Table 2.
Clinical Characteristics, No. (%), of Military Trauma Patients with and without Multi-drug–Resistant Gram-Negative Infections
| Infection type | ||||
|---|---|---|---|---|
| Characteristics | Total (N = 2,699) | None/Non-MDRGN-I (n = 2,454)a | MDRGN-I (n = 245) | p |
| ICU Admission | <0.0001 | |||
| LRMC only | 391 (14.5) | 363 (14.8) | 28 (11.4) | |
| U.S. hospital ± LRMC | 1018 (37.7) | 825 (33.6) | 193 (78.8) | |
| None | 1284 (47.6) | 1261 (51.4) | 23 (9.4) | |
| Missing | 6 (0.2) | 5 (0.2) | 1 (0.4) | |
| Injury Severity Score | <0.0001 | |||
| 0–9 (mild) | 728 (27.0) | 724 (29.5) | 4 (1.6) | |
| 10–14 (moderate) | 363 (13.4) | 352 (14.3) | 11 (4.5) | |
| 15–24 (severe) | 523 (19.4) | 497 (20.2) | 26 (10.6) | |
| ≥ 25 (critical) | 1029 (38.1) | 828 (33.7) | 201 (82.0) | |
| Missing | 56 (2.1) | 53 (2.2) | 3 (1.2) | |
| Blast injury | 1740 (64.5) | 1534 (62.5) | 206 (84.1) | <0.0001 |
| Improvised explosive device (IED) | 1399 (51.8) | 1212 (49.4) | 187 (76.3) | <0.0001 |
| Non-IED | 341 (12.6) | 322 (13.1) | 19 (7.8) | |
| Non-blast injury | 0.058 | |||
| Gunshot wound | 448 (16.6) | 424 (17.3) | 24 (9.8) | |
| Other | 511 (18.9) | 496 (20.2) | 15 (6.1) | |
| Early surgical/traumatic amputation | 541 (20.0) | 400 (16.3) | 141 (57.5) | <0.0001 |
| Any fracture | 2034 (75.4) | 1815 (74.0) | 219 (89.4) | <0.0001 |
| Inpatient ventilation | <0.0001 | |||
| LRMC only | 406 (15.0) | 351 (14.3) | 55 (22.4) | |
| U.S. hospital only | 16 (0.6) | 13 (0.5) | 3 (1.2) | |
| 1–2 week duration | 2 (0.1) | 2 (0.1) | 0 | |
| LRMC and U.S. hospital | ||||
| ≤1week duration | 465 (17.2) | 335 (13.6) | 130 (53.1) | |
| ≥2 week duration | 8 (0.3) | 5 (0.2) | 3 (1.2) | |
| None | 1802 (66.8) | 1748 (71.2) | 54 (22.0) | |
| Death | 29 (1.1) | 20 (0.8) | 9 (3.7) | 0.001 |
| MDRGN colonization | 504 (18.7) | 362 (14.7) | 142 (58.0) | <0.0001 |
| Antibiotic use for ≥2 d | ||||
| Fluoroquinolone | 940 (34.8) | 826 (33.7) | 114 (46.5) | <0.0001 |
| First generation cephalosporins | 1872 (69.4) | 1692 (68.9) | 180 (73.5) | 0.143 |
| Tetracycline | 2230 (82.6) | 2038 (83.0) | 192 (78.4) | 0.065 |
| Aminoglycosides | 242 (9.0) | 204 (8.3) | 38 (15.5) | <0.001 |
| Anti-pseudomonal PCN | 293 (10.9) | 245 (10.0) | 48 (19.6) | < 0.0001 |
| Vancomycin | 713 (26.4) | 609 (24.8) | 104 (42.4) | <0.0001 |
| Carbapenem | 537 (19.9) | 446 (18.2) | 91 (37.1) | <0.0001 |
| Cephalosporin + fluoroquinolone | 747 (27.7) | 657 (26.8) | 90 (36.7) | <0.001 |
| Anti-pseudomonal PCN + aminoglycoside | 66 (2.4) | 54 (2.2) | 12 (4.9) | 0.009 |
| Vancomycin + anti-pseudomonal PCN | 199 (7.4) | 167 (6.8) | 32 (13.1) | <0.001 |
| Vancomycin + carbapenem | 448 (16.6) | 370 (15.1) | 78 (31.8) | <0.0001 |
a
Comparator population includes 1,786 patients with no infection and 668 patients with a non-MDRGN-I event.
MDRGN-I = multi-drug–resistant gram-negative infections; ICU = intensive care unit; LRMC = Landstuhl Regional Medical Center; PCN = penicillin.