Table 4. Bivariate analysis of predisposing factors associated with increased risk of death within 30 days.
| Clinical, microbiological and therapeutic characteristics | Survivors, N = 41 | (%) | Deaths, N = 24 | (%) | RR | (CI 95%) | p |
|---|---|---|---|---|---|---|---|
| Age–year, median (IQR) | 53.5 | (34–63) | 55.2 | (42–63) | NA | NA | 0.5 |
| Elderly (age > 65-yo) | 8 | (20) | 5 | (21) | 1.05 | (0.48–2.28) | 1 |
| Male sex | 22 | (54) | 12 | (50) | 0.91 | (0.48–1.27) | 0.8 |
| Comorbidities | 25 | (61) | 17 | (71) | 1.32 | (0.62–2.73) | 0.6 |
| ECOG > 2 | 3 | (7) | 4 | (17) | 1.65 | (0.79–3.44) | 0.41 |
| Underlying disease | |||||||
| • Acute myelogenous leukemia | 25 | (61) | 16 | (67) | 2.08 | (0.7–6.2) | . |
| • Acute lymphoblastic leukemia | 13 | (32) | 3 | (13) | ref. | NA | 0.11 |
| • Other HM | 3 | (7) | 5 | (21) | 3.33 | (1.05–10.5) | . |
| Remission of underlying disease | 10 | (24) | 2 | (8) | 0.4 | (0.11–1.48) | 0.18 |
| Chemotherapya | 40 | (98) | 19 | (79) | 0.38 | (0.23–0.84) | 0.02 |
| HSCT recipient | 11 | (27) | 7 | (29) | 1.07 | (0.53–2.14) | 1 |
| Clinical characteristics and interventions | |||||||
| Central venous line | 37 | (90) | 20 | (92) | 1.18 | (0.35–3.64) | 1 |
| Neutropeniab | 37 | (90) | 23 | (96) | 1.91 | (0.32–11.4) | 0.64 |
| Severe neutropeniac | 36 | (88) | 21 | (88) | 0.98 | (0.37–2.55) | 1 |
| Persistant neutropeniad | 11 | (27) | 22 | (22) | 10.6 | (2.73–41.7) | < 0.0001 |
| Underlying disease complications | 4 | (10) | 7 | (29) | 2.02 | (1.11–3.66) | 0.08 |
| Microbiological features | |||||||
| Previous treated BSIa | 11 | (27) | 6 | (25) | 0.94 | (0.45–1.97) | 1 |
| Invasive fungal infectione | 6 | (15) | 8 | (33) | 1.82 | (0.99–3.34) | 0.11 |
| Gut colonization by CRKpf | 14 | (34) | 5 | (21) | 0.63 | (0.27–1.45) | 0.39 |
| Polymicrobial infection | 5 | (12) | 1 | (4) | 0.42 | (0.07–2.63) | 0.4 |
| Polymyxin B resistant CRKpg | 18 | (44) | 16 | (67) | 1.82 | (0.91–3.65) | 0.12 |
| Clinical presentation | |||||||
| Hypotension on presentation | 10 | (24) | 16 | (67) | 3.0 | (1.5–5.97) | 0.001 |
| Pitt Score ≥ 4 | 2 | (5) | 8 | (33) | 2.75 | (1.64–4.6) | 0.003 |
| Demand for intensive care unit | 9 | (22) | 16 | (67) | 3.2 | (1.61–3.65) | < 0.001 |
| Acute renal failure | 21 | (51) | 22 | (92) | 5.62 | (1.45–21.78) | 0.001 |
| Acute renal failure (AKIN II / III) | 12 | (29) | 15 | (63) | 2.34 | (1.2–4.5) | 0.01 |
| Treatment attributes | |||||||
| Appropriate empirical therapy | 28 | (68) | 11 | (46) | 0.56 | (0.3–1.06) | 0.07 |
| Appropriate therapy within 3 days | 34 | (83) | 13 | (54) | 0.45 | (0.25–0.81) | 0.02 |
| Appropriate definitive therapy | 37 | (90) | 16 | (67) | 0.36 | (0.15–0.84) | 0.03 |
| CRKp combination therapy | 27 | (66) | 6 | (25) | 0.32 | (0.15–0.71) | 0.002 |
Bivariate analysis of predisposing factors associated with increased risk of death within 30 days in 65 patients with carbapenem-resistant Klebsiella pneumoniae bloodstream infection in patients with haematological malignances and hematopoietic stem cell transplant recipients. Notes: AKIN–Acute kidney injury network; BSI–Bloodstream infection; CRKP–Carbapenem-resistant Klebsiella pneumoniae; HM–Haematological malignances; HSCT–Hematopoietic stem cell transplant; IQR–Interquartile range; MIC–minimum inhibitory concentration.
aIn the 30 days preceding CRKp-BSI
bNeutrophil count below 500 cel./mm3
cNeutrophil count below 100 cel./mm3
dNeutropenia after the fourteenth day or at death
eOnly probable or proven diagnosed or treated during the episode
fIn the 180 days preceding CRKp-BSI
gPolymyxin B MIC > 2mcg/mL