Table 4. Risk factors for 30-day mortality in patients with P. aeruginosa bacteremia.
| Characteristics | Non-survivor (n = 80) | Survivor (n = 215) | Univariable HR (95% CI) | P | Multivariable HR (95% CI) | P | ||
|---|---|---|---|---|---|---|---|---|
| Age ≥ 65 | 49 (61.3) | 128 (59.5) | 1.2 (0.8–1.9) | 0.418 | ||||
| Male sex | 59 (73.8) | 138 (64.2) | 0.7 (0.4–1.1) | 0.146 | ||||
| Underlying conditions | ||||||||
| Cardiovascular disease | 9 (11.3) | 21 (9.8) | 1.0 (0.5–1.9) | 0.892 | ||||
| Cerebrovascular accident | 5 (6.3) | 35 (16.3) | 0.3 (0.1–0.9) | 0.021 | ||||
| Chronic kidney disease | 10 (12.5) | 14 (6.5) | 1.5 (0.8–3.0) | 0.206 | ||||
| COPD or chronic lung disease | 2 (2.5) | 5 (2.3) | 1.0 (0.3–4.2) | 0.967 | ||||
| Dementia | 1 (1.3) | 13 (6.0) | 0.3 (0.1–2.5) | 0.294 | ||||
| Diabetes | 26 (32.5) | 58 (27.0) | 1.2 (0.8–2.0) | 0.384 | ||||
| Heart failure | 5 (6.3) | 9 (4.2) | 1.9 (0.7–4.6) | 0.183 | ||||
| Hypertension | 27 (33.8) | 85 (39.5) | 0.8 (0.5–1.2) | 0.270 | ||||
| Liver disease | 3 (3.8) | 9 (4.2) | 0.9 (0.3–2.9) | 0.882 | ||||
| Solid cancer | 44 (55.0) | 111 (51.6) | 1.1 (0.7–1.8) | 0.512 | ||||
| Hematologic malignancy | 16 (20.0) | 10 (4.7) | 2.8 (1.6–4.9) | < 0.001 | 2.3 (1.3–4.0) | 0.005 | ||
| Immunosuppressive therapy | 35 (43.8) | 67 (31.2) | 1.5 (0.9–2.3) | 0.071 | ||||
| Neutropenia | 28 (35.0) | 26 (12.1) | 2.7 (1.7–4.3) | < 0.001 | ||||
| Transplantation | 2 (2.5) | 5 (2.3) | 1.1 (0.3–4.3) | 0.931 | ||||
| CCI score ≥ 5 | 49 (61.3) | 121 (56.3) | 1.2 (0.8–1.9) | 0.439 | ||||
| Healthcare-associated infection | 65 (81.3) | 180 (83.7) | 0.8 (0.5–1.4) | 0.400 | ||||
| Previous surgery within 90 days | 20 (25.0) | 46 (21.4) | 1.1 (0.7–1.9) | 0.587 | ||||
| Any antibiotic exposure within 90 days | 65 (81.3) | 156 (72.6) | 1.3 (0.7–2.2) | 0.397 | ||||
| Colonization with MDROs | ||||||||
| CRE | 1 (1.3) | 3 (1.4) | 1.6 (0.2–11.6) | 0.638 | ||||
| ESBL | 4 (5.0) | 23 (10.7) | 0.5 (0.2–1.2) | 0.126 | ||||
| MRAB | 9 (11.3) | 7 (3.3) | 2.0 (1.0–4.1) | 0.049 | ||||
| MRSA | 2 (2.5) | 3 (1.4) | 1.2 (0.3–5.2) | 0.738 | ||||
| VRE | 9 (11.3) | 10 (4.7) | 1.8 (0.9–3.6) | 0.095 | ||||
| ICU stay | 25 (31.3) | 23 (10.7) | 2.3 (1.5–3.8) | < 0.001 | 1.7 (1.1–2.8) | 0.025 | ||
| Devices during time at risk | ||||||||
| Central venous catheter | 35 (43.8) | 72 (33.5) | 1.2 (0.8–1.9) | 0.342 | ||||
| Ventilator | 17 (21.3) | 12 (5.6) | 2.6 (1.5–4.5) | < 0.001 | ||||
| Indwelling urinary catheter | 34 (42.5) | 66 (30.7) | 1.4 (0.9–2.2) | 0.132 | ||||
| Antimicrobial resistance | ||||||||
| CRPA | 22 (27.5) | 51 (23.7) | 1.1 (0.7–1.8) | 0.774 | ||||
| MDRPA | 28 (35.0) | 78 (36.3) | 0.9 (0.6–1.4) | 0.669 | ||||
| XDRPA | 14 (17.5) | 33 (15.3) | 1.0 (0.6–1.8) | 0.904 | ||||
| Polymicrobial infection | 21 (26.3) | 29 (13.5) | 1.8 (1.1–3.0) | 0.017 | 1.8 (1.1–3.1) | 0.032 | ||
| Shock on the first day of bacteremia | 56 (70.0) | 28 (13.0) | 8.5 (5.3–13.8) | < 0.001 | 6.4 (3.8–10.7) | < 0.001 | ||
| Primary site of infection | ||||||||
| Hepato-biliary tract | 15 (18.8) | 64 (29.8) | 0.6 (0.4–1.1) | 0.096 | ||||
| Gastrointestinal tract | 7 (8.8) | 12 (5.6) | 1.2 (0.7–3.3) | 0.283 | ||||
| Respiratory tract | 35 (43.8) | 34 (15.8) | 3.4 (2.2–5.2) | < 0.001 | 1.7 (1.0–2.8) | 0.034 | ||
| Urinary tract | 7 (8.8) | 43 (20.0) | 0.4 (0.2–0.9) | 0.023 | ||||
| Central venous catheter | 7 (8.8) | 32 (14.9) | 0.5 (0.2–1.1) | 0.088 | ||||
| Skin and soft tissue | 2 (2.5) | 10 (4.7) | 0.5 (0.1–2.1) | 0.372 | ||||
| Surgical site | 1 (1.3) | 1 (0.5) | 3.3 (0.5–23.7) | 0.239 | ||||
| Primary bloodstream | 6 (7.5) | 19 (8.8) | 0.9 (0.4–2.1) | 0.824 | ||||
| Invasive drainage procedures | 9 (11.3) | 53 (24.7) | 0.5 (0.2–0.9) | 0.024 | ||||
| Active antimicrobial therapy | 67 (83.8) | 177 (82.3) | 0.7 (0.4–1.3) | 0.292 | ||||
| Concordant empirical antimicrobial therapy | 56 (70.0) | 125 (58.1) | 1.4 (0.9–2.3) | 0.141 | ||||
| Single antibiotics | 42 (52.5) | 109 (50.7) | ||||||
| Aminoglycoside | 0 (0) | 6 (2.8) | ||||||
| Anti-pseudomonal cephalosporine | 12 (15.0) | 23 (10.7) | ||||||
| Anti-pseudomonal penicillin | 5 (6.3) | 39 (18.1) | ||||||
| Carbapenem | 17 (21.3) | 31 (14.4) | ||||||
| Fluoroquinolone | 1 (1.3) | 8 (3.7) | ||||||
| Colistin | 7 (8.8) | 2 (0.9) | ||||||
| Combination antibiotics | 14 (17.5) | 16 (7.4) | ||||||
| Anti-pseudomonal cephalosporine + aminoglycoside | 1 (1.3) | 2 (0.9) | ||||||
| Anti-pseudomonal cephalosporine + fluoroquinolone | 1 (1.3) | 1 (0.5) | ||||||
| Anti-pseudomonal penicillin + fluoroquinolone | 9 (11.3) | 12 (5.6) | ||||||
| Carbapenem + aminoglycoside | 2 (2.5) | 0 (0) | ||||||
| Carbapenem + fluoroquinolone | 1 (1.3) | 1 (0.5) | ||||||
Values are presented as number (%).
HR = hazard ratio, CI = confidence interval, COPD = chronic obstructive pulmonary disease, CCI = Charlson comorbidity index, MDRO = multidrug-resistant organism, CRE = carbapenem-resistant Enterobacteriaceae, ESBL = extended-spectrum beta-lactamase-producing bacteria, MRAB = multi-drug resistant Acinetobacter baumannii, MRSA = methicillin-resistant Staphylococcus aureus, VRE = vancomycin-resistant Enterococcus, ICU = intensive care unit, CRPA = carbapenem-resistant P. aeruginosa, MDRPA = multidrug-resistant P. aeruginosa, XDRPA = extensively drug-resistant P. aeruginosa.