Table 4.
Multivariate results for risk factors for IET by ABR status
| Factor | All positive cultures | ABR-positive cultures | MDR-positive cultures | |||
|---|---|---|---|---|---|---|
| OR (CI) | P | OR (CI) | P | OR (CI) | P | |
| ABR | 2.59 (2.52–2.65) | < 0.001 | NA | NA | NA | NA |
| MDR | 1.84 (1.78–1.89) | < 0.001 | 1.86 (1.81–1.92) | < 0.001 | NA | NA |
| SARS-CoV-2 Status | ||||||
| Pre SARS-CoV-2 | Ref | Ref | Ref | |||
| SARS-CoV-2 positive | 1.20 (1.15–1.26) | < 0.001 | 1.07 (1.02–1.12) | 0.005 | 1.13 (1.03–1.25) | 0.013 |
| SARS-CoV-2 negative | 0.99 (0.97–1.01) | 0.564 | 1.01 (0.98–1.04) | 0.396 | 1.03 (0.98–1.08) | 0.237 |
| SARS-CoV-2 not tested | 1.01 (0.98–1.04) | 0.651 | 0.99 (0.96–1.03) | 0.621 | 1.01 (0.95–1.07) | 0.814 |
| Source | ||||||
| Othera | Ref | Ref | Ref | |||
| Respiratory | 1.24 (1.18–1.29) | < 0.001 | 1.05 (1.00-1.09) | 0.042 | 1.11 (1.02–1.20) | 0.021 |
| Urine | 0.92 (0.89–0.95) | < 0.001 | 1.01 (0.96–1.05) | 0.767 | 1.23 (1.16–1.31) | < 0.001 |
| Blood | 0.48 (0.46–0.50) | < 0.001 | 0.66 (0.63–0.70) | < 0.001 | 0.68 (0.62–0.73) | < 0.001 |
| Onset | ||||||
| Community-onset | Ref | Ref | Ref | |||
| Hospital-onset | 1.13 (1.10–1.17) | < 0.001 | 1.08 (1.03–1.12) | < 0.001 | 0.89 (0.84–0.94) | < 0.001 |
| Pathogen type | ||||||
| Gram negative only | Ref | Ref | Ref | |||
| Both gram negative and gram positive | 1.70 (1.63–1.77) | < 0.001 | 2.19 (1.88–2.55) | < 0.001 | 1.98 (1.66–2.36) | < 0.001 |
| Gram positive only | 1.62 (1.57–1.66) | < 0.001 | 0.35 (0.29–0.41) | < 0.001 | 0.30 (0.25–0.37) | < 0.001 |
| Specific pathogen | ||||||
| S. aureus or S. pneumoniae | Ref | Ref | Ref | |||
| Enterococcus spp. | 8.65 (8.18–9.14) | < 0.001 | 2.92 (2.65–3.22) | < 0.001 | 2.91 (2.62–3.24) | < 0.001 |
| S. maltophilia or Acinetobacter complex | 5.40 (4.56–6.39) | < 0.001 | 1.63 (1.31–2.03) | < 0.001 | 1.33 (1.02–1.72) | 0.032 |
| Multiple bacterial pathogens | 2.35 (2.06–2.68) | < 0.001 | 1.11 (0.94–1.30) | 0.233 | 0.93 (0.87–1.02) | 0.127 |
| P. aeruginosa | 1.99 (1.72–2.30) | < 0.001 | 0.83 (0.69–0.99) | 0.048 | 0.76 (0.60–0.95) | 0.018 |
| Enterobacterales | 0.58 (0.51–0.68) | < 0.001 | 0.40 (0.33–0.47) | < 0.001 | 0.37 (0.30–0.47) | < 0.001 |
| Underlying condition | ||||||
| No underlying condition | Ref | Ref | Ref | |||
| Liver dysfunction | 1.11 (1.08–1.13) | < 0.001 | 1.08 (1.05–1.11) | < 0.001 | 1.06 (1.01–1.10) | 0.021 |
| Heart failure or myocardial injury | 1.06 (1.03–1.09) | < 0.001 | 1.08 (1.04–1.11) | < 0.001 | 1.11 (1.06–1.17) | < 0.001 |
| Renal failure/ insufficiency | 1.06 (1.04–1.09) | < 0.001 | 1.03 (0.99–1.06) | 0.118 | 1.07 (1.02–1.12) | 0.005 |
| Diabetes | 1.01 (0.98–1.03) | 0.165 | 1.00 (0.97–1.03) | 0.937 | 1.00 (0.95–1.05) | 0.989 |
| Cytokine release syndrome | 0.99 (0.96–1.01) | 0.900 | 0.98 (0.94–1.03) | 0.432 | 0.94 (0.88-1.00) | 0.065 |
| Sepsis | 0.98 (0.94–1.02) | 0.263 | 0.98 (0.96–1.01) | 0.648 | 0.95 (0.90–1.02) | 0.165 |
| Age | ||||||
| 18–54 years (Q1) | Ref | Ref | Ref | |||
| 55–69 years (Q2) | 1.06 (1.03–1.09) | < 0.001 | 1.05 (1.01–1.10) | 0.011 | 1.06 (1.01–1.13) | 0.032 |
| 70–79 years (Q3) | 1.09 (1.06–1.13) | < 0.001 | 1.06 (1.02–1.11) | 0.006 | 1.10 (1.04–1.17) | 0.001 |
| ≥ 80 years (Q4) | 1.10 (1.06–1.13) | < 0.001 | 1.01 (0.97–1.06) | 0.540 | 1.13 (1.06–1.20) | < 0.001 |
| Other characteristics | ||||||
| Prior 30-day admission | 1.11 (1.07–1.16) | < 0.001 | 1.17 (1.11–1.22) | < 0.001 | 1.12 (1.04–1.20) | 0.001 |
| Prior 90-day admission | 1.10 (1.06–1.13) | < 0.001 | 1.12 (1.07–1.16) | < 0.001 | 1.05 (1.00-1.10) | 0.050 |
| Female | 1.03 (1.01–1.05) | 0.013 | 1.08 (1.05–1.12) | < 0.001 | 1.11 (1.06–1.16) | < 0.001 |
| Ventilated or ICU | 1.02 (0.98–1.06) | 0.244 | 0.97 (0.94–1.01) | 0.114 | 0.97 (0.92–1.02) | 0.217 |
| Antibiotic daysb | 1.02 (1.02–1.02) | < 0.001 | 1.01 (1.01–1.01) | < 0.001 | 1.01 (1.00-1.01) | < 0.001 |
| LOS daysb | 1.00 (1.00-1.01) | < 0.001 | 1.01 (1.00-1.01) | < 0.001 | 1.01 (1.00-1.01) | < 0.001 |
Definitions: ABR = antibiotic resistant; CI = confidence interval; ICU = intensive care unit; IET = inadequate empiric therapy; LOS = length of stay; MDR = multidrug resistant; OR = odds ratio; Q = quarter; Ref = reference group; SARS-CoV-2 = severe acute respiratory syndrome-coronavirus-2
Data are presented OR (CI). Data for hospital characteristics and geographic location are presented in Supplemental Table S1. Multivariate results were adjusted for all variables shown here and in Supplemental Table S1.
aIntra-abdominal, skin/wound, and cultures not defined by the specified categories.
bIncrease in odds for each additional day.