MRSA | Pseudomonas | |
Strong risk factors* | Known MRSA colonization | Known Pseudomonas colonization |
Prior MRSA infection | Prior Pseudomonas infection | |
Detection of gram-positive cocci in clusters on a good-quality sputum Gram stain | Detection of gram-negative rods on a good-quality sputum Gram stain | |
Hospitalization with receipt of IV antibiotics in the prior 3 months | ||
Other factors that should raise suspicion for infection¶ | Recent hospitalization or antibiotic use, particularly hospitalization with receipt of IV antibiotics in the prior 3 months | Recent hospitalization or stay in a long-term care facility |
Recent influenza-like illness | Recent antibiotic use of any kind | |
Necrotizing or cavitary pneumonia | Frequent COPD exacerbations requiring glucocorticoid and/or antibiotic use | |
EmpyemaΔ | Other structural lung diseases (eg, bronchiectasis, cystic fibrosis) | |
Immunosuppression | Immunosuppression | |
Risk factors for MRSA colonization, including:
|
CAP: community-acquired pneumonia; MRSA: methicillin-resistant Staphylococcus aureus; IV: intravenous; COPD: chronic obstructive pulmonary disease.
* The presence of these risk factors generally warrant empiric treatment in patients with CAP of any severity.
¶ The presence of these factors should raise suspicion for MRSA or Pseudomonas infection and generally warrants treatment in those who are severely ill; in others, the need for empiric treatment should take into account local prevalence, severity of illness, and overall clinical assessment.
Δ This factor is associated with community-acquired MRSA infection, which can cause severe toxin-mediated infection. Refer to the UpToDate topic on MRSA infections and treatment of CAP in patients with risk factors for MRSA infection for further detail.Do you want to add Medilib to your home screen?