Patient selection: nosocomial pneumonia (with positive findings for pneumonia on chest X-ray and/or chest CT) with positive sputum culture for MRSA
Outcome: "true" nosocomial pneumonia requiring antibiotics against MRSA (in distinction from a person with MRSA colonization of the upper respiratory tract)
Parameters:
(1) past history of surgery
(2) radiological findings (lobar pneumonia, aspiration pneumonia pattern, pulmonary abscess, other pneumonia pattern)
(3) Pneumonia Patient Outcomes Research Team (PORT) class
(4) quantitative culture of MRSA in CFU (colony-forming unit) per mL from a respiratory tract culture
(5) culture isolation of MRSA from respiratory tract specimen
|
Parameter
|
Finding
|
Points
|
|
past history of surgery
|
head and neck, esophagus, stomach
|
1
|
|
|
other
|
0
|
|
|
none
|
0
|
|
radiological findings
|
lobar pneumonia
|
0
|
|
|
other than lobar pneumonia
|
1
|
|
PORT class
|
< 5
|
0
|
|
|
5
|
1
|
|
MRSA CFU
|
< 10^6 CFU/mL
|
0
|
|
|
>= 10^6 CFU/mL
|
1
|
|
MRSA positive culture
|
0
|
0
|
|
|
>= 1
|
1
|
total number of predictors =
= SUM(points for all of the predictors)
Interpretation:
• minimum score: 0
• maximum score: 5
• The greater the number of predictors the greater the probability of "true" nosocomial pneumonia due to MRSA.
|
Parameter
|
Odds Ratio
|
|
history of surgery
|
8.6
|
|
radiological findings
|
10.2
|
|
severity PORT class
|
5.2
|
|
MRSA CFU
|
12.8
|
|
MRSA culture
|
19.9
|
