Table.
Comparison of children colonized and not colonized with ESBL-producing Enterobacteriaceae on admission to a pediatric intensive care unit.
| ESBL-positive (n=24) |
ESBL-negative (n=72) |
OR (95% CI) | p- value |
|
|---|---|---|---|---|
| Age, years (median, interquartile range) | 6.0 (3.0–18.0) |
8.0 (3.0–15.0) |
1.0 (1.0– 1.1) |
0.40 |
| Male | 14 (58.3) | 50 (69.4) | 0.6 (0.2 – 1.8) |
0.32 |
| Race | ||||
| White | 16 (66.7) | 37 (51.3) | 0.8 (0.3 – 2.2) |
0.24 |
| Black | 4 (16.7) | 24 (33.3) | 0.4 (0.09 – 1.4) |
0.19 |
| Asian | 2 (8.3) | 2 (2.8) | 3.2 (0.2 – 45.6) |
0.26 |
| Latino | 2 (8.3) | 4 (5.6) | 1.5 (0.1 – 11.6) |
0.64 |
| PRISM score (median, IQR) | 4.0 (2.0 – 7.0) |
4.0 (2.0 – 7.0) |
1.0 (0.9 – 1.2) |
0.80 |
| Days from hospital admission to PICU admission (median, IQR) | 0.0 (0.0 – 4.0) |
0.0 (0.0 – 17.0) |
1.4 (1.0 – 2.0) |
0.11 |
| Reason for PICU admission | ||||
| Planned surgical procedure | 11 (45.8) | 32 (44.4) | 1.1 (0.4 – 2.9) |
0.90 |
| Respiratory failure | 2 (8.3) | 12 (16.7) | 0.4 (0.05 – 2.3) |
0.51 |
| Trauma | 0 (0.0) | 13 (18.0) | -- | 0.02 |
| Sepsis | 5 (20.8) | 2 (2.8) | 9.2 (1.3 – 100.8) |
0.01 |
| Metabolic derangements | 1 (4.2) | 4 (5.6) | 0.7 (0.01 – 8.0) |
1.00 |
| Other1 | 5 (20.8) | 8(11.1) | 2.1 (0.5 – 8.3) |
0.23 |
| Pre-existing conditions | ||||
| Previously healthy | 3 (12.5) | 28 (38.9) | 0.2 (0.04 – 0.9) |
0.02 |
| Congenital heart disease | 1 (4.2) | 9 (12.5) | 0.3 (0.01 – 2.4) |
0.44 |
| Chemotherapy within the previous 6 months2 | 4 (16.7) | 3 (4.2) | 4.6 (0.95 – 22.3) |
0.05 |
| Hematopoietic stem-cell transplantation (HSCT) within the previous 12 months | 3 (12.5) | 1 (1.4) | 10.1 (1.00 – 102.6) |
0.03 |
| Chronic steroid use or immunotherapy | 1 (4.2) | 2 (2.8) | 1.5 (0.02 – 30.4) |
1.00 |
| Other3 | 0 (0.0) | 2 (2.8) | -- | 0.41 |
| Healthcare exposures in the 6 months prior to current PICU admission | ||||
| Hospital admission | 12 (50.0) | 29 (40.3) | 1.5 (0.5 – 4.2) |
0.40 |
| PICU admission | 2 (8.3) | 2 (2.8) | 3.2 | 0.26 |
| (0.2 – 45.6) | ||||
| Hospitalization in a foreign country | 4 (16.7) | 1 (1.4) | 14.2 (1.3 – 708.6) |
0.01 |
| ESBL colonization or infection | 4 (16.7) | 1 (1.4) | 14.2 (1.3 – 708.6) |
0.01 |
| Number of hospital days4, mean (SD) | 11.8 (19.5) | 11.3 (20.9) | 1.0 (1.0 – 1.0) |
0.78 |
| Number of antibiotic days4, mean (SD) | 4.5 (7.2) | 11.0 (34.7) | 1.0 (1.0 – 1.0) |
0.47 |
| Antibiotic use in the 6 months prior to current PICU admission |
||||
| Any antibiotic | 9 (37.5) | 24 (33.3) | 1.2 (0.4 – 3.4) |
0.71 |
| Penicillin | 6 (25.0) | 12 (16.7) | 1.7 (0.4 – 5.6) |
0.36 |
| Cephalosporins | 6 (25.0) | 17 (23.6) | 1.1 (0.3 – 3.4) |
0.89 |
| Carbapenems | 3 (12.5) | 1 (1.4) | 10.1 (0.7 – 539.6) |
0.05 |
| Fluoroquinolones | 2 (8.3) | 1 (1.4) | 6.4 (0.3 – 385.9) |
0.15 |
| Aminoglycosides | 3 (12.5) | 5 (6.9) | 1.9 (0.3 – 10.7) |
0.39 |
All values represent n (%), unless otherwise noted.
1
Other reasons for PICU admission included: intractable seizures (3), altered mental status (2), burns (2), myocarditis (1), chemotherapy induction (1), anemia (1), cardiac arrest (1), allergic reactions (2)
2
Patients who received both chemotherapy and HSCT only categorized as HSCT; 3Excludes patients receiving immunotherapy for SOT, HSCT, or chemotherapy
3
Other pre-existing conditions include end-stage renal disease on hemodialysis (1) and solid organ transplantation (1)
4
Calculation of the mean included only patients with the specific exposure.