Table 2.
Analysis of risk factors for 28-day Mortality in 491 patients with E. coli bloodstream infections
| Univariate analysis | Multivariable analysis | ||||||
|---|---|---|---|---|---|---|---|
| Survivors (n = 420) | Non- survivors (n = 71) | P-values | P-values | OR | 95% CI for OR | ||
| Lower | Upper | ||||||
| Demographic | |||||||
| Male, n (%) | 223 (53.1) | 39 (54.9) | 0.774 | ||||
| Ages, mean ± SD | 60.8 ± 16.4 | 60.0 ± 16.8 | 0.736 | ||||
| Total hospital stay, days (median, IQR) | 20 (11–34) | 15 (7–28) | 0.013 | ||||
| Hospital stay before BSI, days (median, IQR) | 3 (0–13) | 7 (1–17) | 0.028 | ||||
| Preexisting medical conditions | |||||||
| Hypertension | 115 (27.4) | 23 (32.4) | 0.385 | ||||
| Diabetes | 71 (16.9) | 8 (11.4) | 0.249 | ||||
| Lung disease | 5 (1.2) | 3 (4.2) | 0.173 | ||||
| Cardiovascular diseases | 10 (2.4) | 1 (1.4) | 0.937 | ||||
| Hepatobiliary disease | 110 (26.2) | 27 (38.0) | 0.040 | 0.034 | 1.890 | 1.048 | 3.410 |
| Urinary system disease | 34 (8.1) | 6 (8.5) | 0.919 | ||||
| Nervous system disease | 13 (3.1) | 2 (2.8) | > 0.050 | ||||
| Malignant solid tumor | 86 (20.5) | 20 (28.2) | 0.145 | ||||
| Hematological Disease | 63 (15.0) | 11 (15.5) | 0.914 | ||||
| Charlson comorbidity score b (median, IQR) | 2 (0–2) | 2 (1–3) | 0.001 | ||||
| Source of infections | |||||||
| Central venous catheterization | 25 (6.0) | 0 (0) | 0.069 | ||||
| Lung infection | 82 (19.5) | 26 (36.6) | 0.001 | 0.071 | 1.781 | 0.951 | 3.336 |
| Abdominal infection | 212 (50.5) | 37 (52.1) | 0.799 | ||||
| Urinary infection | 74 (17.6) | 10 (14.1) | 0.464 | ||||
| Intracranial infection | 4 (1.0) | 1 (1.4) | 0.544 | ||||
| Skin infection | 15 (3.6) | 2 (2.8) | > 0.050 | ||||
| Primary bloodstream infection | 39 (9.3) | 6 (8.5) | 0.822 | ||||
| Nosocomial- acquired infection | 252 (60.0) | 52 (73.2) | 0.034 | ||||
| ESBL-producing E. coli, n (%) | 241 (57.4) | 42 (59.2) | 0.780 | ||||
| ICU stay prior to BSI a | 30 (7.1) | 6 (8.5) | 0.696 | ||||
| ICU stay after BSI c | 32 (7.6) | 11 (15.5) | 0.030 | ||||
| Prior surgery a | 69 (16.4) | 14 (19.7) | 0.494 | ||||
| Surgery after BSI c | 37 (8.8) | 2 (2.8) | 0.084 | ||||
| Invasive procedure and/or devices prior to BSI a | 106 (25.2) | 23 (32.4) | 0.205 | ||||
| Mechanical ventilation | 14 (3.3) | 4 (5.6) | 0.540 | ||||
| Central venous catheterization | 48 (11.4) | 14 (19.7) | 0.052 | ||||
| Urinary catheterization | 47 (11.2) | 13 (18.3) | 0.090 | ||||
| gastric catheterization | 33 (7.9) | 8 (11.3) | 0.337 | ||||
| Percutaneous catheterization | 24 (5.7) | 3 (4.2) | 0.820 | ||||
| Invasive procedure and/or devices after BSI c | 67 (16.0) | 13 (18.3) | 0.619 | ||||
| Mechanical ventilation | 29 (6.9) | 14 (19.7) | < 0.001 | ||||
| Central venous catheterization | 108 (25.7) | 32 (45.1) | 0.001 | ||||
| Urinary catheterization | 103 (24.5) | 27 (38.0) | 0.017 | ||||
| Gastric catheterization | 73 (17.4) | 19 (26.8) | 0.061 | ||||
| Percutaneous catheterization | 47 (11.2) | 7 (9.9) | 0.740 | ||||
| Hemodialysis prior to BSI a | 8 (1.9) | 1 (1.4) | > 0.050 | ||||
| Chemotherapy or radiotherapy prior to BSI a | 65 (15.5) | 12 (16.9) | 0.760 | ||||
| Corticosteroid use prior to BSI a | 28 (6.7) | 8 (11.3) | 0.169 | ||||
| Hemodialysis after BSI c | 14 (3.3) | 3 (4.2) | 0.977 | ||||
| Corticosteroid use after BSI c | 32 (7.6) | 6 (8.5) | 0.808 | ||||
| Prior Antibiotics use a | 164 (39) | 38 (53.5) | 0.022 | ||||
| Cepholosporins | 43 (10.2) | 5 (7.0) | 0.402 | ||||
| BLBLI combination antibiotics | 72 (17.1) | 16 (22.5) | 0.273 | ||||
| Tigecycline | 3 (0.7) | 2 (2.8) | 0.321 | ||||
| Carbapenems | 25 (6.0) | 12 (16.9) | 0.001 | 0.016 | 2.839 | 1.215 | 6.635 |
| Aminoglycosides | 2 (0.5) | 1 (1.4) | 0.375 | ||||
| Quinolones | 52 (12.4) | 10 (14.0) | 0.689 | ||||
| Laboratory examination b | |||||||
| White blood cell (median, IQR) | 9.1 (5.1–14.2) | 9.6 (3.7–13.3) | 0.849 | ||||
| Platelet (median, IQR) | 117 (52–192) | 80 (37–177) | 0.078 | ||||
| Total protein (median, IQR) | 58.9 (53.0–64.7) | 53.9 (46.0–62.0) | < 0.001 | 0.006 | 0.959 | 0.931 | 0.988 |
| Severity of illness at time of BSI b | |||||||
| APACHEII score (median, IQR) | 9 (6–12) | 13 (9–17) | < 0.001 | < 0.001 | 1.131 | 1.071 | 1.195 |
| Appropriate empirical treatment after BSI c | 389 (92.6) | 60 (84.5) | 0.024 | ||||
| 1. Cepholosporins | 25 (6.0) | 3 (4.2) | 0.761 | ||||
| 2. BLBLI combination antibiotics | 150 (35.7) | 25 (35.2) | 0.935 | ||||
| 3. Carbapenems | 189 (45.0) | 34 (47.9) | 0.651 | ||||
| 4. Quinolones | 49 (11.7) | 6 (8.5) | 0.427 | ||||
| 5. Aminoglycosides | 12 (2.9) | 2 (2.8) | > 0.050 | ||||
| 6. Tigecycline | 5 (1.2) | 2 (2.8) | 0.598 | ||||
| Appropriate definitive treatments after BSI c | 407 (96.9) | 64 (90.1) | 0.008 | 0.017 | 2.777 | 1.198 | 6.437 |
Data are expressed as n (%) unless otherwise stated
Abbreviations: ESBL extended-spectrum beta-lactamase; β-lactam-β-lactamase inhibitor (BLBLI) combination antibiotics, APACHE acute physiology and chronic health evaluation, BSI bloodstream infection, ICU intensive care unit, IQR interquartile range, SD standard deviation
aDuring the 30 days preceding BSI onset
bAt time of BSI onset
cAfter BSI onset