Table 1.
Epidemiological Variables in Relation to H30 Status Among 1133 Escherichia coli Clinical Isolates
| Prevalence, No. (Column %) |
||||
|---|---|---|---|---|
| Variable | Total (N = 1133) | Non-H30 (n = 1026) | H30 (n = 107) | P Valuea |
| Location | ||||
| Children's Hospital (Seattle) | 269 (24) | 254 (25) | 15 (14) | .01 |
| Group Health Cooperative (Seattle) | 471 (42) | 436 (43) | 35 (33) | .06 |
| Harborview Medical Center (Seattle) | 135 (12) | 114 (11) | 21 (20) | .02 |
| UWMC (Seattle) | 158 (14) | 141 (14) | 17 (16) | |
| Minneapolis VAMC | 100 (9) | 81 (8) | 19 (18) | .002 |
| Latter 3 (Harborview, UWMC, VAMC) | 393 (35) | 336 (33) | 57 (53) | <.001 |
| Host factors | ||||
| Male | 250 (22) | 212 (21) | 38 (36) | .001 |
| Local compromiseb | 428 (38) | 363 (35) | 65 (61) | <.001 |
| Systemic compromisec | 351 (31) | 300 (29) | 51 (48) | <.001 |
| Hospital stay (past year) | 235 (21) | 196 (19) | 39 (37) | <.001 |
| Long-term care facility stay (past year) | 71 (6) | 46 (5) | 25 (24) | <.001 |
| Any healthcare risk factor | 257 (23) | 213 (21) | 44 (42) | <.001 |
| Prior antibioticsd | ||||
| Any | 244 (22) | 199 (20) | 45 (41) | <.001 |
| Penicillin, cephalosporin, or carbapenem | 111 (10) | 98 (10) | 13 (12) | |
| Fluoroquinolone | 48 (4) | 33 (3) | 15 (14) | <.001 |
| Trimethoprim-sulfamethoxazole | 65 (6) | 53 (5) | 12 (11) | .02 |
| Nitrofurantoin | 29 (3) | 23 (2) | 6 (6) | .047 |
| Vancomycin | 24 (2) | 19 (2) | 5 (5) | .07 |
| Presentation | ||||
| Local manifestationsb | 705 (62) | 643 (63) | 62 (58) | |
| Systemic manifestationsc | 338 (30) | 307 (30) | 31 (29) | |
| Any clinical manifestations | 879 (77) | 806 (79) | 73 (68) | .02 |
| Suspected infection | 973 (86) | 889 (87) | 84 (79) | .03 |
| SIRS | 147 (13) | 126 (12) | 21 (20) | .048 |
| Sepsis diagnosis | 40 (4) | 34 (3) | 6 (6) | |
| Bacteremia | 27 (2.4) | 26 (2.5) | 1 (0.9) | |
| Management | ||||
| Imaging | 254 (22) | 219 (21) | 35 (33) | .01 |
| Procedure | 373 (33) | 322 (31) | 51 (48) | .001 |
| Escalation in level of care | 33 (4) | 31 (4) | 2 (3) | |
| Admission to intensive care unit | 55 (8) | 50 (8) | 5 (7) | |
| Antibiotic therapy | 838 (74) | 779 (76) | 59 (55) | <.001 |
| Outcome | ||||
| Resistant to chosen antibiotic | 99 (9) | 79 (8) | 20 (19) | <.001 |
| Clinical persistencee | 86 (8) | 67 (7) | 19 (18) | <.001 |
| Microbiological persistencee | 61 (5) | 41 (4) | 20 (19) | <.001 |
| Clinical and/or microbiological persistence | 110 (10) | 82 (8) | 28 (26) | <.001 |
| Clinical recurrencef | 36 (3) | 31 (3) | 5 (5) | |
| Microbiological recurrencef | 25 (2) | 23 (2) | 2 (2) | |
| Later sepsis diagnosis | 28 (3) | 22 (2) | 6 (6) | .04 |
| Later outpatient visit(s) | 503 (44) | 445 (43) | 58 (54) | .04 |
| Later escalation in level of care | 36 (3) | 31 (3) | 5 (5) | |
| Later admission to hospital | 59 (5) | 44 (4) | 15 (14) | <.001 |
| Later antibiotics | 478 (42) | 410 (40) | 68 (64) | <.001 |
| Later imaging | 309 (27) | 265 (26) | 44 (41) | .001 |
| Later procedure | 324 (29) | 278 (27) | 46 (43) | .001 |
| New infectiong | 125 (11) | 100 (10) | 25 (24) | <.001 |
| Later complicationh | 224 (20) | 191 (19) | 33 (31) | .005 |
Abbreviations: SIRS, systemic inflammatory response syndrome; UWMC, University of Washington Medical Center (Seattle); VAMC, Veterans Affairs Medical Center (Minneapolis).
a P values (Fisher exact test) are shown where P < .10. Boldface text indicates P < .05.
b Local compromise and local manifestations were specific to the site of infection.
c Systemic compromise: any of diabetes, chronic renal failure, cirrhosis, immunosuppression, neutropenia, prematurity, and pregnancy. Systemic manifestations: any of fever (subjective), chills, malaise, lethargy, irritability, unresponsiveness, and seizure.
d Prior antibiotic use within 30 days of index episode. (Percentage values are based on number evaluable, which for some variables was less than total population.) Data are shown only for antibiotic classes used by >1% of subjects. For other antibiotic classes, the overall prevalence of use was nitrofurans, 0.9%; lincosamides, 0.7%; aminoglycosides, 0.6%; tetracyclines, 0.6%; and nitroimidazoles, 0.5% (no significant differences, H30 vs non-H30).
e Clinical persistence: initial symptoms present 5 days into therapy. Microbiological persistence: repeat positive culture (same site/organism as initially), without intervening negative culture.
f Clinical recurrence: return of initial symptoms after symptom resolution. Microbiological recurrence: repeat positive culture (same site/organism as initially) after negative culture.
g Different site and/or organism than index episode.
h Any of: adverse drug event, drug fever, drug rash, anaphylaxis, Clostridium difficile infection, nausea, vomiting, cytopenias, or acute renal failure.