Table 2.
Clinical characteristic investigated for association with CS-GNB sepsis (Case group 2) in an adult clinical-surgical ICU
| Predictive Factors | Univariate analysis | Odds ratio | 95% CI | pt valor | |
|---|---|---|---|---|---|
| CS-GNB (n = 30) | Controls (n = 94) | ||||
| Demographic data | |||||
| Age in years, median (range) | 66 (27–82) | 62 (19–92) | 1.01 | 0.98–1.04 | 0.46 |
| Male sex, n (%) | 9 (30) | 46 (49) | 2.24 | 0.93–5.39 | 0.07 |
| Comorbiditiesa, n (%) | |||||
| Diabetes mellitusb | 15 (50) | 35 (37) | 1.69 | 0.74–3.86 | 0.22 |
| Renal failurec | 8 (27) | 38 (40) | 0.54 | 0.22–1.33 | 0.18 |
| Hemodialysisd | 3 (10) | 18 (19) | 0.47 | 0.13–1.72 | 0.25 |
| Chronic liver diseasee | 2 (7) | 9 (10) | 0.67 | 0.14–3.31 | 0.63 |
| Immunossupressive conditionf | 6 (20) | 11 (12) | 1.89 | 0.63–5.63 | 0.26 |
| Gastrointestinal disease | 9 (30) | 18 (19) | 1.81 | 0.71–4.61 | 0.21 |
| Geniturinary disease | 3 (10) | 9 (10) | 1.05 | 0.27–4.16 | 0.95 |
| Pulmonary disease | 7 (23) | 14 (15) | 1.74 | 0.63–4.82 | 0.29 |
| AIDS or chronic infectious disease | 2 (7) | 3 (3) | 2.17 | 0.35–13.62 | 0.41 |
| Surgeryg | 19 (63) | 46 (49) | 1.80 | 0.77–4.20 | 0.17 |
| Infection/Colonization by CR-GNB | 5 (17) | 7 (7) | 2.49 | 0.73–8.51 | 0.15 |
| Nosocomial diarrheah | 5 (17) | 6 (6) | 2.93 | 0.83–10.42 | 0.10 |
| Neutropeniai | 1 (3) | 4 (4) | 0.78 | 0.08–7.22 | 0.82 |
| Neoplasm | 17 (57) | 28 (30) | 3.08 | 1.32–7.19 | 0.009 |
| Infection | 10 (33) | 31 (33) | 0.92 | 0.39–2.21 | 0.86 |
| Prior ICU hospitalization, n (%) | 9 (30) | 5 (5) | 7.63 | 2.32–25.13 | 0.001 |
| Length of hospital stay (in days) | |||||
| Median (range) | 15 (0–142) | 10 (0–143) | 1.01 | 0.99–1.03 | 0.16 |
| ICU hospitalization reason, n (%) | |||||
| Elective or emergency surgery | 10 (33) | 28 (30) | 1.18 | 0.49–2.84 | 0.71 |
| Respiratory tract disease | 5 (17) | 14 (15) | 1.14 | 0.38–3.49 | 0.82 |
| Cardiovascular disease | 1 (3) | 8 (9) | 0.37 | 0.04–3.09 | 0.36 |
| Neurological disease | 3 (10) | 11 (12) | 0.84 | 0.22–3.23 | 0.80 |
| Gastrointestinal disease | 1(3) | 5 (5) | 0.61 | 0.07–5.47 | 0.66 |
| Renal pathology | 1 (3) | 11 (12) | 0.26 | 0.03–2.10 | 0.21 |
| Sepsis | 10 (33) | 30 (32) | 1.07 | 0.45–2.56 | 0.89 |
| Sepsis shock | 10 (33) | 27 (39) | 1.24 | 0.51–2.99 | 0.63 |
| Total SOFA scorej at ICU admission, | |||||
| Median (range) | 6 (1–18) | 6 (0–17) | 1.03 | 0.93–1.14 | 0.58 |
| SAPs 3 scorek, median (range) | 66 (27–97) | 64 (29–105) | 1.00 | 0.98–1.02 | 0.95 |
| Invasive devices, n (%) | |||||
| Mechanical ventilation | 18 (60) | 58 (62) | 0.97 | 0.42–2.25 | 0.95 |
| Central vascular catheter | 25 (83) | 81 (86) | 0.80 | 0.26–2.47 | 0.70 |
| Urinary catheter | 23 (77) | 72 (76) | 1.00 | 0.38–2.65 | 0.99 |
| Previous use of antimicrobials, n (%) | |||||
| Aminoglycosidesl | 2 (7) | 7 (7) | 0.89 | 0.17–4.52 | 0.89 |
| Cephalosporins, 3rd and 4rd generationsm | 5 (17) | 16 (17) | 0.98 | 0.32–2.93 | 0.96 |
| Carbapenemsn | 5 (17) | 32 (34) | 0.39 | 0.14–1.11 | 0.08 |
| Glycopeptideso, linezolid and tigecycline | 7 (23) | 35 (37) | 0.51 | 0.19–1.30 | 0.17 |
| Fluoroquinolonesp | 2 (7) | 15 (16) | 0.38 | 0.08–1.75 | 0.21 |
| Metronidazole | 7 (23) | 13 (14) | 1.90 | 0.68–5.31 | 0.22 |
| Piperacilin-tazobactam | 8 (27) | 21 (22) | 1.26 | 0.49–3.25 | 0.63 |
| Polymyxinsq | 3 (10) | 9 (10) | 1.05 | 0.27–4.16 | 0.95 |
| ATB with action for anaerobesr | 14 (47) | 59 (63) | 0.52 | 0.23–1.19 | 0.12 |
| Antifungal agentss | 3 (10) | 13 (14) | 0.69 | 0.18–2.61 | 0.59 |
Abbreviations: AIDS Acquired Immunodeficiency Syndrome, ATB antibiotic agents, CI Confidence interval, CR-GNB Carbapenem resistant Gram-negative bacilli, ICU Intensive Care Unit
aPrior comorbidities or conditions to investigated sepsis episode
bDiagnosis of diabetes mellitus requiring oral or injectable hypoglycemic drug
cCreatinine clearance < 30 cc/min
dRequired in the last 90 days
eLaboratory clinical evidence
fPrednisone > 10 mg for more than 50 days, corticosteroid for > 7 days or immunomodulatory agents (examples: monoclonal agents, methotrexate)
gIn the last 30 days
hNosocomial diarrhea (3 or more daily episodes of stool for 2 or more days)
iGranulocytes < 500 cells/mm3
jSequential Organ Failure Assessment score
kSimplified Acute Physiology Score III
lAmikacin and gentamicin
mCeftriaxone, ceftazidime and cefepime
nErtapenem, imipenem-cilastatin and meropenem
oDaptomycin, teicoplanin and vancomycin
pCiprofloxacin, levofloxacin, moxifloxacin
qPolymyxin B and colistin
rAntibacterial agents with action for anaerobes – Amoxicilin-clavulanate, ampicillin-sulbactam, piperacilin-tazobactam, clindamycin, ertapenem, imipenem, meropenem and metronidazole
sAmphotericin B family (standard, lipid complex or liposomal Amphotericin), echinocandins and azoles
tPearson’s chi-square test or Fisher’s exact test or Mann-Whitney-Wilcoxon U test, as required, and considering statistically significant p < 0.05