Clinical characteristics and risk factors for mortality in patients with community-acquired staphylococcal pneumonia

• Published in: Nagoya journal of medical science Vol. 84; no. 2; pp. 247 - 259
• Main Authors: Thabet, Nancy, Shindo, Yuichiro, Okumura, Junya, Sano, Masahiro, Sakakibara, Toshihiro, Murakami, Yasushi, Kobayashi, Hironori, Saka, Hideo, Kondo, Masashi, Hasegawa, Yoshinori
• Format: Journal Article
• Language: English
• Published: Nagoya University 01-05-2022
• Subjects: Original Paper
• ISSN: 0027-7622; 2186-3326
• DOI: 10.18999/nagjms.84.2.247

Staphylococcus aureus
(
S. aureus
) is increasing in prevalence as a causative pathogen of community-acquired pneumonia (CAP). However, reports on the clinical features and mortality risk factors for
S. aureus
CAP are limited. We therefore aimed to identify the clinical characteristics and risk factors for mortality in these patients. We performed a post hoc and multivariate analysis of a multicenter prospective observational study that included adult hospitalized patients with
S. aureus
CAP. To elucidate the features of
S. aureus
CAP, we comparatively analyzed pneumococcal CAP (PCAP). We analyzed 196 patients with
S. aureus
CAP and 198 patients with PCAP.
S. aureus
CAP had a 30-day mortality of 16% (31/196) and a higher frequency of factors such as advanced age, comorbidities, poor functional ability, altered mental status, hypoalbuminemia, hyponatremia/hypernatremia, acidemia, and hypoxemia. In the multivariate analysis, the significant risk factors for mortality in
S. aureus
CAP were PaO
2
/FiO
2
≤250 [adjusted odds ratio (AOR), 3.29; 95% confidence interval (CI), 1.20–9.04] and albumin <3.0 g/dL (AOR, 2.41; 95% CI, 1.01–5.83). Non-ambulatory status tended to increase the risk (AOR, 2.40; 95% CI, 0.93–6.17). Methicillin resistance was not associated with mortality. In PCAP, hypoalbuminemia and non-ambulatory status affected mortality but hypoxemia did not. In conclusion, patients with
S. aureus
CAP have distinct clinical features, and their mortality risk factors can include hypoxemia and hypoalbuminemia. Physicians should recognize that the factors influencing mortality might differ somewhat among causative pathogens, and appropriate management should be performed after obtaining information on the causative pathogen.