Table 4.
Comparison of patients who died and those who did not within 30 days from CRE superinfection
| Characteristic | Survivors (N = 82) | Non-survivors (N = 41) | P valuea |
|---|---|---|---|
| Demographics | |||
| Age, years, median (IQR) | 65.5 (56–74) | 70 (60.5–76.5) | 0.131 |
| Male sex, n (%) | 62 (75.6) | 33 (80.5) | 0.543 |
| Comorbidities, n (%) | |||
| Cardiovascular disease | 29 (35.4) | 19 (46.3) | 0.239 |
| Cancer | 9 (11) | 11 (26.8) | 0.104 |
| Type 2 diabetes | 17 (20.7) | 12 (29.3) | 0.293 |
| COPD | 10 (12.2) | 5 (12.2) | 1 |
| Chronic renal disease | 10 (12.2) | 6 (14.6) | 0.705 |
| Charlson Comorbidity Score, median (IQR) | 3 (1–4) | 3 (1–4) | 0.314 |
| Clinical features on admission | |||
| PaO2/FiO2 ratio, median (IQR) | 180 (123–277) | 151 (89–223) | 0.075 |
| Thrombocytopenia, n (%) | 20 (24.4) | 18 (43.9) | 0.027 |
| Lymphocytes < 0.8×109/L, n (%) | 34 (41.5) | 29 (70.7) | 0.002 |
| Treatments against COVID-19, n (%) | |||
| Corticosteroids | 48 (58.5) | 27 (65.9) | 0.433 |
| Remdesivir | 19 (23.2) | 10 (24.4) | 0.584 |
| Immunomodulant drugs | 23 (28) | 10 (24.4) | 0.985 |
| Ward of hospitalization at time of CRE infection, n (%) | 0.001 | ||
| ICU | 46 (56.1) | 35 (85.4) | |
| Medical ward | 36 (43.9) | 6 (14.6) | |
| Days from admission to superinfection, median (IQR) | 17 (11–28) | 15 (7–21) | 0.255 |
| Mechanism of resistance, n (%) | |||
| KPC | 40 (48.8) | 23 (56.1) | 0.090 |
| MBL | 40 (48.8) | 14 (34.1) | |
| OXA-48 | 2 (2.4) | 4 (9.8) | |
| Oxygen support at time of CRE infection, n (%) | |||
| High flow nasal cannula | 3 (3.7) | 0 (0) | 0.550 |
| Non-invasive ventilation | 9 (11) | 3 (7.3) | 0.749 |
| Invasive mechanical ventilation | 37 (45.1) | 32 (78) | <0.001 |
| CRE-rectal colonizationb | 53/74 (71.6) | 27/32 (84.4) | 0.161 |
| Type of infection, n (%) | 0.005 | ||
| UTI | 24 (29.3) | 4 (9.8) | |
| BSI | 40 (48.8) | 24 (58.5) | |
| VAP/HAP | 16 (19.5) | 12 (29.3) | |
| Others | 2 (2.4) | 1 (2.4) | |
| Site of infection, n (%) | 0.050 | ||
| Urinary tract | 29 (35.4) | 9 (21.9) | |
| Catheter-related bacteraemia | 30 (36.6) | 10 (24.4) | |
| Respiratory tract | 21 (25.6) | 20 (48.8) | |
| Other | 2 (2.4) | 2 (4.9) | |
| SOFA, median (IQR) at the time of CRE infection | 6 [3–7] | 11 [5–13] | 0.007 |
| Septic shock at the time of CRE infection, n (%) | 17 (20.7) | 18 (43.9) | 0.007 |
| Pitt bacteraemia score, median (IQR) at the time of CRE infection | 2 (2–2.25) | 3 (2–4) | 0.003 |
| Days from admission to superinfection, median (IQR) | 17 (12–29) | 16 (7–22) | 0.330 |
| Days from admission to superinfection, n (%) | 0.129 | ||
| 3–14 days | 28 (34.1) | 19 (46.3) | |
| 15–30 days | 34 (41.5) | 18 (43.9) | |
| >30 days | 20 (24.4) | 4 (9.8) | |
| Appropriate empirical therapy | 41 (50) | 29 (70.7) | 0.029 |
ICU, intensive care unit; COPD, chronic obstructive pulmonary disease; CRE, carbapenem-resistant Enterobacterales; SOFA, Sequential Organ Failure Assessment; VAP/HAP, ventilator-acquired pneumonia/hospital-acquired pneumonia; UTI, urinary tract infection.
a
Bold indicates statistical significance (P < 0.05).
b
Data on rectal colonization was available in 106/123 patients.