Table 3.
Comparison of characteristics by 30-day mortality
| Survival (n = 56) | Death (n = 9) | Odds ratio (95% CI) | p-value | Adjusted odds ratio (95% CI) | p-value | |
|---|---|---|---|---|---|---|
| Demographics | ||||||
| Age (year) | 59 (53, 70) | 64 (52, 71) | 0.864 | |||
| Male sex | 39 (69.6%) | 7 (77.8%) | 1.53 (0.29–8.12) | > 0.999 | ||
| Body mass index (kg/m2) | 22.1 (20.1, 24.1) | 22.4 (18.7, 23.3) | 0.488 | |||
| Comorbidities | ||||||
| Diabetes mellitus | 5 (8.9%) | 3 (33.3%) | 5.10 (0.97–26.89) | 0.074 | 5.58 (0.90–38.55) | 0.064 |
| Liver cirrhosis | 5 (8.9%) | 0 (0.0%) | N/A | > 0.999 | ||
| Solid organ transplant | 7 (12.5%) | 1 (11.1%) | 0.88 (0.09–8.09) | > 0.999 | ||
| Solid cancer | 33 (58.9%) | 3 (33.3%) | 0.35 (0.07–1.54) | 0.278 | ||
| Hematologic cancer | 26 (46.4%) | 2 (22.2%) | 0.33 (0.06–1.73) | 0.280 | ||
| Charlson comorbidity index | 5 (3, 6) | 8 (3, 9) | 0.276 | |||
| Source of bacteremia | ||||||
| Intraabdominal infection | 29 (51.8%) | 4 (44.4%) | 1.34 (0.33–5.53) | 0.733 | ||
| Urinary tract infection | 4 (7.1%) | 0 (0.0%) | N/A | > 0.999 | ||
| Primary bacteremia | 19 (33.9%) | 4 (44.4%) | 1.56 (0.37–6.49) | 0.709 | ||
| Others | 4 (7.1%) | 1 (11.1%) | 1.63 (0.16–16.44) | 0.536 | ||
| Severity of infection | ||||||
| Pitt bacteremia score | 0 (0, 1) | 2 (0, 2) | 0.134 | |||
| ICU admission at the onset of bacteremia | 2 (3.7%) | 0 (0.0%) | N/A | > 0.999 | ||
| AKI at the onset of bacteremia | 5 (8.9%) | 3 (33.3%) | 5.10 (0.97–26.89) | 0.074 | ||
| Laboratory test results | ||||||
| Neutropenia | 21 (37.5%) | 0 (0.0%) | N/A | 0.026 | ||
| White blood cell count (× 103/μL) | 3.00 (0.22, 10.31) | 11.08 (7.97, 13.68) | 0.024 | 1.04 (1.00–1.16) | 0.072 | |
| C-reactive protein (mg/dL) | 8.9 (5.4, 12.9) | 8.9 (4.9, 12.5) | 0.643 | |||
| Creatinine clearance (mL/min) | 96.4 (64.8, 125.6) | 98.6 (57.8, 106.4) | 0.857 | |||
| Factors related to vancomycin treatment | ||||||
| Use of vancomycin loading dose | 44 (78.6%) | 7 (77.8%) | 0.95 (0.18–5.21) | > 0.999 | ||
| Average AUC24 during initial 72 h (mg/L) | 531 (435, 603) | 616 (562, 706) | 0.016 | |||
| Average AUC24/MIC during initial 72 h | 564 (435, 658) | 616 (561, 1053) | 0.043 | |||
| Average AUC24/MIC ≥ 504 | 34 (60.7%) | 9 (100.0%) | 0.023 | |||
| Average trough during initial 72 h (μg/mL) | 12.52 (10.14, 15.14) | 15.88 (14.94, 17.86) | 0.013 | |||
| Average trough ≥ 13.94 μg/mL | 20 (35.7%) | 8 (88.9%) | 14.40 (1.68–123.56) | 0.004 | 8.40 (1.60–86.62) | 0.010 |
| Duration of vancomycin treatment (days) | 11 (8, 14) | 7 (7, 10) | 0.034 | |||
| Nephrotoxicity | 10 (17.9%) | 4 (44.4%) | 3.68 (0.84–16.20) | 0.091 | ||
| Other factors potentially related to prognosis | ||||||
| Bloodstream infection due to other microorganism(s) within a month | 24 (42.9%) | 3 (33.3%) | 0.67 (0.15–2.94) | 0.724 | ||
| Source control indicated | 21 (37.5%) | 5 (55.6%) | 2.08 (0.50–8.63) | 0.465 | ||
| Source control performed (n = 26) | 10 (47.6%) | 2 (40.0%) | 0.73 (0.10–5.33) | > 0.999 | ||
| Consult with infectious disease expert | 17 (30.4%) | 3 (33.3%) | 1.15 (0.26–5.13) | > 0.999 | ||
Logistic regression with backward selection (threshold p < 0.10) was used for the multivariable model
CI, confidence interval; ICU, intensive care unit; AKI, acute kidney injury; AUC24, area under the curve during 24 h; MIC, minimum inhibitory concentration; N/A, not applicable
*Amikacin was the only aminoglycoside in all patients who received aminoglycoside concurrently with vancomycin