Table 1.
Patient characteristics and outcomes after isolation of E. coli from catheter blood cultures obtained using the differential time-to-positivity technique.
| Characteristic | Group, n (%) | p | |||
|---|---|---|---|---|---|
| Total 89 (100) |
Colonization 30 (33.7) |
C-RBSI 8 (9.0) |
Non–C-RBSI 51 (57.3) |
||
| Median (IQR) age, years | 64.00 (51.50–71.50) | 64.00 (45.00–73.00) | 66.00 (49.25–72.75) | 64.00 (56.00–69.00) | 0.475 |
| Male sex | 54 (60.7) | 18 (60.0) | 2 (25.0) | 34 (66.7) | 0.083 |
| Underlying condition | 0.444 | ||||
| Hematologic malignancy | 39 (43.8) | 14 (46.7) | 2 (25.0) | 21 (42.0) | |
| Solid organ tumor | 30 (33.7) | 7 (23.3) | 3 (37.5) | 20 (40.0) | |
| Gastrointestinal disease | 6 (6.7) | 3 (10.0) | 0 (0.0) | 3 (6.0) | |
| Renal disease | 3 (3.4) | 2 (6.7) | 0 (0.0) | 1 (2.0) | |
| Organ transplant | 3 (3.4) | 1 (3.3) | 0 (0.0) | 2 (4.0) | |
| Other | 8 (9.0) | 3 (10.0) | 3 (37.5) | 3 (6.0) | |
| Median (IQR) Charlson score | 8.00 (4.00–10.00) | 8.00 (2.00–10.25) | 8.50 (5.25–10.75) | 7.00 (4.00–10.00) | 0.770 |
| Median (IQR) APACHE II score | 11 (6.25–13.00) | 11.00 (6.00–12.50) | 13.00 (6.75–22.5) | 10.00 (7.00–13.00) | 0.195 |
| McCabe 3 | 60 (67.4) | 23 (76.7) | 3 (37.5) | 34 (66.7) | 0.077 |
| Type of catheter | 0.286 | ||||
| Non-tunneled CVC | 5 (5.6) | 3 (10.0) | 0 (0.0) | 2 (3.9) | |
| Tunneled CVC (Hickman) | 19 (21.3) | 9 (30.0) | 1 (12.5) | 9 (17.6) | |
| Port | 43 (48.3) | 11 (36.7) | 4 (50.0) | 28 (54.9) | |
| PICC | 21 (23.6) | 6 (20.0) | 3 (37.5) | 12 (23.5) | |
| PVC | 1 (1.1) | 1 (3.3) | 0 (0.0) | 0 (0.0) | |
| Median (IQR) in-hospital stay | 21.00 (9.00–39.50) | 23.00 (10.25–43.25) | 16.00 (13.50–33.50) | 18.00 (9.00–46.00) | 0.238 |
| Median (IQR) time to positivity of peripheral BC | 8.95 (7.48–10.34) | NA | 8.13 (7.24–9.54) | 9.33 (7.57–10.4) | 0.905 |
| Median (IQR) time to positivity of catheter lumen BC | 8.93 (7.09–10.40) | 9.80 (7.10–11.29) | 5.86 (3.60–7.45) | 8.93 (7.47–10.11) | 0.190 |
| Catheter withdrawal | 14 (15.7) | 9 (30.0) | 1 (12.5) | 4 (7.8) | 0.03 |
| Catheter lock therapy | 29 (32.6) | 16 (53.3) | 6 (75.0) | 7 (13.7) | <0.001 |
| Amikacin | 28 (31.5) | 15 (93.8) | 6 (100) | 7 (100) | |
| Ciprofloxacin | 1 (1.1) | 1 (6.3) | 0 (0.0) | 0 (0.0) | |
| Median (IQR) days of lock therapy | 7.00 (4.00–10.00) | 6.00 (4.25–8.50) | 7.00 (4.00–14.00) | 10.00 (7.00–10.00) | 0.280 |
| IV antimicrobial therapy | 87 (97.8) | 29 (96.7) | 8 (100) | 50 (98.0) | 0.835 |
| Median (IQR) days of IV antimicrobial therapy | 8.00 (6.00–10.00) | 7.50 (5.00–9.25) | 7.50 (7.00–9.50) | 8.00 (6.00–10.00) | 0.724 |
| Median (IQR) DDDs | 14.00 (3.00–18.00) | 15.50 (3.00–18.25) | 9.50 (4.25–15.75) | 14.00 (3.00–18.00) | 0.894 |
| Treatment success rate a | 69 (69.7) | 16 (53.3) | 3 (37.5) | 43 (84.3) | 0.002 |
| Catheter as the only presumed site of infection | 53 (59.6) | 24 (80.0) | 5 (62.5) | 24 (70.6)) | |
| Infection at another site | 36 (40.4) | 6 (20) | 3 (37.5) | 27 (52.9) | 0.610 |
| Abdominal | 13 (14.6) | 1 (3.3) | 2 (25.0) | 10 (19.6) | |
| Urinary | 13 (14.6) | 3 (10.0) | 1 (12.5) | 9 (17.6) | |
| Biliary tract | 8 (9.0) | 2 (6.7) | 0 (0.0) | 6 (11.8) | |
| Mucosal | 1 (1.1) | 0 (0.0) | 0 (0.0) | 1 (2.0) | |
| Perianal | 1 (1.1) | 0 (0.0) | 0 (0.0) | 1 (2.0) | |
| Crude mortality rate | 16 (18.0) | 3 (10.0) | 3 (37.5) | 10 (19.6) | 0.1081 |
| C-RBSI-associated mortality rate | 1 (1.1) | 0 (0.0) | 1 (12.5) | 0 (0.0) | 0.006 |
| Median (IQR) absorbance for CV assay * | 0.075 (0.000–0.996) | 0.060 (0.000–0.853) | 0.069 (0.036–0.142) | 0.094 (0.014–0.996) | 0.516 |
| Median (IQR) absorbance for XTT assay * | 0.156 (0.051–0.732) | 0.171 (0.053–0.534) | 0.294 (0.117–0.344) | 0.144 (0.051–0.732) | 0.228 |
C-RBSI, catheter-related bloodstream infection; IQR, interquartile range; CVC, central venous catheter; PICC, peripherally inserted central catheter; PVC, peripheral venous catheter; DTTP, differential time to positivity; BC, blood culture; IV, intravenous; DDD, defined daily dose; CV, crystal violet; XTT, tetrazolium salt. a Successful treatment was defined as catheter maintenance and obtaining sterile control blood cultures. * Absorbance was tested for only 72/89 strains.