Table 5. Factors associated with 30-day survival according to multivariate Cox regression model.
| Clinical, microbiological and therapeutic characteristics | Crude | analysis | p | Adjusted | analysis | p |
|---|---|---|---|---|---|---|
| Clinical exposures | HR | (CI 95%) | aHR | (CI 95%) | ||
| ECOG > 2 | 2.36 | (0.79–7.1) | 0.18 | … | … | … |
| Underlying disease | ||||||
| • Acute myelogenous leukemia | 2.51 | (0.73–8.64) | 0.1 | … | … | … |
| • Acute lymphoblastic leukemia | reference | … | … | … | … | … |
| • Other HM | 4.64 | (1.1–19.5) | 0.03 | … | … | … |
| Remission of underlying disease | 0.34 | (0.08–1.43) | 0.14 | … | … | … |
| Chemotherapya | 0.21 | (0.08–0.57) | 0.002 | … | … | … |
| Persistant neutropeniab | 16.72 | (3.9–71.3) | < 0.001 | … | … | … |
| Underlying disease complications | 2.19 | (0.91–5.28) | 0.08 | … | … | … |
| Microbiological features | ||||||
| Invasive fungal infectionc | 2.16 | (0.03–5.06) | 0.07 | 2.97 | (1.2–7.4) | 0.02 |
| Gut colonization by CRKpd | 0.59 | (0.22–1.58) | 0.08 | … | … | … |
| Polymyxin B resistant CRKpe | 2.29 | (0.97–5.36) | 0.06 | … | … | … |
| Clinical presentation | ||||||
| Hypotension on presentation | 4.9 | (2.1–11.5) | < 0.001 | 3.88 | (1.4–10.7) | 0.01 |
| Pitt Score ≥ 4 | 5.8 | (2.45–13.71) | < 0.001 | … | … | … |
| Demand for intensive care unit | 4.68 | (1.99–11.03) | < 0.001 | 2.16 | (0.8–5.9) | 0.13 |
| Acute renal failure | 7.12 | (1.68–30.36) | 0.008 | … | … | … |
| Acute renal failure (AKIN II / III) | 2.99 | (1.3–6.9) | 0.01 | … | … | … |
| Treatment attributes | ||||||
| Appropriate empirical therapy | 0.47 | (0.21–1.06) | 0.07 | … | … | … |
| Appropriate therapy within 3 days | 0.34 | (0.15–0.76) | 0.009 | 0.33 | (0.14–0.76) | 0.02 |
| Appropriate definitive therapy | 0.29 | (0.13–0.69) | 0.005 | … | … | … |
Multivariate analysis of 30-day survival-modifying factors in 65 patients with carbapenem-resistant Klebsiella pneumoniae bloodstream infection, according to Cox proportional hazards model. All variance inflation factor values of the variables included in the final multivariate model were less than 1.5. Notes: AKIN–Acute kidney injury network; BSI–Bloodstream infection; CRKP–Carbapenem-resistant Klebsiella pneumoniae; ECOG– Eastern Cooperative Oncology Group; HM–Haematological malignances; HSCT: Hematopoietic stem cell transplant; MIC–minimum inhibitory concentration.
aIn the 30 days preceding CRKp-BSI
bNeutropenia after the fourteenth day or at death
cOnly probable or proven diagnosed or treated during the episode
dIn the 180 days preceding CRKp-BSI
fPolymyxin B MIC > 2mcg/mL