Risk Factors, Clinical Features, and Management of Community-Acquired Staphylococcus aureus Pneumonia in Chongqing, China

Background Staphylococcus aureus is an important but under-recognized cause of community-acquired pneumonia (CAP), particularly methicillin-resistant S. aureus (MRSA), which is associated with poor outcomes. Methods We conducted a retrospective comparative study of 180 adults with S. aureus CAP and 180 with non-S. aureus CAP. Clinical features, imaging, laboratory findings, and outcomes were analysed, including subgroup comparisons of MRSA and MSSA. Results Diabetes mellitus, chronic lung disease, and bronchiectasis were independent risk factors for S. aureus CAP. Prior pneumonia and dyspnea predicted MRSA infection. S. aureus CAP was associated with greater radiographic abnormalities, systemic inflammation, longer hospital stays, and higher ICU admission and mortality rates. Co-infections occurred in 38.3% of cases, mainly involving Gram-negative bacteria and respiratory viruses. Conclusion S. aureus CAP presents more severely than non-S. aureus CAP, particularly in patients with MRSA. Early risk stratification and appropriate empirical therapy are crucial for improving outcomes in this high-risk group.