TABLE 1.
Baseline and infection characteristics of patients receiving MT, NVCT, and VCT
| Characteristic | Result for the following treatment arm: |
P value | ||
|---|---|---|---|---|
| MT (n = 58) | NVCT (n = 203) | VCT (n = 30) | ||
| Demographics | ||||
| Median (range) age (yr) | 63 (16–93) | 58 (16–87) | 59 (21–92) | 0.389 |
| No. (%) of male patients | 37 (63.8) | 137 (67.5) | 19 (63.3) | 0.815 |
| No. (%) of patients with the following comorbidities: | ||||
| Ischemic heart disease | 14 (24.1) | 45 (22.2) | 5 (16.7) | 0.721 |
| Congestive heart failure | 6 (10.3) | 15 (7.4) | 6 (20.0) | 0.081 |
| Cerebrovascular disease | 6 (10.3) | 18 (8.9) | 7 (23.3) | 0.056 |
| Diabetes mellitus | 29 (50.0) | 72 (35.5) | 11 (36.7) | 0.131 |
| Chronic kidney disease | 19 (32.8) | 52 (25.6) | 6 (20.0) | 0.387 |
| Hepatic disease | 4 (6.9) | 17 (8.4) | 4 (13.3) | 0.582 |
| Malignancy disease | 9 (15.5) | 42 (20.7) | 12 (40.0) | 0.025 |
| Autoimmune disease | 1 (1.7) | 4 (2.0) | 3 (10.0) | 0.037 |
| Immunocompromised | 5 (8.6) | 13 (6.4) | 10 (33.3) | 0.037 |
| Median (range) CCI | 2 (0–8) | 2 (0–10) | 4.5 (0–14) | <0.001 |
| Median (range) APACHE II score | 12 (0–23) | 14 (0–29) | 16 (5–31) | 0.023 |
| No. (%) of patients with the following primary infection or site of infectiona: | ||||
| Central nervous system | 0 (0.0) | 1 (0.5) | 0 (0.0) | 0.805 |
| Nosocomial pneumonia | 18 (31.0) | 89 (43.8) | 11 (36.7) | 0.194 |
| Tracheobronchitis | 1 (1.7) | 3 (1.5) | 0 (0.0) | 0.784 |
| Skin and soft tissue | 21 (36.2) | 84 (41.4) | 1 (3.3) | <0.001 |
| Bone and joint | 4 (6.9) | 15 (7.4) | 4 (13.3) | 0.504 |
| Gastrointestinal system | 1 (1.7) | 11 (5.4) | 2 (6.7) | 0.450 |
| Urinary tract | 11 (19.0) | 25 (12.3) | 0 (0.0) | 0.038 |
| Blood | 13 (22.4) | 62 (30.5) | 13 (43.3) | 0.127 |
| Secondary bacteremia | 4 (6.9) | 39 (19.2) | 11 (36.7) | 0.003 |
| No. (%) of patients in whom the following XDR GNB was responsible for infectionb: | ||||
| A. baumannii | 47 (81.0) | 170 (83.7) | 11 (36.7) | <0.001 |
| P. aeruginosa | 9 (15.5) | 38 (18.7) | 14 (46.7) | <0.001 |
| K. pneumoniae | 2 (3.4) | 7 (3.4) | 5 (16.7) | 0.006 |
| Other XDR-GNBc | 2 (3.4) | 5 (2.5) | 0 (0.0) | 0.289 |
| Details of polymyxin used | ||||
| Median (range) duration between XDR culture and treatment (days) | 3 (0–55) | 3 (0–79) | 3 (1–39) | 0.046 |
| No. (%) of patients who received polymyxin B | 44 (21.7) | 162 (79.8) | 30 (100) | 0.016 |
| Median (range) avg no. of IU of polymyxin B/kg/day administered to each patient | 18,006 (2,315–33,846) | 21,467 (3,163–45,977) | 25,000 (25,000–25,000) | <0.001 |
| No. (%) of patients who received i.v. CMS | 7 (12.1) | 39 (19.2) | 1 (3.3) | 0.056 |
| Median (range) avg no. of IU of i.v. CMS/day administered to each patient | 2,500,000 (1,000,000–3,500,000) | 4,090,000 (1,530,000–9,000,000) | 9,000,000 | 0.009 |
| No. (%) of patients who received nebulized CMS | 16 (27.6) | 81 (39.9) | 11 (36.7) | 0.231 |
| Median (range) avg no. of IU of nebulized CMS/day administered to each patient | 6,000,000 (3,000,000–6,000,000) | 6,000,000 (2,860,000–9,000,000) | 6,000,000 (6,000,000–6,000,000) | 0.122 |
| Median (range) proportion of treatment days with adequate i.v. polymyxin dosese | 0.00 (0.00–1.00) | 0.52 (0.00–1.00) | 1.00 (1.00–1.00) | <0.001 |
| Median (range) proportion of treatment days with adequate nebulized CMS dosese | 1.00 (1.00–1.00) | 1.00 (0.86–1.00) | 1.00 (1.00–1.00) | 0.845 |
| Median (range) duration (days) of polymyxin treatment | 9.5 (3–27) | 15 (3–139) | 16.5 (6–126) | <0.001 |
a
There may be multiple primary sites of XDR GNB infection per patient.
b
There may be multiple XDR GNB cultured at each site of infection.
c
Other GNB included Stenotrophomonas maltophilia (n = 1), Enterobacter cloacae (n = 2), Pseudomonas putida (n = 2), a Citrobacter species (n = 1), and an Enterobacter species (n = 1).
d
The patient may have received ≥1 polymyxin in the course of treatment.
e
Defined as the proportion of i.v. polymyxin B or i.v. CMS treatment days on which each patient received adequate doses of the respective polymyxin.