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Semin Respir Crit Care Med 2009; 30(1): 052-060
DOI: 10.1055/s-0028-1119809
© Thieme Medical Publishers

The Role of MRSA in Healthcare-Associated Pneumonia

Anna P. Lam1 , Richard G. Wunderink1
  • 1Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Publication History

Publication Date:
06 February 2009 (online)

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ABSTRACT

An important continued trend in healthcare-associated infection, including healthcare-associated pneumonia (HCAP), is the rise of methicillin-resistant Staphylococcus aureus (MRSA). The emergence of community-acquired strains of MRSA has complicated the management further. We review likely risk factors for MRSA HCAP, which include prior antibiotic therapy, nasal colonization, poor infection control practices, and antecedent viral infection. The multiple mechanisms of antibiotic resistance are also described, and virulence factors that may affect antibiotic choices are discussed. The limitations of vancomycin and evidence for superior outcomes with linezolid are reviewed. Alternatives for community-acquired strains and future options are mentioned.

KEYWORDS

Staphylococcus aureus - methicillin-resistant S. aureus - vancomycin - linezolid - Panton-Valentine leukocidin (PVL)

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Richard G WunderinkM.D. 

Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine

676 North St. Clair St., Ste. 14-044, Chicago, IL 60611

Email: r-wunderink@northwestern.edu