What is the role of S aureus in the etiology of community-acquired pneumonia (CAP)?

Updated: Oct 31, 2019
  • Author: Stephanie L Baer, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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S aureus has not traditionally been considered a typical cause of CAP in otherwise healthy hosts, with the exception of potentially severe CAP after influenza infection. [3] Community-acquired methicillin-resistant S aureus (MRSA) has been associated with multilobar necrotizing CAP, including in previously healthy individuals. However, in a prospective multicenter US surveillance study of 2259 adults hospitalized for CAP, S aureus was identified in only 1.6% of patients, and MRSA accounted for only 0.7% of all cases. [38] Interestingly, in that study, the clinical presentation of MRSA CAP did not differ from that of all-cause non–S aureus or pneumococcal CAP with regard to concurrent influenza infection, presence of multilobar infiltrates, or hemoptysis. MRSA CAP was significantly associated with prior long-term hemodialysis use and carried a higher inpatient mortality rate (13.3%) than all-cause non–S aureus CAP (2%). [38]

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