Table 1.
Epidemiological Characteristics of Study Patients With Bloodstream Infection on Admission to an Acute Care Hospital
| Parameter | MDRO on Admission | OR (95% CI) | P Value | |
|---|---|---|---|---|
| Yes (n = 100), No. (%) | No (n = 215), No. (%) | |||
| Demographic characteristics | ||||
| Male sex | 52 (52) | 79 (36.7) | 1.9 (1.2–3.0) | .01 |
| Age ≥70 y | 78 (78) | 122 (56.7) | 2.7 (1.6–4.7) | <.001 |
| Exposure to health care | ||||
| Hospitalization in previous 90 d | 66 (66) | 83/214 (38.8) | 3.1 (1.9–5.0) | <.001 |
| Residence in LTCF before hospitalization | 50 (50) | 28 (13.0) | 6.7 (3.8–11.7) | <.001 |
| Regular (at least weekly) outpatient visits | 12 (12) | 39/214 (18.2) | 0.61 (0.31–1.2) | .17 |
| Hemodialysis | 8 (8) | 4 (1.9) | 4.6 (1.3–15.6) | .02 |
| Home IV or wound care in previous 30 d | 11 (11) | 7 (3.3) | 3.7 (1.4–9.8) | .01 |
| Antibiotic use in previous 90 d | 56/99 (56.6) | 54 (25.1) | 3.9 (2.3–6.4) | <.001 |
| Invasive procedure in previous 3 mo | 53 (53) | 67 (31.2) | 2.5 (1.5–4.1) | <.001 |
| Invasive device present on admission | 42 (42.4) | 46/214 (21.5) | 2.7 (1.6–4.5) | <.001 |
| Underlying conditions | ||||
| Poor functional status [39] | 81 (81) | 102/214 (47.7) | 4.7 (2.7–8.3) | <.001 |
| Ischemic heart disease | 15 (15) | 30 (14) | 1.1 (0.56–2.1) | .81 |
| Congestive heart failure | 22 (22) | 30 (14) | 1.7 (0.94–3.2) | .08 |
| Diabetes | 50 (50) | 93 (43.3) | 1.3 (0.82–2.1) | .26 |
| Chronic renal disease (including hemodialysis patients) | 38 (38) | 39 (18.1) | 2.8 (1.6–4.7) | <.001 |
| Chronic lung disease | 20 (20) | 31 (14.4) | 1.5 (0.80–2.8) | .21 |
| Neurological disease | 55 (55) | 61 (28.4) | 3.1 (1.9–5.1) | <.001 |
| Impaired cognition (including dementia) | 55 (55) | 57 (26.5) | 3.4 (2.1–5.6) | <.001 |
| Active malignancy | 21 (21) | 62 (28.8) | 0.66 (0.37–1.2) | .14 |
| Chronic skin ulcers | 41 (41) | 43 (20) | 2.8 (1.7–4.7) | <.001 |
| Immunosuppression | 37 (37) | 53 (24.7) | 1.8 (1.1–3.0) | .03 |
| Source of bacteremia | ||||
| Urinary tract infection | 33 (33) | 101 (46.9) | 0.6 (0.4–1) | .04 |
| Pneumonia | 26 (26) | 35 (16.3) | 1.9 (1.1–3.3) | .03 |
| Skin and soft tissue infection | 21 (21) | 31 (14.4) | 1.6 (0.9–2.9) | .14 |
| Intrabdominal infection | 14 (14) | 30 (13.9) | 1 (0.5–2) | .9 |
| Primary bloodstream infection | 4 (4) | 11 (5.1) | 0.8 (0.3–2.6) | .72 |
| Endocarditis | 4 (4) | 11 (5.1) | 0.8 (0.2–2.5) | .7 |
| Acute illness indices | ||||
| Severe sepsis, septic shock, multi-organ failure [23] | 59 (59) | 63 (29.3) | 3.5 (2.1–5.7) | <.001 |
| McCabe score, mean ± SD [29] | 2 ± 1 | 2 ± 1 | <.001 | |
| Pitt bacteremia score [28], median (IQR) | 2 (0–14) | 0 (0–1) | <.001 | |
| Clinical outcomes | ||||
| Days to appropriate therapy, median (IQR) | 2 (0–9) | 0 (0–7) | <.001 | |
| Death during current hospitalization | 45 (52.9) | 40 (18.6) | 3.7 (2.2–6.3) | <.001 |
| Death within 30 d of culture date | 45 (45) | 45 (20.9) | 3.2 (1.9–5.4) | <.001 |
| Death within 90 d of culture date | 57 (46.7) | 65 (30.2) | 3.2 (2–5.2) | <.001 |
| Length of stay (excluding deceased patients), median (IQR), d | 11 (0–35) | 7 (1–100) | <.001 | |
Abbreviations: CI, confidence interval; IQR, interquartile range; LTCF, long-term care facility; MDRO, multidrug-resistant organism; OR, odds ratio; SIRS, systemic inflammatory response syndrome.