Table 4.
Analysis of Risk Factors of CR-GNB Clearance Failure After PMB Treatment
| Risk Factors | Success N=136 | Failure N=209 | P | Binary Logistic Regression | |||
|---|---|---|---|---|---|---|---|
| B | OR | 95% CI | P | ||||
| Sex (male) | 96 (70.59%) | 148 (70.80%) | 0.964 | ||||
| Age (years) | 56 (46.25–70.00) | 58 (48–71) | 0.460 | ||||
| Mechanical ventilation | 94 (69.12%) | 153 (73.20%) | 0.411 | ||||
| Vasoactive agents | 63 (46.32%) | 115 (55.00%) | 0.114 | ||||
| Admission to ICU | 94 (69.12%) | 152 (72.70%) | 0.469 | ||||
| APACHE II score | 20 (14.00–23.50) | 20 (15–26) | 0.387 | ||||
| Primary disease | |||||||
| Cardiovascular and cerebrovascular diseases | 84 (61.76%) | 138 (66.00%) | 0.419 | ||||
| Respiratory diseases | 110 (80.88%) | 175 (83.70%) | 0.495 | ||||
| Kidney disease | 56 (41.17%) | 102 (48.80%) | 0.165 | ||||
| Liver disease | 33 (24.26%) | 53 (25.40%) | 0.818 | ||||
| Diseases of digestive system | 29 (21.32%) | 42 (20.10%) | 0.783 | ||||
| Nutritional diseases | 27 (19.85%) | 26 (12.40%) | 0.062 | −0.576 | 0.562 | 0.299–1.057 | 0.074 |
| Diabetes mellitus | 22 (16.18%) | 41 (19.60%) | 0.419 | ||||
| Infection site | |||||||
| Respiratory tract | 120 (88.23%) | 188 (90.00%) | 0.615 | ||||
| Blood | 33 (24.26%) | 52 (24.90%) | 0.897 | ||||
| Urinary system | 21 (15.44%) | 16 (7.70%) | 0.022 | −0.956 | 0.384 | 0.180–0.821 | 0.014 |
| Intracranial | 11 (8.09%) | 10 (4.80%) | 0.210 | ||||
| Digestive tract | 15 (11.03%) | 23 (11.00%) | 0.994 | ||||
| Wound | 6 (4.41%) | 9 (4.30%) | 0.963 | ||||
| Pathogenic bacteria (CR-GNB) | |||||||
| Acinetobacter baumannii | 79 (58.08%) | 91 (43.50%) | 0.008 | −0.597 | 0.551 | 0.323–0.938 | 0.028 |
| Klebsiella pneumoniae | 39 (28.70%) | 70 (33.50%) | 0.347 | ||||
| Pseudomonas aeruginosa | 15 (11.00%) | 45 (21.50%) | 0.012 | 0.600 | 1.822 | 0.866–3.836 | 0.114 |
| E. coli or E. cloacae | 3 (2.20%) | 3 (1.40%) | 0.684 | ||||
| Multiple site infection | 72 (52.94%) | 110 (52.88%) | 0.955 | ||||
| Antimicrobial susceptibility | |||||||
| Tigecycline MIC >2 (mg/L) | 89 (65.44%) | 120 (57.69%) | 0.787 | ||||
| Polymyxin MIC >2 (mg/L) | 2 (1.50%) | 7 (3.40%) | 0.456 | ||||
| Previous carbapenem treatment time (days) | 3 (0–12) | 5 (0–12) | 0.232 | ||||
| Previous tigecycline treatment time (days) | 0 (0–7) | 0 (0–7) | 0.145 | ||||
| Previous use of carbapenem | 84 (61.80%) | 142 (67.90%) | 0.238 | ||||
| Previous use of tigecycline | 50 (36.80%) | 99 (47.40%) | 0.052 | 0.313 | 1.368 | 0.844–2.218 | 0.204 |
| Preemptive therapy | 114 (83.80%) | 148 (70.80%) | 0.006 | −0.294 | 0.745 | 0.328–1.692 | 0.482 |
| Delay days of PMB use (days) | 0 (0–1) | 1 (0–4) | 0.015 | 0.058 | 1.060 | 0.983–1.143 | 0.127 |
| Loading dose≥2.0mg/kg | 31 (22.79%) | 48 (23.00%) | 0.970 | ||||
| Maintenance dose≥1.25mg/kg q12h | 15 (11.00%) | 27 (12.90%) | 0.600 | ||||
| Use loading dose | 66 (48.53%) | 88 (42.10%) | 0.241 | ||||
| Maintenance dose (mg/kg q12h) | 0.83 (0.83–1.00) | 0.83 (0.83–1.00) | 0.833 | ||||
| Loading dose (mg/kg) | 1.20 (0.83–1.67) | 1 (0.83–1.67) | 0.402 | ||||
| Cumulative dose (mg) | 1150 (700–1550) | 950 (550–1350) | 0.015 | 0.000 | 1.000 | 1.000–1.001 | 0.296 |
| Treatment duration time (days) | 12 (7.50–15.50) | 10 (6–14) | 0.006 | −0.068 | 0.935 | 0.873–1.000 | 0.051 |
| Combination of drugs | |||||||
| Tigecycline | 44 (32.35%) | 76 (36.40%) | 0.445 | ||||
| Carbapenems | 38 (27.94%) | 58 (27.80%) | 0.969 | ||||
| β-lactams | 49 (36.03%) | 67 (32.10%) | 0.445 | ||||
| Glycopeptides | 21 (15.44%) | 32 (15.30%) | 0.974 | ||||
| Others | 15 (11.03%) | 29 (13.90%) | 0.439 | ||||
Notes: Bold font indicates data with significant differences. B indicates regression coefficient.
Abbreviations: PMB, Polymyxin B; ICU, Intensive Care Unit; APACHE II, Acute Physiology and Chronic Health Evaluation II; CR-GNB, Carbapenem-resistant Gram-negative Bacteria; MIC, minimum inhibitory concentration.