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Updated: Sep 26, 2025
Biosensor for Detection of Antibiotic Resistant Staphylococcus Bacteria
Published on: May 8, 2013
Methicillin-resistant Staphylococcus aureus among elderly patients with community-acquired pneumonia
Akihiko Goto1, Kosaku Komiya1, Mari Yamasue2
1Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan; Department of Internal Medicine, Tenshindo Hetsugi Hospital, 5956 Nihongi, Nakahetsugi, Oita, 879-7761, Japan.
Introduction:
The 2019 American Thoracic Society/Infectious Diseases Society of America guidelines for community-acquired pneumonia (CAP) recommend methicillin-resistant Staphylococcus aureus (MRSA) coverage for patients with prior sputum isolation of MRSA. This study aimed to determine the impact of MRSA coverage on in-hospital mortality in elderly patients with CAP among whom MRSA was isolated.
Methods:
Consecutive elderly patients who were admitted for CAP and had positive sputum culture for MRSA were retrospectively included, and the association between MRSA coverage and in-hospital mortality was analyzed.
Results:
Twenty (18%) of 111 patients received MRSA coverage. Although patients who received MRSA coverage tended to have more frequent prior isolation of MRSA compared to those who did not, no significant difference in in-hospital mortality was observed between both groups (2/20, 10% vs. 8/91, 9%). MRSA coverage was not associated with in-hospital mortality (odds ratio: 1.15; 95% CI: 0.23-5.89, p = 0.864); however, advanced age, hemoglobin level, a high A-DROP score, and C-reactive protein levels were associated with in-hospital mortality. MRSA coverage may not improve the prognosis of elderly patients with CAP who had positive sputum culture for MRSA.
Conclusions:
A randomized control study is required to determine the efficacy of MRSA coverage on the management of CAP in elderly patients.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) coverage did not significantly impact in-hospital mortality for elderly patients with community-acquired pneumonia (CAP) when MRSA was previously isolated. Further randomized trials are needed to confirm these findings for MRSA pneumonia management.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Geriatric Medicine
Background:
- Current guidelines recommend methicillin-resistant Staphylococcus aureus (MRSA) coverage for community-acquired pneumonia (CAP) patients with prior MRSA isolation.
- The efficacy of this recommendation in elderly CAP patients with MRSA isolation remains unclear.
Purpose of the Study:
- To evaluate the impact of MRSA coverage on in-hospital mortality in elderly patients diagnosed with CAP and MRSA isolated from sputum.
Main Methods:
- Retrospective analysis of consecutive elderly patients admitted with CAP and positive MRSA sputum cultures.
- Comparison of in-hospital mortality rates between patients who received MRSA coverage and those who did not.
Main Results:
- Eighteen percent (20/111) of patients received MRSA coverage.
- No significant difference in in-hospital mortality was observed between groups (10% with coverage vs. 9% without).
- Advanced age, low hemoglobin, high A-DROP score, and elevated C-reactive protein were associated with mortality, not MRSA coverage.
Conclusions:
- MRSA coverage may not improve outcomes for elderly CAP patients with prior MRSA isolation.
- A randomized controlled study is necessary to definitively assess the efficacy of MRSA coverage in this population.
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