Table 1.
Bivariate predictors of mortality among patients with bloodstream infection due to ESBL-producing Enterobacteriaceae
| Characteristic | Value for patientsa |
OR | 95 % CI | P | |
|---|---|---|---|---|---|
| Dead | Alive | ||||
| Demographics | |||||
| Male sex | 30 (56.60) | 41 (44.57) | 1.62 | 0.82–3.20 | 0.17 |
| African-American ethnicity | 38 (71.70) | 77 (83.70) | 0.49 | 0.21–1.11 | 0.09 |
| Age (mean ± SD) | 66.86 ± 14.88 | 65.45 + 16.24 | 0.42 | ||
| Severity of illness and comorbid conditions | |||||
| Hospitalization within 30 days prior to admission | 37 (69.81) | 51 (55.43) | 1.86 | 0.90–3.80 | 0.11 |
| Median duration of hospitalization within 30 days prior to positive culture (IQR) | 7 (0–19) | 2 (0–15) | 0.1 | ||
| Median Charlson scoreb (IQR) | 3 (0–6) | 4 (0–7) | 0.98 | ||
| Median McCabe score on admission (IQR) | 2 (1–2) | 2 (2–3) | <0.0001 | ||
| McCabe score of 1c | 25 (47.2) | 11 (2) | 6.57 | 2.86–15.06 | <0.0001 |
| Diabetes mellitus | 22 (41.51) | 48 (52.17) | 0.65 | 0.32–1.28 | 0.23 |
| Chronic obstructive lung diseases | 13 (24.53) | 20 (21.74) | 1.17 | 0.52–2.59 | 0.68 |
| Congestive heart failure | 22 (41.51) | 38 (41.30) | 1.00 | 0.50–2.00 | 1.00 |
| Cerebrovascular accident | 12 (8.28) | 32 (34.78) | 0.54 | 0.25–1.18 | 0.13 |
| Human immunodeficiency virus infection | 1 (1.89) | 1 (1.09) | 1.75 | 0.10–28.56 | 1.00 |
| Hemiplegia | 3 (5.66) | 13 (14.13) | 0.36 | 0.01–1.34 | 0.17 |
| Peptic ulcer disease | 6 (11.32) | 10 (10.87) | 1.04 | 0.35–3.06 | 1.00 |
| Peripheral vascular disease | 8 (15.09) | 24 (26.09) | 0.50 | 0.21–1.21 | 0.15 |
| Metastatic solid tumor | 6 (11.32) | 7 (7.61) | 1.55 | 0.50–4.88 | 0.55 |
| Moderate to severe liver disease | 8 (15.09) | 9 (9.78) | 1.64 | 0.59–4.54 | 0.42 |
| Myocardial infarction | 11 (20.75) | 19 (20.65) | 1.01 | 0.44–2.31 | 1.00 |
| Lymphoma | 0 (0.00) | 3 (3.30) | 0.62 | 0.549–0.70 | 0.29 |
| Leukemia | 2 (3.77) | 2 (2.17) | 1.76 | 0.24–12.90 | 0.62 |
| Low albumin level | 47 (88.68) | 71 (77.71) | 2.31 | 0.87–6.16 | 0.12 |
| ADLsd at time of admission | 20 (39.22) | 37 (39.36) | 0.99 | 0.00 | 1.00 |
| Need for assistance with bathing | 37 (72.55) | 70 (74.47) | 0.90 | 0.06 | 0.84 |
| Need for assistance with feeding | 32 (62.75) | 55 (58.51) | 1.19 | 0.24 | 0.72 |
| Need for assistance with ambulation | 37 (72.55) | 71 (75.53) | 0.85 | 0.15 | 0.69 |
| Bowel incontinence | 15 (28.3) | 26 (28.3) | 1.0 | 0.47–2.1 | 1.00 |
| Urine incontinence | 36 (70.59) | 65 (69.15) | 0.93 | 0.03 | 1.00 |
| Admission information and hospital exposures prior to culture | |||||
| Admission from home | 16 (31.37) | 38 (40.43) | 0.67 | 1.15 | 0.36 |
| Presence of ventilation | 28 (52.83) | 26 (28.26) | 2.84 | 1.40–5.75 | 0.004 |
| Admission to intensive care unit | 31 (58.49) | 29 (31.52) | 3.06 | 1.51–6.17 | 0.001 |
| Exposure to Foley catheter | 25 (47.10) | 46 (50.00) | 0.89 | 0.45–1.75 | 0.863 |
| Exposure to central-line catheter | 48 (90.57) | 61 (66.30) | 4.87 | 1.76–13.49 | 0.001 |
| Receipt of total parenteral nutrition | 4 (7.55) | 15 (16.30) | 0.42 | 0.13–1.33 | 0.20 |
| Admission to intensive care unit prior to culture | 23 (45.10) | 14 (14.89) | 4.69 | 15.87 | 1.19 |
| Organism(s) | |||||
| Escherichia coli | 8 (15.69) | 16 (17.02) | 0.2 | ||
| Klebsiella pneumoniae | 42 (81) | 79 (83) | |||
| Klebsiella pneumoniae and Escherichia coli | 1 (1.96) | 0 (0.00) | |||
| Empirical therapy | |||||
| Cefepime | 26 (49.06) | 443 (46.7) | 1.09 | 0.55–2.15 | 0.86 |
| Carbapenem | 15 (28.30) | 25 (27.17) | 1.06 | 0.49–2.24 | 1.00 |
| Cefotaxime | 1 (1.89) | 0 (0.00) | 0.36 | 0.30–132.09 | 0.36 |
| Ceftazidime | 0 (0.00) | 1 (1.09) | 0.63 | 0.55–0.71 | 1.00 |
| Cefoxitin | 0 (0.00) | 3 (3.26) | 0.63 | 0.55–0.711 | 0.30 |
| Ceftrioxone | 6 (11.32) | 15 (16.30) | 0.66 | 0.23–1.80 | 0.47 |
| Tobramycin | 4 (7.55) | 15 (16.30) | 0.42 | 0.13–1.33 | 0.20 |
| Ciprofloxacin | 5 (9.43) | 6 (6.52) | 1.50 | 0.43–5.15 | 0.53 |
| Consolidative therapy | |||||
| Cefepime alone | 3 (5.66) | 6 (6.52) | 0.86 | 0.20–3.59 | 1.00 |
| Cefazolin | 0 (0.00) | 3 (3.26) | 0.62 | 0.55–0.71 | 0.29 |
| Cefotaxime | 0 (0.00) | 1 (1.09) | 0.63 | 0.55–0.71 | 1.00 |
| Carbapenem alone | 12 (22.64) | 21 (22.83) | 0.98 | 0.44–2.21 | 1.00 |
| Gentamicin | 3 (5.66) | 0 (0.00) | 0.35 | 0.28–0.44 | 0.05 |
| Cefoxitin | 0 (0.00) | 1 (1.09) | 0.63 | 0.55–0.71 | 1.00 |
| Ceftrixone | 3 (5.66) | 6 (6.52) | 0.86 | 0.20–3.59 | 1.00 |
| Cefoxime | 5 (9.43) | 8 (8.70) | 1.09 | 0.33–3.53 | 1.00 |
| Piperacillin-tazobactam | 7 (13.21) | 11(11.96) | 1.12 | 0.40–3.09 | 0.80 |
| Tigecycline | 3 (5.66) | 5 (5.43) | 1.04 | 0.23–4.55 | 1.00 |
| Colistin | 2 (3.77) | 4 (4.35) | 0.86 | 0.15–4.87 | 1.00 |
| Amikacin | 4 (7.55) | 9 (9.78) | 0.75 | 0.22–2.57 | 0.76 |
| Amoxicillin | 1 (1.89) | 4 (4.35) | 0.42 | 0.04–3.88 | 0.65 |
| Ampicillin | 0 (0.00) | 1 (1.09) | 0.63 | 0.55–0.71 | 1.00 |
| Total | 53 (36.5) | 92 (63.5) | |||