Table 1.
Univariate analysis of factors associated with bacterial pulmonary co-infection at ICU admission.
| Variables | No. of Patients | No. of Patients | Univariate Analysis | ||
|---|---|---|---|---|---|
| Total Cohort (n = 331) |
No Co-Infection (n = 152) |
Co-Infection (n = 179) |
p Value | OR (95% CI) | |
| Demographics and comorbidities | |||||
| Age, years | 67 [59–74] | 65 [58–72] | 68.5 [60–74] | 0.23 | 1.01 (0.99–1.03) |
| Gender (male) | 233 (70.4) | 101 (66.45) | 132 (73.74) | 0.15 | 1.42 (0.88–2.28) |
| COVID-19 Vaccinated | 24 (7.3) | 3 (2) | 21 (11.73) | 0.003 | 6.6 (1.93–22.59) |
| Recent hospitalization * | 29 (8.8) | 8 (5.3) | 21 (11.7) | 0.04 | 2.39 (1.03–5.57) |
| BMI ≥ 30 kg/m2 | 96 (29.0) | 55 (36.2) | 41 (22.9) | 0.008 | 0.52 (0.32–0.85) |
| CHD ** | 69 (20.8) | 20 (13.2) | 49 (27.4) | 0.002 | 2.49 (1.40–4.42) |
| COPD | 70 (21.1) | 29 (19.1) | 41 (22.9) | 0.39 | 1.26 (0.74–2.15) |
| Non-cardiac vasculopathy | 45 (13.6) | 13 (8.6) | 32 (17.9) | 0.02 | 2.33 (1.17–4.62) |
| Diabetes | 89 (26.9) | 34 (22.4) | 55 (30.7) | 0.09 | 1.54 (0.94–2.53) |
| CKD | 41 (12.4) | 7 (4.6) | 34 (19.0) | <0.001 | 4.86 (2.09–11.31) |
| Immunosuppression *** | 60 (18.0) | 26 (17.0) | 34 (19.0) | 0.51 | 0.83 (0.47–1.46) |
| CLD | 13 (3.9) | 7 (4.6) | 6 (3.4) | 0.56 | 0.72 (0.23–2.19) |
| Charlson index | 3 [2–5] | 3 [2–4] | 4 [2–5] | <0.01 | 1.23 (1.1–1.38) |
| Clinical ICU presenting features | |||||
| SAPS II score | 39 [30–52] | 36 [27–45] | 42 [33–57] | <0.01 | 1.04 (1.03–1.06) |
| SOFA score | 5 [4–7] | 4 [3–6] | 5 [4–7] | <0.01 | 1.24 (1.12–1.36) |
| Pre-ICU Hospital LOS, days | 5 [2–8] | 4 [2–7] | 5 [3–9] | 0.025 | 1.05 (1.01–1.10) |
| Time from symptoms, days | 9 [6–13] | 9 [5–12] | 10 [6–14] | 0.38 | 1.02 (0.98–1.05) |
| Septic Shock | 74 (22.4) | 29 (19.1) | 45 (25.1) | 0.19 | 1.42 (0.84–2.4) |
| Barotrauma | 43 (13.0) | 23 (15.1) | 20 (11.2) | 0.29 | 0.71 (0.37–1.34) |
| Pulmonary embolism | 18 (5.4) | 5 (3.3) | 13 (7.3) | 0.12 | 2.30 (0.80–6.61) |
| MDR colonization **** | 64 (19.3) | 19 (12.5) | 45 (25.1) | 0.004 | 2.35 (1.31–4.23) |
| PaO2/FiO2 | 88 [75–101] | 88 [76–101] | 88 [73–101] | 0.69 | 1.00 (0.99–1.01) |
| Body Temperature, T° | 37.0 [36.5–37.6] | 37.0 [36.4–37.4] | 37.0 [36.5–37.6] | 0.27 | 1.13 (0.91.1.42) |
| Laboratory ICU presenting features | |||||
| WBC (109/L) | 10.60 [7.65–15.11] | 9.50 [6.89–13.05] | 11.51 [8.30–16.36] | 0.72 | 1.00 (0.99–1.02) |
| Neutrophils (109/L) | 9.41 [6.55–13.28] | 8.39 [6.09–11.67] | 10.09 [6.92–14.35] | 0.002 | 1.07 (1.03–1.12) |
| Lymphocytes (109/L) | 0.68 [0.46–0.95] | 0.69 [0.47–1.07] | 0.65 [0.43–0.90] | 0.48 | 0.99 (0.95–1.02) |
| PCT, ng/mL | 0.20 [0.09–0.42] | 0.12 [0.06–0.20] | 0.29 [0.14–0.98] | <0.001 | 39.07 (9.37–162.94) |
| CRP, mg/L | 107.60 [51.7–169.50] | 86.40 [45.15–163.15] | 128.75 [62.75–180.89] | <0.001 | 1.005 (1.003–1.008) |
| Platelets (109/L) | 244 [174–312] | 251 [186–329] | 236 [162–295] | 0.02 | 0.99 (0.99–1.00) |
| D-Dimer, mg/L | 1954 [868–4262] | 1472 [727–3735] | 2142 [965–4895] | 0.94 | 1.00 (1.00–1.00) |
| LDH, U/L | 399 [319–513] | 399 [323–529] | 402 [316–508] | 0.51 | 1.00 (1.00–1.00) |
| Fibrinogen, mg/dL | 531 [416–677] | 530 [416–687] | 535 [414–674] | 0.80 | 1.00 (1.00–1.00) |
| Radiology ICU presenting features | |||||
| Brixia score, total | 9 [6–13] | 8 [5–10] | 10 [8–12] | <0.001 | 1.18 (1.11–1.26) |
| Monolateral consolidation | 114 (34.4) | 46 (30.3) | 68 (38.0) | 0.14 | 1.41 (0.89–2.23) |
| Bilateral consolidation | 76 (22.9) | 28 (18.4) | 48 (26.8) | 0.07 | 1.62 (0.96–2.75) |
| Monolateral effusion | 77 (23.3) | 32 (21.1) | 45 (25.1) | 0.38 | 1.26 (0.75–2.11) |
| Bilateral effusion | 36 (10.9) | 16 (10.5) | 20 (11.2) | 0.85 | 1.07 (0.53–2.14) |
| Treatments at ICU admission | |||||
| Dexamethasone | 281 (84.9) | 128 (84.2) | 153 (85.5) | 0.75 | 1.10 (0.60–2.01) |
| Remdesivir | 160 (48.3) | 75 (49.3) | 85 (47.5) | 0.74 | 0.93 (0.60–1.43) |
| IL-6 inhibitors | 44 (13.3) | 20 (13.2) | 24 (13.4) | 0.95 | 1.02 (0.54–1.93) |
| Outcomes | |||||
| Post-BAL ICU LOS, days | 15 [8–25] | 16 [11–30] | 13 [6–23] | 0.51 | 0.99 (0.98–1.01) |
| Post-BAL Hospital LOS, days | 20 [9–36] | 22 [13–38] | 16 [7–35] | 0.62 | 1.00 (0.99–1.01) |
| Tracheostomy | 109 (32.9) | 54 (35.5) | 55 (30.7) | 0.36 | 0.81 (0.51–1.28) |
| 28-day mortality | 144 (43.5) | 66 (43.4) | 78 (43.6) | 0.98 | 1.01 (0.65–1.56) |
| 90-day mortality | 166 (50.3) | 77 (51.0) | 89 (49.7) | 0.82 | 0.95 (0.62–1.47) |
* Previous three months; ** Including coronary and congestive disease; *** Including active neoplasm, chronic steroids, and immunosuppressive agents; **** MRSA nasal colonization and CRE/CRPa/CRAb rectal colonization. Categorical variables are expressed in count and percentage; continuous variables are expressed in median and interquartile range. We included all variables in the multivariable logistic regression if they reached p ≤ 0.05 during univariate analysis. A stepwise selection procedure was used to select variables for inclusion in the final model. Legend: CHD: chronic heart disease; COPD: chronic obstructive pulmonary disease; CKD: chronic kidney disease; LOS: length of stay; ICU: intensive care unit; BMI: body mass index; CLD: chronic liver disease; SAPS II: Simplified Acute Physiology Score II; SOFA: Sequential Organ Failure Assessment; MDR: multidrug-resistant; WBC: white blood cells; PCT: procalcitonin; CRP: C-reactive protein; LDH: lactate dehydrogenase; IL-6: interleukin-6; BAL: bronchoalveolar lavage; MRSA: methicillin-resistant Staphylococcus aureus; CRE: carbapenem-resistant Enterobacterales; CRAb: carbapenem-resistant Acinetobacter baumannii; CRPa: carbapenem-resistant Pseudomonas aeruginosa.