Iniciative global de prevalencia, factores de riesgo y manejo para Staphylococcus aureus resistente a la meticilina, en pacientes hospitalizados con neumonía de la comunidad

Methicillin resistant Staphylococcus aureus (MRSA) es a growing problem around the world as cause of hospital acquired infections and recently linked to community acquired pneumonia (CAP). However, the real impact at a global level is unknown, with limited data regarding the prevalence of CAP due to MRSA. The objetive of this doctoral thesis was to evaluate the prevalence, risk factors and empiric treatment for hospitalized patientes with CAP. An international, multicentric, epidemiological, point prevalence study evaluated hospitalized patients with CAP with microbiological testing within 24 hours of hospital admission. This study recruited more than 3000 patients from 222 participanting centers from 54 countries and six continents. The prevalence of CAP due to MRSA was very low (3%) and only three variables were independently associated with MRSA-CAP: prior MRSA infection or colonization, recurrent skin infection and severe CAP. The empiric MRSA treatment occurred mainly in USA, despite the low level of prevalence. The conclusion of this study suggest that a clinical suspicion for MRSA CAP requires to be place in context, the prevalence of MRSA in the population where the patient belongs and the risk factors before deciding the use of empiric therapy against MRSA.