finding that may necessitate a change in treatment.