Table 3.
Analysis of risk factors associated with CR and Non-CR cases
| Characteristics | Total Enterobacteriaceae HAI cases(N = 1598) n % | CRE cases (N = 871) n % | CSE cases (N = 727) n % | Unadjusted OR (95% CI) | p-value | |||
|---|---|---|---|---|---|---|---|---|
| Specimen Type | < 0.001a | |||||||
| Blood | 655 | 41.0 | 409 | 47.0 | 246 | 33.8 | Reference | |
| Respiratory* | 346 | 21.7 | 180 | 20.7 | 166 | 22.8 | 0.65 (0.5–0.85) | 0.001b |
| Urine | 236 | 14.8 | 117 | 13.4 | 119 | 16.4 | 0.59 (0.44–0.8) | 0.001 b |
| Tissue or Wound | 361 | 22.6 | 165 | 18.9 | 196 | 27.0 | 0.51 (0.39–0.66) | 0.001 b |
| Type of Enterobacteriaceae Pathogen | < 0.001 a | |||||||
| Klebsiella | 1177 | 73.7 | 741 | 85.1 | 436 | 60.0 | Reference | |
| Enterobacter | 78 | 4.9 | 41 | 4.7 | 37 | 5.1 | 0.65 (0.41–1.03) | 0.068 b |
| E-coli | 343 | 21.5 | 89 | 10.2 | 254 | 34.9 | 0.21 (0.16–0.27) | < 0.00 b |
| Age, years, median (IQR) | 28 (1–58) | 19 (1–55) | 37 (1–61) | 0.87 (0.79–0.97) | 0.007 a | |||
| Patient Sex | 0.4 a | |||||||
| Male | 859 | 53.7 | 475 | 54.5 | 384 | 52.8 | Reference | |
| Female | 739 | 46.3 | 396 | 45.5 | 343 | 47.2 | 1.07 (0.88–1.31) | |
| Hospital Type | < 0.001 a | |||||||
| General | 433 | 27.1 | 248 | 28.5 | 185 | 25.5 | Reference | |
| Medical | 242 | 15.1 | 109 | 12.5 | 133 | 18.3 | 0.61 (0.45–0.84) | 0.002 b |
| Obstetrics | 362 | 22.7 | 234 | 26.9 | 128 | 17.6 | 1.36 (1.12–1.82) | 0.03 b |
| Pediatrics | 208 | 13.0 | 126 | 14.5 | 82 | 11.3 | 1.15 (0.82–1.61) | 0.42 b |
| Surgical | 353 | 22.1 | 154 | 17.7 | 199 | 27.4 | 0.58 (0.43–0.77) | 0.001 b |
| Hospital Size | < 0.001 a | |||||||
| > =501 | 630 | 39.4 | 317 | 36.4 | 313 | 43.1 | Reference | |
| 201–500 | 602 | 37.7 | 307 | 35.3 | 295 | 40.6 | 1.03 (0.82–1.28) | 0.81 b |
| < =200 | 366 | 22.9 | 247 | 28.4 | 119 | 16.4 | 2.05 (1.57–2.68) | 0.001 b |
| ICU Category | < 0.001 a | |||||||
| Surgical CC | 335 | 21.0 | 166 | 19.1 | 169 | 23.3 | Reference | |
| Burn CC | 54 | 3.4 | 13 | 1.5 | 41 | 5.6 | 0.32 (0.17–0.62) | 0.001 b |
| Medical CC | 50 | 3.1 | 26 | 3.0 | 24 | 3.3 | 1.1 (0.61–2) | 0.75 b |
| Medical CC | 160 | 10.0 | 69 | 7.9 | 91 | 12.5 | 0.77 (0.53–1.13) | 0.18 b |
| Medical Neurological Care | 26 | 1.6 | 9 | 1.0 | 17 | 2.3 | 0.54 (0.23–1.24) | 0.15 b |
| Medical/Surgical CC | 169 | 10.6 | 103 | 11.8 | 66 | 9.1 | 1.59 (1.09–2.31) | 0.01 b |
| NICU | 419 | 26.2 | 288 | 33.1 | 131 | 18.0 | 2.24 (1.66–3.01) | 0.001 b |
| Neurosurgical Critical Care | 101 | 6.3 | 48 | 5.5 | 53 | 7.3 | 0.92 (0.59–1.44) | 0.72 b |
| Ped. Medical Critical Care | 77 | 4.8 | 40 | 4.6 | 37 | 5.1 | 1.1 (0.67–1.81) | 0.71 b |
| Pediatric Cardiothoracic CC | 20 | 1.3 | 17 | 2.0 | 3 | 0.4 | 5.77 (1.66–20.05) | 0.006 b |
| Prenatal/Surgical | 33 | 2.1 | 15 | 1.7 | 18 | 2.5 | 0.85 (0.41–1.74) | 0.65 b |
| Respiratory CC | 44 | 2.8 | 25 | 2.9 | 19 | 2.6 | 1.34 (0.71–2.52) | 0.36 b |
| Surgical Cardiothoracic CC | 29 | 1.8 | 8 | 0.9 | 21 | 2.9 | 0.39 (0.17–0.9) | 0.02 b |
| Trauma CC | 81 | 5.1 | 44 | 5.1 | 37 | 5.1 | 1.21 (0.74–1.97) | 0.44 b |
| Hospitalized prior to ICU admission | 0.008 a | |||||||
| No | 428 | 26.8 | 210 | 24.1 | 218 | 30.0 | Reference | |
| Yes | 1.170 | 73.2 | 661 | 75.9 | 509 | 70.0 | 1.35 (1.1–1.68) | |
| Surgical Procedure during hospital admission | < 0.001 a | |||||||
| No | 972 | 60.8 | 561 | 64.4 | 411 | 56.5 | Reference | |
| Yes | 626 | 39.2 | 310 | 35.6 | 316 | 43.5 | 0.72 (0.59–0.88) | |
| Mechanical ventilation | ||||||||
| No | 713 | 44.6 | 377 | 43.3 | 336 | 46.2 | Reference | 0.08a |
| Yes | 885 | 55.4 | 494 | 56.7 | 391 | 53.8 | 1.13 (0.92–1.37) | |
| Urinary Catheter | < 0.001 a | |||||||
| No | 579 | 36.2 | 374 | 42.9 | 205 | 28.2 | Reference | |
| Yes | 1.019 | 63.8 | 497 | 57.1 | 522 | 71.8 | 0.52 (0.42–0.64) | |
| Central Line | 0.89 a | |||||||
| No | 537 | 33.6 | 294 | 33.7 | 243 | 33.4 | Reference | |
| Yes | 1.061 | 66.4 | 577 | 66.3 | 484 | 66.6 | 0.99 (0.8–1.21) | |
| LOS in ICU prior to specimen collection, median, days, (IQR) | 7 (3–13) | 8 (3–15) | 5 (2–11) | 1.31 (1.1–2.1) | < 0.001 a | |||
| Patient outcome | < 0.001 a | |||||||
| Discharged/ Transferred | 690 | 43.2 | 339 | 38.9 | 351 | 48.3 | Reference | |
| Died | 908 | 56.8 | 532 | 61.1 | 376 | 51.7 | 1.46 (1.2–1.79) | |
a p-value generated using chi-square test or 2-tailed Fisher Exact test for categorical variables and Student t test or Mann–Whitney test, dependent on the validity of normality assumption for continuous variables
b p-values generated using the logistic regression for specific categories of non-dichotomous variables
c Include: Deep Tracheal Aspirate & BAL: Broncho alveolar lavage
d includes both hospital where Enterobacteriaceae HAI occurred and other hospitals