Table 4.
Risk factors of 30-day crude mortality in patients with follow-up blood culture (FUBC) sampled at different time related to appropriate antibiotic therapy (AAT).
| Variables | Patient number (%) | Univariate analysis | Multivariate analysis | |||
|---|---|---|---|---|---|---|
| Death | Survival | OR (95% CI) | P value | Adjusted OR (95% CI) | P value | |
| FUBCs prior to AAT (n = 65) | n = 10 | n = 55 | ||||
| Fatal comorbidities (McCabe classification) | 6 (60.0) | 17 (30.9) | 3.35 (0.84 = 13.44) | 0.15 | 6.81 (1.02–45.41) | 0.048 |
| Pitt bacteremia score ≥4 at onset | 3 (30.0) | 7 (12.7) | 2.94 (0.61–14.10) | 0.18 | 1.00 (0.13–7.46) | 1.00 |
| Bacteremic pneumonia | 4 (40.0) | 5 (9.1) | 6.67 (1.40–31.85) | 0.03 | 6.33 (0.77–51.90) | 0.09 |
| Nursing-home residents | 3 (30.0) | 2 (3.6) | 11.36 (1.61–80.24) | 0.02 | 12.80 (1.24–132.27) | 0.03 |
| Bacterial growth in FUBCs | 5 (50.0) | 15 (27.3) | 2.67 (0.68–10.54) | 0.26 | 2.86 (0.49–16.84) | 0.25 |
| FUBCs sampled at 0–3 day’s AAT (n = 202) | n = 37 | n = 165 | ||||
| Fatal comorbidities (McCabe classification) | 22 (59.5) | 34 (20.6) | 5.65 (2.65–12.04) | <0.001 | 3.79 (1.23–11.66) | 0.02 |
| Comorbid malignancies | 20 (54.1) | 49 (29.7) | 2.79 (1.35–5.77) | 0.005 | 1.48 (0.48–4.59) | 0.50 |
| Pitt bacteremia score ≥4 at onset | 19 (51.4) | 22 (13.3) | 6.86 (3.13–15.05) | <0.001 | 5.13 (1.93–13.65) | 0.001 |
| Pseudomonas bacteremia | 5 (13.5) | 3 (1.8) | 8.44 (1.92–37.09) | 0.006 | 2.26 (0.33–15.65) | 0.41 |
| Bacteremia sources | ||||||
| Pneumonia | 14 (37.8) | 17 (10.3) | 5.30 (2.31–12.19) | <0.001 | 2.83 (0.93–8.57) | 0.07 |
| Urinary tract infections | 1 (2.7) | 37 (22.4) | 0.10 (0.01–0.73) | 0.006 | 0.12 (0.01–1.05) | 0.06 |
| Inadequate source control | 4 (10.8) | 5 (3.0) | 3.88 (0.99–15.22) | 0.06 | 3.36 (0.64–17.63) | 0.15 |
| Bacterial growth in FUBCs | 7 (18.9) | 62 (37.6) | 0.39 (0.16–0.94) | 0.03 | 0.39 (0.14–1.11) | 0.08 |
| FUBCs sampled at 3.1–6 day’s AAT (n = 470) | n = 46 | n = 424 | ||||
| Inappropriate empirical antimicrobial therapy | 11 (23.9) | 41 (9.7) | 2.94 (1.39–6.22) | 0.003 | 2.29 (0.97–5.40) | 0.06 |
| Nursing-home residents | 8 (17.4) | 27 (6.4) | 3.10 (1.32–7.29) | 0.01 | 1.34 (0.45–3.96) | 0.60 |
| Fatal comorbidities (McCabe classification) | 21 (45.7) | 114 (26.9) | 2.28 (1.23–4.24) | 0.008 | 1.56 (0.71–3.43) | 0.27 |
| Comorbidities | ||||||
| Liver cirrhosis | 9 (19.6) | 45 (10.6) | 2.05 (0.93–4.52) | 0.07 | 2.22 (0.91–5.41) | 0.08 |
| Malignancies | 22 (47.8) | 120 (28.3) | 2.32 (1.25–4.30) | 0.006 | 2.33 (1.05–5.15) | 0.04 |
| Neurological diseases | 20 (43.5) | 114 (26.9) | 2.09 (1.12–3.89) | 0.02 | 1.99 (0.92–4.28) | 0.08 |
| Pitt bacteremia score ≥4 at onset | 19 (41.3) | 79 (18.6) | 3.07 (1.63–5.80) | <0.001 | 3.20 (1.56–6.54) | 0.001 |
| Bacterial growth in FUBCs | 16 (34.8) | 55 (13.0) | 3.58 (1.83–6.99) | <0.001 | 3.75 (1.80–7.79) | <0.001 |
| FUBCs sampled at 6.1–9 day’s AAT (n = 299) | n = 39 | n = 260 | ||||
| Fatal comorbidities (McCabe classification) | 20 (51.3) | 81 (31.2) | 2.33 (1.18–4.59) | 0.01 | 0.55 (0.19–1.56) | 0.26 |
| Comorbidities | ||||||
| Hypertension | 13 (33.3) | 133 (51.2) | 0.48 (0.24–0.97) | 0.04 | 0.84 (0.36–1.96) | 0.68 |
| Diabetes mellitus | 7 (17.9) | 107 (41.2) | 0.32 (0.13–0.74) | 0.005 | 0.29 (0.10–1.02) | 0.06 |
| Liver cirrhosis | 11 (28.2) | 34 (13.1) | 2.61 (1.19–5.73) | 0.01 | 4.44 (1.57–12.60) | 0.005 |
| End-stage renal diseases | 0 (0) | 26 (10.0) | — | 0.03 | — | 1.00 |
| Malignancies | 25 (64.1) | 73 (28.1) | 4.57 (2.25–9.29) | <0.001 | 3.83 (1.40–10.49) | 0.009 |
| Pitt bacteremia score ≥4 at onset | 16 (41.0) | 47 (18.1) | 3.15 (1.55–6.43) | 0.001 | 3.08 (1.22–7.78) | 0.02 |
| Polymicrobial bacteremia | 8 (20.5) | 26 (10.0) | 2.32 (0.97–5.58) | 0.06 | 1.64 (0.54–5.01) | 0.38 |
| Causative microorganisms | ||||||
| Pseudomonas species | 4 (10.3) | 5 (1.9) | 5.83 (1.49–22.74) | 0.02 | 2.14 (0.25–18.61) | 0.49 |
| Enterobacter species | 3 (7.7) | 4 (1.5) | 5.33 (1.15–24.81) | 0.05 | 28.07 (2.48–317.46) | 0.007 |
| Klebsiella species | 10 (25.6) | 36 (13.8) | 2.15 (0.96–4.78) | 0.06 | 1.45 (0.54–3.89) | 0.46 |
| Bacteremia sources | ||||||
| Pneumonia | 17 (43.6) | 46 (17.7) | 3.60 (1.777–7.30) | <0.001 | 3.84 (1.51–9.77) | 0.005 |
| Bone and joint infections | 0 (0) | 25 (9.6) | – | 0.06 | – | 1.00 |
| Bacterial growth in FUBCs | 4 (10.3) | 12 (4.6) | 2.36 (0.72–7.73) | 0.14 | 2.19 (0.46–10.36) | 0.32 |
| FUBCs sampled at >9 day’s AAT (n = 211) | n = 25 | n = 186 | ||||
| Comorbidities | ||||||
| Diabetes mellitus | 7 (28.0) | 90 (48.4) | 0.42 (0.17–1.04) | 0.06 | 0.48 (0.18–1.28) | 0.14 |
| Malignancies | 13 (52.0) | 65 (34.9) | 2.02 (0.87–4.67) | 0.097 | 1.72 (0.70–4.22) | 0.24 |
| Neurological diseases | 3 (12.0) | 52 (28.0) | 0.35 (0.10–1.22) | 0.096 | 0.25 (0.07–1.00) | 0.05 |
| Pitt bacteremia score ≥4 at onset | 12 (48.0) | 48 (25.8) | 2.65 (1.13–6.21) | 0.04 | 2.78 (1.08–7.17) | 0.04 |
| Bacteremic pneumonia | 9 (36.0) | 37 (19.9) | 2.27 (0.93–5.53) | 0.07 | 1.97 (0.73–5.31) | 0.18 |
| Bacterial growth in FUBCs | 1 (4.0) | 22 (11.8) | 0.31 (0.04–2.41) | 0.24 | 0.41 (0.05–3.43) | 0.41 |
CI = confidence interval; OR = odds ratio.