Table 1.
Bivariate Comparisons of Baseline Demographics, Clinical Characteristics, and Outcomes Between 30-Day Survivors and Nonsurvivors and Patients Receiving Early and Delayed Therapy
| Characteristic | 30-Day Mortality |
P Value | Delayed Therapy |
P Value | ||
|---|---|---|---|---|---|---|
| No (n = 146) | Yes (n = 44) | No (n = 137) | Yes (n = 53) | |||
| Demographics | ||||||
| Age, y, mean (SD) | 62.4 (17.1) | 66.6 (13.4) | .14 | 62.9 (17.1) | 64.6 (14.5) | .54 |
| Female sex | 79 (54.1) | 24 (54.5) | .96 | 75 (54.7) | 28 (52.8) | .81 |
| Race/ethnicity | .59 | .60 | ||||
| African American | 113 (77.4) | 34 (77.3) | … | 105 (76.6) | 42 (79.9) | … |
| White | 20 (13.7) | 5 (11.4) | … | 17 (12.4) | 8 (15.1) | … |
| Hispanic/Latino | 3 (2.1) | 0 | … | 2 (1.5) | 1 (1.9) | … |
| Other | 10 (6.8) | 5 (11.4) | … | 13 (9.5) | 2 (3.8) | … |
| Comorbidities/past medical history | ||||||
| Prior hospitalization (1 y) | 108 (74.0) | 32 (72.7) | .87 | 95 (69.3) | 45 (84.9) | .03 |
| Prior surgery (30 d) | 55 (37.7) | 12 (27.3) | .21 | 49 (35.8) | 18 (34.0) | .82 |
| VRE infection (1 y) | 5 (3.4) | 2 (4.5) | .66 | 4 (2.9) | 3 (5.7) | .40 |
| IVDU | 12 (8.2) | 1 (2.3) | .31 | 9 (6.6) | 4 (7.5) | .76 |
| Prosthetic device/hardware | 4 (2.7) | 5 (11.4) | .03 | 6 (4.4) | 3 (5.7) | .71 |
| Chronic kidney disease | 74 (50.7) | 27 (61.4) | .21 | 72 (52.6) | 29 (54.7) | .79 |
| Chronic hemodialysis | 46 (31.5) | 19 (43.2) | .15 | 49 (35.8) | 16 (30.2) | .47 |
| Liver disease | 24 (16.4) | 9 (20.5) | .54 | 21 (15.3) | 12 (22.6) | .23 |
| Diabetes mellitus | 65 (44.5) | 21 (47.7) | .71 | 64 (46.7) | 22 (41.5) | .52 |
| Cerebrovascular accident | 31 (21.2) | 11 (25.0) | .60 | 28 (20.4) | 14 (26.4) | .37 |
| Hemiplegia/paraplegia | 9 (6.2) | 2 (4.5) | 1 | 7 (5.1) | 4 (7.5) | .50 |
| HIV/AIDS | 8 (5.5) | 1 (2.3) | .69 | 8 (5.8) | 1 (1.9) | .45 |
| Immunosuppression (30 d) | 15 (10.3) | 7 (15.9) | .31 | 16 (11.7) | 6 (11.3) | .95 |
| Bone marrow transplant | 0 | 1 (2.3) | .23 | 0 | 1 (1.9) | .28 |
| Solid organ transplant | 0 | 1 (2.3) | .23 | 1 (0.7) | 0 | 1 |
| Chemotherapy/radiation therapy (30 d) | 11 (7.5) | 7 (15.9) | .10 | 12 (8.8) | 6 (11.3) | .59 |
| Urinary cathetera | 18 (12.3) | 10 (22.7) | .09 | 23 (16.8) | 5 (9.4) | .20 |
| Acute kidney injurya | 44 (30.1) | 16 (36.4) | .44 | 45 (32.8) | 15 (28.3) | .55 |
| Mechanical ventilationa | 21 (14.4) | 13 (29.5) | .02 | 26 (19.0) | 8 (15.1) | .53 |
| Decubitus ulcer | 19 (13.0) | 13 (29.5) | .02 | 15 (10.9) | 9 (17.0) | .26 |
| Malignancy | 21 (14.4) | 11 (25.0) | .10 | 23 (16.8) | 9 (17.0) | .98 |
| Receiving TPNa | 10 (6.8) | 2 (4.5) | .74 | 9 (6.6) | 3 (5.7) | 1 |
| Prior antibiotics (90 d) | 75 (51.4) | 29 (65.9) | .09 | 71 (51.8) | 33 (62.3) | .20 |
| Charlson comorbidity indexa, median (IQR) | 7 (4–9) | 7.5 (5–9) | .05 | 7 (5–8) | 7 (5–8) | .88 |
| EBSI characteristics | ||||||
| Hospital LOS pre-EBSI, d, median (IQR) | 10 (5–21.5) | 13.5 (4.3–28) | .22 | 10 (5–25) | 8 (3–22) | .22 |
| Primary source | .10 | .32 | ||||
| Intra-abdominal | 22 (15.1) | 8 (18.2) | .62 | 19 (13.9) | 11 (20.8) | … |
| Infective endocarditis | 4 (2.7) | 3 (6.8) | .20 | 4 (2.9) | 3 (5.7) | … |
| Intravenous catheter | 76 (52.1) | 18 (40.9) | .20 | 71 (51.8) | 23 (43.4) | … |
| Skin/soft tissue | 16 (11.0) | 2 (4.5) | .25 | 12 (8.8) | 6 (11.3) | … |
| Urinary tract | 16 (11.0) | 4 (9.1) | 1 | 17 (12.4) | 3 (5.7) | … |
| Unknown | 12 (8.2) | 8 (18.2) | .06 | 14 (10.2) | 6 (11.3) | … |
| Enterococcal species | ||||||
| Enterococcus faecium | 65 (44.5) | 24 (54.5) | .24 | 61 (44.5) | 28 (52.8) | .30 |
| Polymicrobial BSI | 50 (34.2) | 11 (25.0) | .25 | 44 (32.1) | 18 (32.1) | 1 |
| Intensive care unita | 47 (32.2) | 22 (50.0) | .03 | 48 (35.0) | 21 (39.6) | .56 |
| Pitt bacteremia scoreb, median (IQR) | 3 (3–4) | 4 (3–5) | .01 | 3 (3–5) | 3 (3–5) | .68 |
| Susceptibility phenotypes | ||||||
| Ampicillin-resistant | 63 (43.2) | 24 (54.5) | .18 | 59 (43.1) | 28 (52.8) | .23 |
| Vancomycin-resistant | 89 (61.0) | 30 (68.2) | .39 | 75 (54.7) | 44 (83.0) | <.001 |
| Daptomycin-nonsusceptible | 5 (11.1) | 4 (19.0) | .38 | 3 (2.2) | 6 (11.3) | .06 |
| Linezolid-intermediate | 1 (1.7) | 0 | 1 | 0 | 1 (1.9) | .28 |
| Treatment data | ||||||
| Antimicrobial therapy | ||||||
| Empiric | ||||||
| Vancomycin | 111 (76.0) | 30 (68.2) | .30 | 100 (73.0) | 41 (77.4) | .54 |
| Linezolid | 33 (33.6) | 7 (15.9) | .34 | 36 (26.3) | 4 (7.5) | .005 |
| Daptomycin | 19.9 (29) | 7 (15.9) | .56 | 29 (21.2) | 7 (13.2) | .20 |
| Ampicillin | 15 (10.3) | 6 (13.6) | .53 | 15 (10.9) | 6 (11.3) | .94 |
| Piperacillin/tazobactam | 7 (4.8) | 2 (4.5) | 1 | 7 (5.1) | 2 (3.8) | 1 |
| Other | 4 (2.7) | 3 (6.8) | .20 | 6 (4.4) | 1 (1.9) | .68 |
| Definitive | ||||||
| Vancomycin | 27 (18.5) | 5 (11.4) | .27 | … | … | … |
| Linezolid | 48 (32.9) | 13 (29.5) | .68 | … | … | … |
| Daptomycin | 42 (28.8) | 16 (36.4) | .34 | … | … | … |
| Ampicillin | 37 (25.3) | 12 (27.2) | .80 | … | … | … |
| Piperacillin/tazobactam | 10 (6.8) | 2 (4.5) | .74 | … | … | … |
| Other | 10 (6.8) | 3 (6.8) | 1 | … | … | … |
| Combination therapy | 13 (8.9) | 7 (15.9) | .18 | … | … | … |
| Vancomycin trough, mg/dL, mean (SD) | 19.0 (5.9) | 18.8 (7.0) | .89 | 18.8 (6.1) | 19.4 (6.3) | .70 |
| Daptomycin dose, mg/kg, median (IQR) | 9 (7–10) | 8 (6.9–9.9) | .46 | 9.1 (7–10) | 8.6 (6.9–9.5) | .33 |
| Time to appropriate therapy, h, mean (SD) | 33.1 (25.6) | 56.9 (37.4) | <.001 | … | … | … |
| Time to appropriate therapy, h, median (IQR) | 28.7 (14.6–44) | 50.7 (30.3–76.3) | <.001 | … | … | … |
| Other treatment information | ||||||
| Source control intervention pursued | 87 (59.6) | 18 (40.9) | .03 | 82 (59.9) | 23 (43.4) | .04 |
| ID consult within 24 h after index | 76 (52.1) | 22 (50.0) | .81 | 80 (58.4) | 18 (34.0) | .003 |
| Outcomes | ||||||
| Hospital LOS post-EBSI, d, median (IQR) | … | … | … | 11 (8–17.5) | 13 (8–20) | .61 |
| Duration EBSI, d, median (IQR) | 3 (2–4) | 3 (2–4) | .46 | 3 (2–4) | 4 (2–5.5) | .01 |
| 30-day mortality | … | … | … | 18 (13.1) | 19 (35.8) | <.001 |
| In-hospital mortality | … | … | … | 20 (14.6) | 24 (45.3) | <.001 |
Data are presented as No. (%) unless otherwise specified.
Abbreviations: BSI, bloodstream infection; EBSI, enterococcal bloodstream infection; HIV, human immunodeficiency virus; ID, infectious diseases; IQR, interquartile range; IVDU, intravenous drug use; LOS, length of stay; SD, standard deviation; TPN, total parenteral nutrition; VRE, vancomycin-resistant enterococci.
a At time of index culture.
b Worst score within 48 hours preceding index culture.