Table 2.
Outcome for patients with Staphylococcus aureus hospital-acquired pneumonia stratified by clinically relevant characteristics
| Parameter | Value by PVL status |
|||||
|---|---|---|---|---|---|---|
| MRSA |
MSSA |
|||||
| Cure rate (%) |
P valuea | Cure rate (%) |
P valuea | |||
| pvl negative (n = 155) | pvl positive (n = 18) | pvl negative (n = 109) | pvl positive (n = 5) | |||
| Demographic characteristics | ||||||
| Age | 0.524 | 0.153 | ||||
| <65 yr | 50/54 (92.6) | 7/8 (87.5) | 55/63 (87.3) | 3/5 (60.0) | ||
| ≥65 yr | 73/101 (72.3) | 9/10 (90.0) | 38/46 (82.6) | 0/0 | ||
| Sex | 0.362 | 0.178 | ||||
| Male | 59/80 (73.8) | 12/13 (92.3) | 54/63 (85.7) | 1/3 (33.3) | ||
| Female | 64/75 (85.3) | 4/5 (80.0) | 39/46 (84.8) | 2/2 (100.0) | ||
| Region of enrollment | 0.349 | 0.215 | ||||
| Europe | 37/45 (82.2) | 3/3 (100.0) | 44/49 (89.8) | 0/1 (0.0) | ||
| North America | 26/35 (74.3) | 9/11 (81.8) | 20/25 (80.0) | 1/2 (50.0) | ||
| Otherb | 60/75 (80.0) | 4/4 (100.0) | 29/35 (82.9) | 2/2 (100.0) | ||
| Prior antimicrobial therapy | 0.531 | 0.167 | ||||
| Yes | 92/116 (79.3) | 10/11 (90.9) | 37/42 (88.1) | 2/4 (50.0) | ||
| No | 31/39 (79.5) | 6/7 (85.7) | 56/67 (83.6) | 1/1 (100) | ||
| MRSA risk factor | 0.531 | 0.145 | ||||
| Yes | 122/153 (79.7) | 16/18 (88.9) | 81/97 (83.5) | 2/4 (50.0) | ||
| No | 1/2 (50.0) | 0/0 | 12/12 (100) | 1/1 (100.0) | ||
| Hospitalization within previous 6 months | 0.532 | 0.193 | ||||
| Yes | 80/100 (80.0) | 8/9 (88.9) | 35/40 (87.5) | 1/1 (100.0) | ||
| No | 43/55 (78.2) | 8/9 (88.9) | 58/69 (84.1) | 2/4 (50.0) | ||
| Antibiotic treatment within prior 3 months | 0.531 | 0.175 | ||||
| Yes | 84/108 (77.8) | 9/10 (90.0) | 31/36 (86.1) | 0/1 (0.0) | ||
| No | 39/47 (83.0) | 7/8 (87.5) | 62/73 (84.9) | 3/4 (75.0) | ||
| Chronic illness | 0.531 | 0.197 | ||||
| Yes | 101/130 (77.7) | 13/14 (92.9) | 53/63 (84.1) | 2/4 (50.0) | ||
| No | 22/25 (88.0) | 3/4 (75.0) | 40/46 (87.0) | 1/1 (100.0) | ||
| Prior infection with MRSA | 0.533 | 0.165 | ||||
| Yes | 15/17 (88.2) | 1/2 (50.0) | 1/2 (50.0) | 0/0 | ||
| No | 108/138 (78.3) | 15/16 (93.8) | 92/107 (86.0) | 3/5 (60.0) | ||
| Admission from a nursing home or long term care facility | 0.533 | 0.206 | ||||
| Yes | 23/30 (76.7) | 3/4 (75.0) | 10/10 (100.0) | 0/0 | ||
| No | 100/125 (80.0) | 13/14 (92.9) | 83/99 (83.8) | 3/5 (60.0) | ||
| Surgical procedure during current hospital stay | 0.532 | 0.137 | ||||
| Yes | 33/42 (78.6) | 3/4 (75.0) | 35/44 (79.5) | 0/1 (0.0) | ||
| No | 90/113 (79.6) | 13/14 (92.9) | 58/65 (89.2) | 3/4 (75.0) | ||
| Residing in an area known to have a high prevalence of community-acquired MRSA | 0.356 | 0.143 | ||||
| Yes | 21/30 (70.0) | 5/7 (71.4) | 10/14 (71.4) | 0/0 | ||
| No | 102/125 (81.6) | 11/11 (100.0) | 83/95 (87.4) | 3/5 (60.0) | ||
| Smoking status | 0.530 | 0.182 | ||||
| Nonsmoker | 54/67 (80.6) | 5/5 (100.0) | 52/59 (88.1) | 2/2 (100.0) | ||
| Current or ex-smoker | 69/86 (80.2) | 11/13 (84.6) | 41/49 (83.7) | 1/3 (33.3) | ||
| On hemodialysis | 0.531 | 0.176 | ||||
| Yes | 5/6 (83.3) | 0/0 | 0/0 | 0/0 | ||
| No | 118/149 (79.2) | 16/18 (88.9) | 93/109 (85.3) | 3/5 (60.0) | ||
| Currently in acute renal failure | 0.532 | 0.193 | ||||
| Yes | 12/15 (80.0) | 1/1 (100.0) | 6/6 (100.0) | 0/0 | ||
| No | 111/140 (79.3) | 15/17 (88.2) | 87/103 (84.5) | 3/5 (60.0) | ||
| Patient was nonoperative | 0.532 | 0.150 | ||||
| Yes | 95/118 (80.5) | 13/14 (92.9) | 58/66 (87.9) | 3/4 (75.0) | ||
| No | 28/37 (75.7) | 3/4 (75.0) | 35/43 (81.4) | 0/1 (0.0) | ||
| History of severe organ system insufficiency/immunocompromised | 0.530 | 0.187 | ||||
| Yes | 5/9 (55.6) | 1/1 (100.0) | 4/4 (100.0) | 0/0 | ||
| No | 118/146 (80.8) | 15/17 (88.2) | 89/105 (84.8) | 3/5 (60.0) | ||
| Diabetes and cardiac comorbidity | 0.361 | 0.203 | ||||
| Yes | 76/104 (73.1) | 13/14 (92.9) | 43/55 (78.2) | 1/3 (33.3) | ||
| No | 47/51 (92.2) | 3/4 (75.0) | 50/54 (92.6) | 2/2 (100.0) | ||
| Respiratory insufficiency/failure | 0.532 | 0.196 | ||||
| Yes | 71/93 (76.3) | 10/12 (83.3) | 60/72 (83.3) | 2/4 (50.0) | ||
| No | 52/62 (83.9) | 6/6 (100.0) | 33/37 (89.2) | 1/1 (100.0) | ||
| On a ventilator at the time of randomization | 0.530 | 0.137 | ||||
| Yes | 54/71 (76.1) | 4/5 (80.0) | 40/49 (81.6) | 0/0 | ||
| No | 69/84 (82.1) | 12/13 (92.3) | 53/60 (88.3) | 3/5 (60.0) | ||
| Baseline bacteremia with S. aureus | 0.532 | 0.181 | ||||
| Yes | 7/10 (70.0) | 3/3 (100.0) | 7/8 (87.5) | 0/0 | ||
| No | 116/145 (80.0) | 13/15 (86.7) | 86/101 (85.1) | 3/5 (60.0) | ||
| In ICUc at baseline | 0.532 | 0.124 | ||||
| Yes | 59/77 (76.6) | 7/8 (87.5) | 48/60 (80.0) | 1/1 (100.0) | ||
| No | 64/78 (82.1) | 9/10 (90.0) | 45/49 (91.8) | 2/4 (50.0) | ||
| APACHE II score | 0.525 | 0.184 | ||||
| 0-13 points | 59/68 (86.8) | 8/8 (100.0) | 55/61 (90.2) | 2/3 (66.7) | ||
| 14-19 points | 41/51 (80.4) | 4/6 (66.7) | 26/30 (86.7) | 1/1 (100.0) | ||
| ≥20 points | 23/36 (63.9) | 4/4 (100.0) | 12/18 (66.7) | 0/1 (0.0) | ||
a
Two-sided P value from an exact test of the null hypothesis of no association between clinical outcome and pvl status, stratifying on the covariate.
b
“Other” includes Argentina, Australia, Brazil, Chile, China, India, Israel, Lebanon, Malaysia, Peru, Philippines, South Africa, South Korea, Taiwan, and Thailand.
c
ICU, intensive care unit.