Table 2.
Univariate analyses: factors associated with severity among ≥5 year-old patients hospitalized with community-acquired acute lower respiratory infection, April 2007 - December 2009, Kampong Cham and Takeo provinces, Cambodia (N = 1,904)
| Severe cases | Non-severe cases | p values | |||
|---|---|---|---|---|---|
| Total numbers (N = 1904) |
188 |
9.9% |
1716 |
90.1% |
|
|
Median age in years (range) |
25.5 |
8-56 |
55 |
41-66 |
<0.001 |
|
Mean age in years |
32.1 |
|
51.8 |
|
<0.001 |
|
Age groups in years |
|
|
|
|
|
| 5-14 |
80 |
42.6% |
74 |
4.3% |
<0.001 |
| 15 - 49 |
50 |
26.6% |
609 |
35.5% |
0.019 |
| ≥50 |
58 |
30.9% |
1033 |
60.2% |
<0.001 |
|
Gender, male |
106 |
56.4% |
835 |
48.7% |
0.068 |
|
Signs and symptoms |
|
|
|
|
|
| Wheezing |
63 |
33.5% |
198 |
11.5% |
<0.001 |
| Dry cough |
84 |
44.7% |
435 |
25.3% |
<0.001 |
|
Time interval between presentation and symptoms onset in days |
|
|
|
||
| Median (IQR) |
4 |
2-7 |
6 |
4-9 |
<0.001 |
| Mean |
4.9 |
|
6.4 |
|
<0.001 |
|
Duration of hospital stay in days |
|
|
|
|
|
| Median (IQR) |
5 |
3-7 |
7 |
4-11 |
<0.001 |
| Mean |
6.1 |
|
8.6 |
|
<0.001 |
|
Reports of medicine use prior to admission |
|
|
|
|
|
| no antibiotics used |
97 |
51.6% |
835 |
48.7% |
NS |
| Unidentified drugs used |
62 |
33.0% |
714 |
41.6% |
0.028 |
| Antibiotics used |
29 |
15.4% |
154 |
9.0% |
0.007 |
|
Patient outcomes |
|
|
|
|
|
| Deceased |
17 |
9.0% |
44 |
2.6% |
<0.001 |
| Cured or improved |
132 |
70.2% |
1132 |
66.0% |
NS |
| Transferred |
32 |
17.0% |
450 |
26.2% |
0.008 |
| Escaped |
7 |
3.7% |
90 |
5.2% |
NS |
|
Co-morbidities |
|
|
|
|
|
| Cardiovascular disorder |
28 |
14.9% |
190 |
11.1% |
NS |
| Diabetes mellitus |
20 |
10.6% |
175 |
10.2% |
NS |
| Renal disorder |
18 |
9.6% |
113 |
6.6% |
NS |
| Liver disorder |
0 |
0.0% |
16 |
0.9% |
NS |
|
Laboratory results |
|
|
|
|
|
| Leukocytosis |
106 |
57.3% |
552 |
32.3% |
<0.001 |
| Neutrocytosis |
106 |
58.6% |
523 |
34.0% |
<0.001 |
| Lymphocytosis |
14 |
8.5% |
85 |
5.6% |
NS |
|
Patients tested by microbiology method |
|
|
|
|
|
| Blood culture |
168 |
89.4% |
1527 |
89.0% |
NS |
| Sputum culture |
47 |
25.0% |
843 |
49.1% |
0.002 |
| Blood or sputum culture |
173 |
92.0% |
1616 |
94.2% |
NS |
| Sputum smear for acid-fast bacilli (AFB) |
113 |
60.1% |
1569 |
91.4% |
<0.001 |
| Nasopharyngeal swabs |
184 |
97.9% |
1671 |
97.4% |
NS |
| Samples collected for bacterial & AFB etiologies |
173 |
92.0% |
1623 |
94.6% |
NS |
| Samples collected for bacterial & viral etiologies |
169 |
89.9% |
1579 |
92.0% |
NS |
|
Bacterial or viral yield |
|
|
|
|
|
| Positive blood culture |
9 |
5.4% |
24 |
1.6% |
0.002 |
| Positive sputum culture |
15 |
31.9% |
257 |
30.5% |
NS |
| Positive blood or sputum culture |
24 |
13.9% |
276 |
17.1% |
NS |
| Positive smear for AFB |
13 |
11.5% |
251 |
16.0% |
<0.001 |
| Positive PCR for viruses |
55 |
29.9% |
250 |
15.0% |
<0.001 |
|
Bacterial etiologies |
|
|
|
|
|
| H. influenzae |
5 |
2.9% |
109 |
6.7% |
0.074 |
| S. pneumoniae |
3 |
1.7% |
50 |
3.1% |
NS |
| B pseudomallei |
5 |
2.9% |
23 |
1.4% |
NS |
| Klebsiella pneumoniae |
5 |
2.9% |
38 |
2.4% |
NS |
| P. aeroginosa |
1 |
0.6% |
36 |
2.2% |
NS |
| S. aureus |
1 |
0.6% |
10 |
0.6% |
NS |
| AFB |
13 |
7.5% |
251 |
15.5% |
0.030 |
|
Viral etiologies |
|
|
|
|
|
| Rhinovirus |
32 |
17.4% |
119 |
7.1% |
<0.001 |
| Respiratory syncytial virus |
6 |
3.3% |
48 |
2.9% |
NS |
| Influenza viruses |
4 |
2.2% |
33 |
2.0% |
NS |
| Coronaviruses |
6 |
3.3% |
25 |
1.5% |
NS |
| Human metapneumovirus |
4 |
2.2% |
10 |
0.6% |
0.054 |
| Other viruses |
5 |
2.7% |
21 |
1.3% |
NS |
|
Mixed infections (% = # of the positive results) |
|
|
|
|
|
| >1 pathogen (AFB, bacterium or virus) |
3 |
3.5% |
60 |
8.9% |
NS |
| >1 bacterium identified |
1 |
1.2% |
25 |
3.7% |
NS |
| AFB and ≥1 bacterium identified |
1 |
1.2% |
29 |
4.3% |
NS |
| Co-infections AFB & virus |
0 |
0.0% |
26 |
3.9% |
NS |
| Co-infections virus-virus |
2 |
2.3% |
6 |
0.9% |
NS |
|
Overall etiology results |
|
|
|
|
|
| Bacterial etiologies (AFB or other bacteria) |
36 |
20.8% |
498 |
30.7% |
<0.001 |
| Viral and bacterial etiologies | 86 | 50.9% | 674 | 42.7% | <0.001 |