Table 5. The results of univariate and multivariable risk factor analyses of extended-spectrum beta-lactamase-producing Enterobacteriaceae carriage among asylum seekers and refugees admitted to Helsinki University Hospital, Finland, January 2010–August 2017 (n = 447).
| Risk factor | Patients (n = 447) |
ESBL-PE carriers (n = 147) | Non-carriers (n = 300) |
OR (95% Cl) in univariate analysis |
p value in univariate analysis |
AOR (95% CI) in multivariable analysisa
|
p value in multivariable analysis |
||
|---|---|---|---|---|---|---|---|---|---|
| n | n | % | n | % | |||||
| Sex | |||||||||
| Female | 237 | 68 | 28.7 | 169 | 71.3 | 1.0 | NA | NA | NA |
| Male | 210 | 79 | 37.6 | 131 | 62.4 | 1.5 (1.0–2.2) | 0.045 | NA | NA |
| Age group (years) | < 0.001 | ||||||||
| 0–5 | 54 | 30 | 55.6 | 24 | 44.4 | 1.0 | NA | 1.0 | NA |
| 6–15 | 53 | 16 | 30.2 | 37 | 69.8 | 0.3 (0.2–0.8)b | 0.009 | 0.2 (0.1–0.5)b | 0.001 |
| 16–25 | 121 | 30 | 24.8 | 91 | 75.2 | 0.3 (0.1–0.5)b | < 0.001 | 0.3 (0.2–0.7)b | 0.003 |
| 26–35 | 152 | 44 | 28.9 | 108 | 71.1 | 0.3 (0.2–0.6)b | < 0.001 | 0.4 (0.2–0.8)b | 0.010 |
| > 35 | 67 | 27 | 40.3 | 40 | 59.7 | 0.5 (0.3–1.1)b | 0.096 | 0.5 (0.2–1.2)b | 0.123 |
| Geographical regionc | < 0.001 | ||||||||
| Europe | 26 | 3 | 11.5 | 23 | 88.5 | 1.0 | NA | 1.0 | NA |
| North Africa and Middle East | 268 | 111 | 41.4 | 157 | 58.6 | 5.4 (1.6–18.5)d | 0.007 | 7.7 (2.1–28.1)d | 0.002 |
| Sub-Saharan Africa | 86 | 13 | 15.1 | 73 | 84.9 | 1.4 (0.4–5.2)d | 0.649 | 1.4 (0.4–5.9)d | 0.617 |
| Asia | 57 | 18 | 31.6 | 39 | 68.4 | 3.5 (0.9–13.3)d | 0.062 | 5.9 (1.4–24.1)d | 0.014 |
| Other or unknown | 10 | 2 | 20.0 | 8 | 80.0 | 1.9 (0.3–13.6)d | 0.516 | 7.0 (0.8–64.9)d | 0.086 |
| Prior hospitalisation abroad | |||||||||
| No or not specified | 367 | 100 | 27.2 | 267 | 72.8 | 1.0 | NA | 1.0 | NA |
| Yes | 80 | 47 | 58.8 | 33 | 41.3 | 3.8 (2.3–6.3) | < 0.001 | 4.1 (2.3–7.4) | < 0.001 |
| Prior invasive procedure abroad | |||||||||
| No or not specified | 398 | 118 | 29.6 | 280 | 70.4 | 1.0 | NA | NA | NA |
| Yes | 49 | 29 | 59.2 | 20 | 40.8 | 3.4 (1.9–6.3) | < 0.001 | NA | NA |
| Prior ICU care abroad | |||||||||
| No or not specified | 429 | 134 | 31.2 | 295 | 68.8 | 1.0 | NA | NA | NA |
| Yes | 18 | 13 | 72.2 | 5 | 27.8 | 5.7 (2.0–16.4) | 0.001 | NA | NA |
| Time from arrival to first sample (days, median)e | 59 | 38 | 83 | 0.91 (0.85–0.96)e | 0.002 | 0.91 (0.86–0.97) | 0.002 | ||
| Charlson Comorbidity Index (points) | 0.063 | ||||||||
| 0 | 417 | 133 | 31.9 | 284 | 68.1 | 1.0 | NA | NA | NA |
| 1 | 6 | 1 | 16.7 | 5 | 83.3 | 0.4 (0.05–3.7)f | 0.439 | NA | NA |
| 2–3 | 20 | 13 | 65.0 | 7 | 35.0 | 4.0 (1.5–10.2)f | 0.004 | NA | NA |
| 4–5 | 2 | 0 | 0 | 2 | 100 | NA | NA | NA | NA |
| > 5 | 2 | 0 | 0 | 2 | 100 | NA | NA | NA | NA |
AOR: adjusted odds ratio; CI: confidence interval; ESBL-PE: extended-spectrum beta-lactamase-producing Enterobacteriaceae; ICU: intensive care unit; NA: not applicable; OR: odds ratio; SD: standard deviation.
aWhen selecting the variables for the multivariable model with binary logistic regression, the Akaike information criteria (AIC) was used. Time between arrival and first sample was not known for all cases; missing values were taken into account by multiple imputations, assuming that data were missing at random.
bCompared with the youngest age group.
cPatients’ countries of origin in the various geographical regions:
Europe: Albania, Georgia, Greece, Kosovo*, Russia, Serbia, Ukraine;
North Africa and Middle East: Iraq, Iran, Jordan, Kuwait, Lebanon, Morocco, Syria, Turkey, Yemen;
Sub-Saharan Africa: Burundi, Cameroon, Congo, Ethiopia, Eritrea, Gambia, Ghana, Kenya, Nigeria, Rwanda, Somalia, South Africa, Sudan, Uganda, Zambia;
Asia: Afghanistan, Azerbaijan, Kazakhstan, China, Kyrgyzstan, Myanmar, Nepal, Pakistan, Sri Lanka.
dCompared with Europe.
en = 283; only in 283/447 cases arrival date to Finland was known. Analysed as a continuous variable, OR and adjusted OR given per 30 days.
fCompared with those with 0 points.
*This designation is without prejudice to positions on status, and is in line with United Nations Security Council Resolution 1244/99 and the International Court of Justice Opinion on the Kosovo Declaration of Independence.