Table 3.
Infection-related characteristics according to the empirical antimicrobial treatment strategy used
| Total | Broad-spectrum antimicrobial group | Narrow-spectrum antimicrobial group | p value | |
|---|---|---|---|---|
| Health care exposure (N = 244) | 106 (43.4%) | 76 (49.0%) | 30 (33.7%) | 0.023 |
| Hospitalization for ≥ 2 days in the 12 months prior to study inclusion | 56 (23.0%) | 38 (24.5%) | 18 (20.2%) | 0.528 |
| Antimicrobial exposure in the 3 months prior to study inclusion | 45 (18.4%) | 35 (22.6%) | 10 (11.2%) | 0.039 |
| Resident in a nursing home or long-term care facility | 19 (7.8%) | 13 (8.4%) | 6 (6.7%) | 0.805 |
| Receiving invasive procedures at homea | 17 (7.0%) | 9 (5.8%) | 8 (9.0%) | 0.434 |
| Chronic hemodialysisa | 11 (4.5%) | 8 (5.2%) | 3 (3.4%) | 0.750 |
| Immunosuppressed status (N = 248)b | 34 (13.7%) | 25 (15.9%) | 9 (9.9%) | 0.250 |
| Baseline MDR colonization (N = 253)c | 22 (8.7%) | 18 (11.3%) | 4 (4.3%) | 0.065 |
| Source of infectiond | ||||
| Respiratory tract | 89 (35.0%) | 49 (30.8%) | 40 (42.1%) | 0.078 |
| Gastrointestinal tract | 59 (23.2%) | 45 (28.3%) | 14 (14.7%) | 0.014 |
| Skin soft tissue | 24 (9.4%) | 14 (8.8%) | 10 (10.5%) | 0.663 |
| Genitourinary tract | 24 (9.4%) | 12 (7.5%) | 12 (12.6%) | 0.190 |
| Catheter-related | 9 (3.5%) | 6 (3.8%) | 3 (3.2%) | > 0.999 |
| Other focus | 13 (5.1%) | 9 (5.7%) | 4 (4.2%) | 0.772 |
| Unknown | 41 (16.1%) | 24 (15.1%) | 17 (17.9%) | 0.599 |
| Septic shock | 68 (26.8%) | 51 (32.1%) | 17 (17.9%) | 0.019 |
| SOFA day 0 | 7 (4–10) | 8 (5–11) | 6 (3–9) | 0.001 |
| SOFA day 3 | 5 (3–8) | 6 (3–9) | 4 (2–6) | < 0.001 |
| Microbiologically documented infection | 126 (49.6%) | 82 (51.6%) | 44 (46.3%) | 0.439 |
| Polymicrobial infection | 35 (13.8%) | 24 (15.1%) | 11 (11.6%) | 0.459 |
| Bacteremia | 61 (24.0%) | 43 (27.0%) | 18 (18.9%) | 0.172 |
| Need for source control | 75 (29.5%) | 54 (34.0%) | 21 (22.1%) | 0.048 |
| Effectiveness of source control on day 3e | 63 (84.0%) | 43 (79.6%) | 20 (95.2%) | 0.952 |
| From hospital admission to empirical antimicrobial initiation | 1 (1–4) | 1 (1–10) | 1 (1–1) | < 0.001 |
| From ICU admission to empirical antimicrobial initiation | 1 (0–1) | 1 (1–1) | 1 (1–1) | 0.202 |
Results are shown as n (%) or median (IQR) where applicable
SOFA Sequential Organ Failure Assessment
aIn the last 30 days prior to study inclusion
bThe presence of congenital immunodeficiency, neutropenia (absolute neutrophil count < 1000 cells/μL), patient receiving corticosteroid treatment (prednisolone or equivalent > 0.5 mg/kg/day for > 3 months prior to study inclusion), solid organ transplant patient receiving immunosuppressive treatment, bone marrow transplant patient receiving immunosuppressive treatment, administration of chemotherapy in the year prior to enrollment, radiotherapy in the year prior to enrollment, autoimmune disease with the use of an immunosuppressive treatment, or human immunodeficiency virus (HIV) infection in the subgroup of patients with data available
cDefined as all MDR pathogens presumed to be already present on ICU admission, within 1 year prior to study inclusion combined with all MDR pathogens not present on ICU admission and detected before day 2 (day 0 is considered start date of the empiric antimicrobial therapy) in the subgroup of patients with data available
dPatients could have multiple infection diagnoses
en = number of patients who need source control