Table 2.
Patients With Enterobacter spp. Bacteremia and Subsequent Blood Cultures Within 1 Day of Antimicrobial Initiation to Assess Clearance of Bacteremia
| Characteristic | Total Cohort (n = 271) | Cleared Bacteremia <1 d (n = 242) | Persistent Bacteremia ≥1 d (n = 29) | P Valuea |
|---|---|---|---|---|
| Clinical characteristics | ||||
| Male sex, No. (%) | 152 (58) | 140 (58) | 12 (41) | .10 |
| Median age, y (IQR) | 59 (48–69) | 59 (50–69) | 58 (44–64) | .25 |
| Neutropenic, No. (%) | 51 (19) | 42 (17) | 9 (31) | .09 |
| ICU on day of bacteremia, No. (%) | 59 (22) | 47 (19) | 12 (41) | .01 |
| Comorbid medical conditions, No. (%) | ||||
| Solid organ malignancy | 105 (39) | 95 (40) | 10 (36) | .59 |
| Hematologic malignancy | 56 (21) | 52 (22) | 4 (14) | .36 |
| Diabetes mellitus | 67 (25) | 63 (26) | 4 (14) | .17 |
| Cardiac disease | 107 (40) | 92 (38) | 15 (54) | .12 |
| COPD | 27 (10) | 24 (10) | 3 (11) | .91 |
| Chronic renal insufficiency | 64 (24) | 56 (23) | 8 (29) | .54 |
| Liver disease | 59 (22) | 52 (22) | 7 (25) | .69 |
| Solid organ transplant | 17 (6) | 12 (5) | 5 (18) | .01 |
| Hematopoietic stem cell transplant | 16 (6) | 16 (7) | 0 (0) | .16 |
| Secondary culture source, No. (%) | ||||
| Cardiovascular catheter tip | 12 (4) | 9 (4) | 3 (10) | .10 |
| Abdominal | 12 (4) | 12 (5) | 0 (0) | .22 |
| Respiratory | 15 (6) | 13 (5) | 2 (7) | .73 |
| Urinary | 20 (7) | 16 (7) | 4 (14) | .16 |
| Blood culture positive only | 205 (76) | 185 (76) | 20 (69) | .38 |
| Pitt bacteremia score, No. (%) | .62 | |||
| 0 | 53 (20) | 49 (20) | 4 (14) | |
| 1–4 | 198 (73) | 176 (73) | 22 (76) | |
| 5–8 | 20 (7) | 17 (7) | 3 (10) | |
| Enterobacter cloacae, No. (%) | 212 (78) | 188 (78) | 24 (83) | .53 |
| Massachusetts General Hospital, No. (%) | 160 (59) | 144 (60) | 16 (56) | .65 |
| Median days from positive culture to antibiotic initiation (IQR) | 0 (0–1) | 0 (0–1) | 0 (0–1) | .02 |
| In-hospital death, No. (%) | 38 (14) | 30 (13) | 7 (25) | .08 |
| Antimicrobial susceptibilityb | ||||
| Ceftriaxone susceptible (n = 249), No. (%) | 172 (69) | 159 (71) | 13 (52) | .051 |
| Cefepime susceptible (n = 267), No. (%) | 260 (97) | 237 (97) | 29 (100) | .35 |
| Carbapenem susceptible (n = 203), No. (%) | 191 (94) | 171 (94) | 20 (91) | .50 |
| Quinolone susceptible, No. (%) | 229 (85) | 211 (88) | 18 (62) | <.001 |
| Antimicrobial(s) used, No. (%) | ||||
| Ceftriaxone | 28 (10) | 26 (11) | 2 (7) | .52 |
| Ceftazidime | 61 (23) | 54 (22) | 7 (24) | .82 |
| Cefepime | 107 (39) | 99 (41) | 8 (28) | .17 |
| Cefepime dose per 24 h | .74 | |||
| <2 g | 22 (21) | 21 (22) | 1 (13) | |
| 2–4 g | 66 (63) | 60 (62) | 6 (75) | |
| 6 g | 17 (16) | 16 (17) | 1 (13) | |
| Carbapenem | 57 (21) | 48 (19) | 9 (31) | .16 |
| Quinolone | 121 (45) | 107 (44) | 14 (48) | .68 |
| Gentamicin | 39 (14) | 35 (15) | 4 (14) | .92 |
| Other antibiotic | 24 (9) | 21 (9) | 3 (10) | .77 |
| Any 2 antibiotics | 149 (55) | 132 (55) | 17 (59) | .68 |
| Any 3 antibiotics | 27 (10) | 26 (11) | 1 (3) | .21 |
Abbreviations: COPD, chronic obstructive pulmonary disease; ICU, intensive care unit; IQR, interquartile range.
a P values are for differences between those who did and did not clear bacteremia within 1 day, calculated with χ2 tests for categorical variables and rank-sum tests for continuous, non-normally distributed variables.
b Susceptibility testing determined by the Vitek system and classified using Clinical and Laboratory Standards Institute M100-S22 [30].