TABLE 1.
Comparison of clinical characteristics and treatment between deceased and surviving patients with CRE-BSI
| Variablea | Mean no. of patients ± SD or indicated value |
P valueb | ||
|---|---|---|---|---|
| Total (n = 187) | Deceased (n = 78) | Survived (n = 109) | ||
| Mean age (yr) | 67.0 ± 14.5 | 66.7 ± 15.2 | 67.3 ± 14.0 | 0.797 |
| Male | 115 (61.5) | 47 (60.3) | 68 (62.4) | 0.468 |
| Comorbidities | ||||
| Cardiovascular disease | 49 (26.2) | 22 (28.2) | 27 (24.8) | 0.598 |
| Cerebrovascular disease | 40 (21.4) | 20 (25.6) | 20 (18.3) | 0.230 |
| COPD | 37 (19.8) | 16 (20.5) | 21 (19.3) | 0.833 |
| Diabetes mellitus | 34 (18.2) | 12 (15.4) | 22 (20.2) | 0.543 |
| Chronic kidney disease | 11 (5.9) | 6 (7.7) | 5 (4.6) | 0.566 |
| Immunocompromised statusc | 52 (27.8) | 33 (42.3) | 19 (17.4) | <0.001 |
| Infected by isolate with meropenem MIC of ≥8 mg/literc | 141 (75.4) | 64 (82.1) | 77 (70.6) | 0.074 |
| Illness severity at time of BSI | ||||
| APACHE II scorec | 12.0 (9.0, 15.0) | 13.0 (12.0, 16.3) | 10.0 (8.0, 14.0) | <0.001 |
| Pitt scorec | 2.0 (1.0, 3.0) | 3.0 (2.0, 5.0) | 1.5 (1.0, 2.0) | <0.001 |
| Possible source of BSI | ||||
| CVC-related infection | 53 (28.3) | 20 (25.6) | 33 (30.3) | 0.488 |
| LRT infectionc | 45 (24.1) | 24 (30.8) | 21 (19.3) | 0.066 |
| Abdominal infection | 43 (23.0) | 15 (19.2) | 28 (25.7) | 0.301 |
| Urinary infection | 34 (18.2) | 10 (12.8) | 24 (22.0) | 0.108 |
| Primary BSIc | 12 (6.4) | 9 (11.5) | 3 (2.8) | 0.016 |
| Source control of infection | 71 (38.0) | 24 (30.8) | 47 (43.1) | 0.086 |
| Prior exposure to antibiotics within 30 days | ||||
| Cephalosporins | 80 (42.8) | 31 (39.7) | 49 (45.0) | 0.478 |
| Carbapenems | 49 (26.2) | 23 (29.5) | 26 (23.9) | 0.388 |
| Quinolones | 32 (17.1) | 12 (15.4) | 20 (18.3) | 0.596 |
| Aminoglycosides | 21 (11.2) | 9 (11.5) | 12 (11.0) | 0.910 |
| Tigecycline | 5 (2.7) | 2 (2.6) | 3 (2.8) | 1.000 |
| Prior invasive procedures within 30 days | ||||
| Central venous catheterization | 65 (34.8) | 24 (30.8) | 41 (37.6) | 0.332 |
| Urinary catheterization | 41 (21.9) | 15 (19.2) | 26 (23.9) | 0.451 |
| Gastric catheterization | 25 (13.4) | 7 (9.0) | 18 (16.5) | 0.135 |
| Mechanical ventilation | 7 (3.7) | 1 (1.3) | 6 (5.5) | 0.267 |
| Epidemiology | ||||
| Community-onset healthcare-associated infection | 8 (4.3) | 4 (5.1) | 4 (3.7) | 0.905 |
| ICU at time of BSI onsetc | 62 (33.2) | 33 (42.3) | 29 (26.6) | 0.025 |
| Median no. of days from BSI onset to ICU admission (IQR) | 14.0 (8.0, 19.0) | 14.0 (8.5, 19.0) | 14.0 (8.0, 19.5) | 0.961 |
| Appropriate empirical therapyc | 26 (13.9) | 7 (9.0) | 19 (17.4) | 0.099 |
| Duration from BSI onset to appropriate therapy of ≥24 h | 7 (3.7) | 5 (6.4) | 2 (1.8) | 0.217 |
| Combination therapy | 7 (3.7) | 2 (2.6) | 5 (4.6) | 0.963 |
| Definitive therapy | ||||
| Combination therapyc | 137 (73.3) | 52 (66.7) | 85 (78.0) | 0.085 |
| Median no. of days of appropriate antimicrobial therapy (IQR)c | 10.0 (7.5–13.5) | 10.0 (5.0–17.3) | 12.0 (8.5–18.0) | 0.049 |
CRE, carbapenem-resistant Enterobacterales; BSI, bloodstream infection; COPD, chronic obstructive pulmonary disease; APACHE II, acute physiology and chronic health evaluation; CVC, central venous catheter; LRT, lower respiratory tract; ICU, intensive care unit; IQR, interquartile range. Immunocompromised status included primary immune deficiency diseases, active malignancy, HIV infection with a CD4 T-lymphocyte count of <200 cells/ml or percentage of <14%, immunosuppressive therapy, solid organ transplantation, hematopoietic stem cell transplantation, and splenectomy.
Values in boldface are P values of <0.05, which represented significant differences between deceased and surviving patients.
This variable was among the candidates that were entered into the multivariate logistic regression model.