Staphylococcus aureus meticilino resistente adquirido en la comunidad: una nueva amenaza

Objetivos: Conocer la frecuencia de Staphylococcus aureus meticilino resistente adquirido en la comunidad (SAMR-AC) en neumonia adquirida en la comunidad (NAC); examinar sus caracteristicas clinicas - evolutivas y analizar factores de riesgo. Pacientes, material y metodos: Estudio retrospectivo, descriptivo, observacional, realizado en una unidad de cuidados intensivos respiratorios entre 2006 y 2012. Resultados: Se evaluaron 180 pacientes con NAC con diagnostico etiologico. Etiologias mas frecuentes: Streptococcus pneumoniae (50.5%), Haemophillus influenzae (18.3%) ySAMR-AC (12.2%, 22 casos). La neumonia por SAMR-AC se presento en individuos jovenes, mayoritariamente hombres. En el 81.8% de los casos el foco primario fue infeccion de piel y estructuras relacionadas (IPER), 95.4% presento criterios clinicos de sepsis, 72.7% tuvo compromiso radiologico bilateral y 45.5% desarrollo derrame pleural. El 40.9% requirio ventilacion mecanica y el 45.4% utilizo drogas vasoactivas. El 81.8% de los pacientes no alcanzo criterios de estabilidad clinica al cabo de la primer semana y la mortalidad fue del 36.3%, significativamente superior al resto de los microorganismos (8.8%, p Objectives: To know the incidence of Community Acquired Pneumonia (CAP) caused by Methicillin Resistant Sthaphylococcus aureus (MRSA), to examine their clinical and developmental characteristics and to analyze risk factors. Materials and Methods: Retrospective, descriptive and observational study carried out at a Respiratory Intensive Care Unit, between 2006 and 2012. Results: 180 patients with etiologic diagnosis of CAP were evaluated. The most common causes were Streptococcus pneumoniae (50.5%), Haemophillus influenzae (18.3%) and MRSA (12.2%, 22 cases). Community Acquired MRSA (CA-MRSA) pneumonia was present in young people, especially in male. In 81.8% of the cases, skin and related structure infections (SRSI) were the primary focus, 95.4% presented clinical criteria of sepsis, 72.7% had bilateral radiology involvement and 45.5% developed pleural effusion. 40.9% needed mechanical ventilation and 45.4% used vasoactive drugs. Clinical stability at the first week was not reached in 81.8% and mortality rate was 36.6%, significantly higher than for pneumonia caused by other microorganisms (8.8% p