Increased risk of healthcare-associated Pneumonia in chronic dialysis

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Chronic dialysis is associated with an increased risk of healthcare-associated pneumonia caused by which of the following? 

A. Acinetobacter species 

B. Candida species 

C. Methicillin-resistant S aureus (MRSA) 

D. Multidrug-resistant Enterobacteriaceae 

E. P aeruginosa 

The answer is C. (Chap. 121) There are multiple clinical conditions associated with healthcare-associated pneumonia (HCAP). Residence in a nursing home or extended-care facility, hospitalizations for 2 or more days in the prior 3 months, and current hospitalizations that have been 48 hours or longer are associated with HCAP due to methicillin-resistant S aureus (MRSA), P aeruginosa, Acinetobacter species, and multidrug-resistant Enterobacteriaceae. HCAP due to P aeruginosa is also associated with antibiotic therapy in the preceding 3 months. Chronic dialysis, home infusion therapy, and home wound care place patients at risk for HCAP due to MRSA. Having a family member with a multidrug-resistant infection is associated with HCAP due to both MRSA and multidrug-resistant Enterobacteriaceae.