Table 4.
Factors associated with ESBL-Klebsiella pneumoniae bloodstream infection (BSI)
| Risk factors for ESBL KPBSI | ESBL | Non-ESBL | Univariate analysis | Adjusted analysis (n = 271) | ||
|---|---|---|---|---|---|---|
| n/N (%) | n/N (%) | RRa (95 % CI) | p-value | RR (95 % CI) | p-value | |
| Moderate or severe underweight for age | 209/339 (61.7) | 32/71 (45.1) | 1.13 (1.02–1.24) | 0.01 | 0.99 (0.97–1.01) | 0.40 |
| HIV-infection | 79/249 (31.7) | 3/39 (7.7) | 1.22 (1.13–1.30) | <0.001 | 1.14 (1.04–1.25) | 0.01 |
| Patient in the PICUb | 92/339 (27.1) | 11/71 (15.5) | 1.11 (1.02–1.21) | 0.04 | 0.99 (0.88–1.12) | 0.94 |
| Cephalosporin exposure in the last 12 months pre-BSI | 184/339 (54.3) | 12/71 (16.9) | 1.30 (1.18–1.42) | <0.001 | 1.18 (1.06–1.31) | 0.002 |
| Mechanical ventilation prior to BSI | 142/335 (42.4) | 13/71 (18.3) | 1.19 (1.10–1.29) | <0.001 | 1.08 (0.93–1.24) | 0.31 |
| Continuous infusion for >3 days prior to BSI | 247/334 (74.0) | 30/71 (42.3) | 1.31 (1.16–1.49) | <0.001 | 1.15 (1.04–1.28) | 0.009 |
| Indwelling urinary catheter prior to BSI | 139/335 (41.5) | 12/71 (16.9) | 1.20 (1.10–1.30) | <0.001 | 1.09 (0.99–1.20) | 0.10 |
| Major surgical procedure prior to BSIc | 115/336 (34.2) | 16/71 (22.5) | 1.10 (1.01–1.20) | 0.04 | 1.06 (0.95–1.18) | 0.33 |
| Skin erosions | 111/336 (33.0) | 19/71 (26.8) | 1.05 (0.96–1.15) | 0.30 | 1.07 (0.98–1.17) | 0.12 |
| Previous KP infection within last 12 months | 39/338 (11.5) | 3/71 (4.2) | 1.14 (1.03–1.26) | 0.01 | 0.96 (0.84–1.11) | 0.62 |
Multivariable model adjusted for gender, age, HIV infection, underweight-for-age, mechanical ventilation, patient in the PICU at the time of the BSI, continuous IV infusion for more than 3 days before the BSI, indwelling urinary catheter, major surgery before the BSI, Previous KP infection within last 12 months, skin erosions and cephalosporin exposure during last 12 months before the BSI. aRR adjusted risk ratio
ESBL-KP extended-spectrum-β-lactamase-producing Klebsiella pneumoniae, BSI bloodstream infection
aRR risk ratio; bPICU: paediatric intensive care unit; c A major surgical procedure included a laparotomy (emergency or elective), a thoracotomy, a skin graft or a craniotomy; Risk ratio 95 % confidence intervals that do not cross the null value of 1 are shown in bold