Table 1.
Baseline Demographic and Clinical Characteristics According to Study Group
| Characteristic | Control (n = 207) | Rapid Multiplex PCR (n = 198) | Rapid Multiplex PCR + Stewardship (n = 212) |
|---|---|---|---|
| Demographics | |||
| Male sex | 142 (69) | 116 (59) | 127 (60) |
| Age, y, mean ± SD | 61.5 ± 19.32 | 61.4 ± 21.22 | 61.2 ± 20.08 |
| Race, white | 176 (85) | 186 (93.9) | 179 (84.4) |
| Location before admission | |||
| Nursing home | 22 (10.6) | 13 (6.6) | 15 (7.1) |
| Outside hospital | 27 (13) | 34 (17.2) | 30 (14.2) |
| Patient home | 114 (55.1) | 103 (52) | 104 (49.1) |
| Outpatient clinic | 22 (10.6) | 13 (6.6) | 15 (7.1) |
| Location at enrollment | |||
| Outpatient | 14 (6.8) | 20 (10.1) | 28 (13.2) |
| General ward | 125 (60.4) | 120 (60.6) | 125 (59) |
| Intensive care unit | 68 (32.9) | 58 (29.3) | 59 (27.8) |
| Comorbidities | |||
| Charlson comorbidity score, mean ± SD | 5.3 ± 3.2 | 5.2 ± 4.7 | 4.9 ± 3.0 |
| Myocardial infarction | 17 (8.2) | 16 (8.1) | 9 (4.2) |
| Chronic heart failure | 31 (15) | 32 (16.2) | 22 (10.4) |
| Cerebrovascular accident | 24 (11.6) | 21 (10.6) | 18 (8.5) |
| Chronic obstructive pulmonary disease | 25 (12.1) | 22 (11.1) | 27 (12.7) |
| Peptic ulcer disease | 27 (13) | 15 (7.6) | 21 (9.9) |
| Lymphoma | 21 (10.1) | 21 (10.6) | 25 (11.8) |
| Leukemia | 15 (7.2) | 21 (10.6) | 21 (9.9) |
| Solid tumor | 41 (19.8) | 34 (17.2) | 31 (14.6) |
| Diabetes mellitus | 68 (32.9) | 50 (25.3) | 63 (29.7) |
| Immunosuppressant usea | 79 (38.2) | 77 (38.9) | 82 (38.7) |
| Surgery in prior 30 d | 30 (14.5) | 27 (13.6) | 45 (21.2) |
| Renal replacement therapy | 16 (7.7) | 13 (6.6) | 14 (6.6) |
| Any malignancy | 76 (36.7) | 72 (36.4) | 73 (34.4) |
| Chronic heart disease | 81 (39.1) | 87 (43.9) | 73 (34.4) |
| Chronic renal disease | 62 (30) | 49 (24.7) | 52 (24.5) |
| Chronic liver disease | 35 (16.9) | 24 (12.1) | 33 (15.6) |
| Chronic lung disease | 43 (20.8) | 44 (22.2) | 50 (23.6) |
| Central venous catheter | 95 (45.9) | 91 (46) | 94 (44.3) |
| Acute kidney injury | 53 (25.6) | 35 (17.7) | 37 (17.5) |
| Concurrent infectious syndromesb | 97 (46.9) | 87 (43.9) | 108 (50.9) |
| Neutropenic fever | 24 (11.6) | 24 (12.1) | 27 (12.7) |
| Respiratory infection | 31 (15) | 21 (10.6) | 29 (13.7) |
| Urinary tract infection | 15 (7.3) | 17 (8.6) | 19 (9) |
| Intra-abdominal infection | 22 (10.6) | 21 (10.6) | 26 (12.3) |
| Source of bacteremia | |||
| Central venous catheter | 32 (15.5) | 38 (19.2) | 37 (17.5) |
| Urinary | 31 (15) | 34 (17.2) | 33 (15.6) |
| Intra-abdominal | 38 (18.4) | 22 (11.1) | 37 (17.5) |
| Skin/soft tissue | 11 (5.3) | 13 (6.6) | 8 (3.8) |
| Respiratory | 9 (4.3) | 11 (5.6) | 8 (3.8) |
| Bone/joint | 2 (1) | 4 (2) | 12 (5.7) |
| Eyes, ears, nose, throat | 1 (0.5) | 2 (1) | 1 (0.5) |
| Cardiovascular | 2 (1) | 3 (1.5) | 2 (0.9) |
| Surgical site infection | 0 (0) | 0 (0) | 2 (0.9) |
| Unidentified | 18 (8.7) | 16 (8.1) | 9 (4.2) |
| Complicated bloodstream infectionc | 14 (6.8) | 21 (10.6) | 13 (6.1) |
| Source control within 5 dd | 44 (21.3) | 46 (23.2) | 57 (26.9) |
| Contact isolation for MRSA, VRE, or Clostridium difficile | 51 (24.6) | 40 (20.2) | 43 (20.3) |
| Possible contaminante | 63 (30.4) | 55 (27.8) | 62 (29.3) |
| Severity of illness | |||
| APACHE II score, mean ± SDf | 18.3 ± 8.2 | 17.4 ± 7.8 | 16.4 ± 7.3 |
| Requiring mechanical ventilation | 21 (10.1) | 23 (11.6) | 16 (7.5) |
| Hypotensiong | 80 (38.6) | 76 (38.4) | 63 (29.7) |
| Pitt bacteremia score, mean ± SDf | 2.0 ± 2.5 | 2.0 ± 2.3 | 1.6 ± 2.0 |
| Infectious diseases consultation within 72 h of enrollment | 103 (49.8) | 97 (49) | 96 (45.3) |
| On active antibiotic at the time of enrollmenth | 99 (69) | 102 (71) | 113 (75) |
Data are presented as No. (%) unless otherwise specified. There were no significant differences in baseline characteristics between the study groups with the exception of race (P = .005).
Abbreviations: APACHE II, Acute Physiology and Chronic Health Evaluation II; MRSA, methicillin-resistant Staphylococcus aureus; PCR, polymerase chain reaction; SD, standard deviation; VRE, vancomycin-resistant Enterococcus species.
a Received cytotoxic agents within prior 6 weeks, >15 mg prednisone for >1 week in prior 4 weeks, or any other immunosuppressant within 2 weeks of blood culture.
b A patient was classified with concurrent infection other than neutropenic fever when a site of infection was documented in the medical record (eg, pneumonia, intraabdominal infection), and culture from the concurrent infection site grew at least 1 organism that was not isolated from blood.
c Positive blood culture after 3 days of effective antimicrobial therapy, metastatic infection, or infective endocarditis.
d Catheter removal or surgical drainage procedure.
e Growth of common contaminant (eg, coagulase-negative Staphylococcus species) from a single blood culture set when ≥2 blood culture sets were collected, except among subjects suspected to have true bacteremia associated with central venous catheters or devices.
f Excludes outpatients.
g Requiring vasopressors or systolic blood pressure decrease by >20 mm Hg.
h Active antibiotic defined as an agent to which the blood culture organism was susceptible by conventional antimicrobial susceptibility testing.