Table 1. Comparison of clinical characteristics and outcome of ESBL-producing and non-ESBL-producing Klebsiella pneumoniae bacteremia (n = 278).
| Characteristics | Total (n =278) | Non-ESBL (n = 228) | ESBL (n = 50) | P-value | |
|---|---|---|---|---|---|
| Age (mean, SD) | 57.7, 14.0 | 55.8, 14.6 | 0.41 | ||
| Male gender (%) | 166 | 140 (61.4) | 26 (52.0) | 0.27 | |
| Type of cancer | |||||
| Solid tumors (%) | 155 | 125 (54.8) | 30 (50.0) | 0.53 | |
| Hematologic malignancies (%) | 132 | 111 (48.7) | 21 (42.0) | 0.44 | |
| Comorbidities | |||||
| Diabetes mellitus (%) | 76 | 59 (25.9) | 17 (34.0) | 0.29 | |
| Chronic liver disease (%) | 21 | 18 (7.9) | 3 (6.0) | 0.78 | |
| Hematopoietic stem cell transplant (%) | 19 | 17 (7.5) | 2 (4.0) | 0.54 | |
| Cardiovascular disease (%) | 17 | 14 (6.1) | 3 (6.0) | 1.00 | |
| Chronic renal disease (%) | 5 | 5 (2.2) | 0 (0.0) | 0.59 | |
| Neurologic disease (%) | 4 | 4 (1.8) | 0 (0.0) | 1.00 | |
| Chronic pulmonary disease (%) | 2 | 1 (0.0) | 1 (2.0) | 0.33 | |
| Rapidly fatal disease (%) | 79 | 65 (28.5) | 14 (28.0) | 1.00 | |
| Charlson score (mean, SD) | 4.96, 2.43 | 5.16, 2.49 | 0.53 | ||
| Risk factors | |||||
| Neutropenia (%) | 144 | 122 (53.5) | 22 (44.0) | 0.27 | |
| Corticosteroid use (%) | 7 | 4 (1.8) | 3 (6.0) | 0.11 | |
| Immunosuppressant use (%) | 25 | 20 (8.8) | 5 (10.0) | 0.78 | |
| Foley catheter (%) | 64 | 49 (21.5) | 15 (30.0) | 0.20 | |
| Central venous catheter (%) | 146 | 117 (51.3) | 29 (58.0) | 0.44 | |
| Percutaneous drainage catheter (%) | 28 | 15 (6.6) | 13 (26.0) | <0.001 | |
| Nasogastric tube (%) | 12 | 6 (2.6) | 6 (12.0) | 0.01 | |
| Invasive procedure within 7 d (%) | 27 | 23 (10.1) | 4 (8.0) | 0.80 | |
| Surgery within 90 d (%) | 32 | 21 (9.2) | 11 (22.0) | 0.02 | |
| Hemodialysis (%) | 5 | 3 (1.3) | 2 (4.0) | 0.22 | |
| Mechanical ventilation (%) | 6 | 4 (1.8) | 2 (4.0) | 0.30 | |
| Length of hospital stay (d), (mean, SD) | 23.0, 27.2 | 31.0, 35.9 | 0.08 | ||
| Hospital-acquired infection (%) | 149 | 120 (52.9) | 29 (58.0) | 0.53 | |
| Severity of infection | |||||
| Pitt bacteremia score (mean, SD) | 1.76, 1.86 | 1.46, 1.58 | 0.32 | ||
| Prior antibiotics exposure (n = 275) | 219 | 172 (75.4) | 47 (94.0) | 0.001 | |
| Beta-lactam/beta-lactamase inhibitors (%) | 95 | 71 (31.1) | 24 (48.0) | 0.32 | |
| First- or second-generation cephalosporins (%) | 50 | 41 (18.0) | 9 (18.0) | 0.56 | |
| Third-generation cephalosporins (%) | 83 | 58 (25.4) | 25 (50.0) | 0.03 | |
| Fourth-generation cephalosporins (%) | 103 | 83 (36.4) | 20 (40.0) | 0.51 | |
| Aminoglycosides (%) | 4 | 2 (0.9) | 2 (4.0) | 0.21 | |
| Fluoroquinolones (%) | 86 | 69 (30.3) | 17 (34.0) | 0.62 | |
| Carbapenem (%) | 87 | 64 (28.1) | 23 (46.0) | 0.19 | |
| Glycopeptides (%) | 103 | 74 (32.5) | 29 (58.0) | 0.04 | |
| Metronidazole (%) | 72 | 48 (21.1) | 24 (48.0) | 0.01 | |
| Trimethoprim-sulfamethoxazole (%) | 49 | 37 (16.2) | 12 (24.0) | 0.70 | |
| Outcome measures (n = 278) | |||||
| Treatment failure at 72 hr (%) | 58 | 43 (18.9) | 15 (30.0) | 0.09 | |
| 14-day mortality (%) | 23 | 15 (6.6) | 8 (16.0) | 0.04 | |
| 30-day mortality (%) | 46 | 35 (15.4) | 11 (22.0) | 0.20 | |
| ICU care (%) | 75 | 61 (26.8) | 14 (28.0) | 0.86 | |
| Acute kidney injury (%) | 30 | 21 (9.2) | 9 (18.0) | 0.08 | |
| Mechanical ventilation (%) | 33 | 27 (11.8) | 6 (12.0) | 1.00 | |
| Hospital stay (d) (mean, SD) | 23.0, 27.2 | 31.0, 35.9 | 0.04 | ||
| Time to death (d) (mean, SD) | 94.4, 120.7 | 67.6, 106.8 | 0.09 | ||
ESBL, extended-spectrum beta-lactamase; SD, standard deviation; d, days; hr, hours.