Table 4. Detailed outcome data according to risk status on presentation.
Low risk (n=231) | High risk (n=419) | P-value | |
---|---|---|---|
Primary diagnosis, n (%) | <0.001 | ||
MDI (bacteraemia) | 9 (3.9) | 52 (12.4) | |
MDI (other) | 24 (10.4) | 68 (16.2) | |
CDI | 34 (14.7) | 57 (13.6) | |
Fever without focus | 164 (71.0) | 242 (57.8) | |
Gram-negative bacteraemia, n | 4a | 30a | ND |
Escherichia coli | 1 | 13 | |
Klebsiella spp. | − | 7 | |
Pseudomonas aeruginosa | 2 | 3 | |
Enterobacter cloacae | − | 2 | |
Acinetobacter baumanii | − | 2 | |
Capnocytophaga spp. | − | 2 | |
Citrobacter braakii | 1 | − | |
Fusobacterium spp. | − | 1 | |
Gram-positive bacteraemia, n | 6a | 30a | ND |
Viridans group streptococci | 2 | 15 | |
Staphylococcus aureus | 1 | 4 | |
Coagulase negative staph | 2 | 4 | |
Kocuria kristinae | − | 2 | |
Granulicatella adiacens | 1 | − | |
Enterococcus faecalis | − | 1 | |
Group B streptococcus | − | 1 | |
Clostridium spp. | − | 1 | |
Rothia spp. | − | 1 | |
Streptococcus pneumoniae | − | 1 | |
Other MDI, n | ND | ||
Viral URTI | 6 | 33 | |
Viral LRTI | 4 | 7 | |
Bacterial urinary tract infection | 4b | 11c | |
Bacterial SSTI | 3d | 3e | |
C. difficile colitis | 4 | 4 | |
Gastroenteritis | − | 4f | |
HSV gingivostomatitis | 3 | 4 | |
Candida oesophagitis | − | 1 | |
Herpes zoster | − | 1 | |
Clinically documented infection, n | ND | ||
URTI | 15 | 27 | |
LRTI | 7 | 14 | |
SSTI | 8 | 6 | |
Sinusitis | 1 | 0 | |
Enterocolitis | 0 | 6 | |
Tooth abscess | 0 | 2 | |
Other | 3 | 2 | |
Sepsis at ED presentation, n (%) | <0.001 | ||
No sepsis | 44 (19.0) | 25 (6.0) | |
Sepsis | 184 (79.7) | 379 (90.5) | |
Severe sepsis/septic shock | 3 (1.3) | 15 (3.5) | |
Late onset (>4 h) severe sepsis, n (%) (time to dx) | 1 (0.4) (4.5 h) | 2 (0.5) (259 h, 246 h) | >0.99 |
Admission to ICU, n (%) | 2 (0.9) | 15 (3.6) | 0.04 |
Median time to ICU, h (IQR) | 6.1 (3.3–8.9) | 13.5 (6.3–291.9) | 0.37 |
Median ICU LOS, h (IQR) | 32.6 (30.0–35.3 h) | 20.0 (11.3–64.5 h) | 0.52 |
Median hospital LOS, days (IQR) | 3.5 (2.5–5.7) | 6.9 (3.9–11.8) | <0.001 |
Relapse of primary MDI within 30 days | 0 | 3 (2.5)g | >0.99 |
30-Day all-cause mortality, n (%) | 0 | 2 (0.5) | 0.54 |
Abbreviations: CDI=clinically defined infection; dx= diagnosis; ED=emergency department; HSV=herpes simplex virus; ICU=intensive care unit; IQR=interquartile range; LOS=length of stay; LRTI=lower respiratory tract infection; MDI=microbiologically defined infection; ND=not done; SSTI=skin and soft tissue infection; URTI=upper respiratory tract infection.
Polymicrobial bacteraemia in 1 low-risk episode (1 had 2 pathogens) and 7 high-risk episodes (6 had 2 pathogens, and 1 had 3 pathogens).
Pathogens include E. coli, K. pneumoniae, P. mirabilis and Group B streptococcus.
Pathogens included E. coli (3 ×), C. koseri, E. cloacae and Group B streptococcus.
Pathogens included methicillin-sensitive S. aureus (MSSA) (× 2) and P. aeruginosa.
Pathogens included MSSA, methicillin-resistant S. aureus (MRSA) and P. aeruginosa.
Pathogens included norovirus, Cryptosporidium spp., Salmonella enterica serova Mbandaka and Campylobacter jejuni.
Included three episodes of bacteraemia: E. coli, E. cloacae and P. aeruginosa.