Table 2.
Association of 30 Days Mortality With Patient Characteristics, Site of Infection and Hospital Location With Infections Secondary to MDR P. aeruginosa From Hamad Medical Corporation Between October 2014 and September 2017
| Year 1 | Year 2 | Year 3 | Sum of 3 Years | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Characteristics | 30-Day Mortality | No Mortality | Total | % of 30-Day Mortality | 30-Day Mortality | No Mortality | Total | % of 30-Day Mortality | 30-Day Mortality | No Mortality | Total | % of 30-Day Mortality | 30-Day Mortality | No Mortality | Total | % of 30-Day Mortality | P Value |
| Age group | |||||||||||||||||
| Pediatric, <14 y | 0 | 12 | 12 | 0 | 0 | 10 | 10 | 0 | 1 | 13 | 14 | 7.1 | 1 | 35 | 36 | 2.8 | .069* |
| Adult, 14–65 y | 5 | 127 | 132 | 3.8 | 7 | 98 | 105 | 6.7 | 5 | 66 | 71 | 7.0 | 17 | 291 | 308 | 5.5 | |
| Geriatric, >65 y | 3 | 58 | 61 | 4.9 | 7 | 55 | 62 | 11.3 | 10 | 48 | 58 | 17.2 | 20 | 161 | 181 | 11.0 | |
| Sex | |||||||||||||||||
| Male | 7 | 147 | 154 | 4.5 | 12 | 122 | 134 | 9.0 | 9 | 98 | 107 | 8.4 | 28 | 367 | 395 | 7.1 | .818* |
| Female | 1 | 50 | 51 | 2.0 | 2 | 41 | 43 | 4.7 | 7 | 29 | 36 | 19.4 | 10 | 120 | 130 | 7.7 | |
| Location | |||||||||||||||||
| Intensive care unit | 7 | 97 | 104 | 6.7 | 11 | 55 | 66 | 16.7 | 12 | 24 | 36 | 33.3 | 30 | 176 | 206 | 14.6 | <.001* |
| Inpatient | 1 | 47 | 48 | 2.1 | 3 | 29 | 32 | 9.4 | 4 | 26 | 30 | 13.3 | 8 | 102 | 110 | 7.3 | |
| Outpatient | 0 | 53 | 53 | 0 | 0 | 79 | 79 | 0 | 0 | 77 | 77 | 0 | 0 | 209 | 209 | 0 | |
| Isolation site | |||||||||||||||||
| Respiratory | 4 | 88 | 92 | 4.3 | 8 | 79 | 87 | 9.2 | 4 | 51 | 55 | 7.3 | 16 | 218 | 234 | 6.8 | <.001 † |
| Skin and soft tissue | 2 | 52 | 54 | 3.7 | 4 | 35 | 39 | 10.3 | 7 | 35 | 42 | 16.7 | 13 | 122 | 135 | 9.6 | |
| Urine | 0 | 48 | 48 | 0 | 1 | 40 | 41 | 2.4 | 1 | 36 | 37 | 2.7 | 2 | 124 | 126 | 1.6 | |
| Blood | 2 | 3 | 5 | 40 | 1 | 4 | 5 | 20 | 2 | 4 | 6 | 33.3 | 5 | 11 | 16 | 31.3 | |
| Sterile body fluid and others | 0 | 6 | 6 | 0 | 0 | 5 | 5 | 0 | 2 | 1 | 3 | 66.7 | 2 | 12 | 14 | 14.3 | |
| Common associated underlying conditions | |||||||||||||||||
| Extensive healthcare contact a | 8 | 182 | 190 | 4.2 | 14 | 156 | 170 | 8.2 | 16 | 122 | 138 | 11.6 | 38 | 460 | 498 | 7.6 | |
| History of antibiotic exposure within 90 d | 8 | 167 | 175 | 4.6 | 13 | 131 | 144 | 9 | 16 | 104 | 120 | 13.3 | 37 | 402 | 439 | 8.4 | |
| Invasive device b | 8 | 134 | 142 | 5.6 | 14 | 116 | 130 | 10.8 | 15 | 62 | 77 | 19.5 | 37 | 312 | 349 | 10.6 | |
| Diabetes mellitus | 6 | 91 | 97 | 6.2 | 9 | 72 | 81 | 11.1 | 13 | 73 | 86 | 15.1 | 28 | 236 | 264 | 10.6 | |
| History of MDR infection or colonization within prior 90 d | 4 | 120 | 124 | 3.2 | 7 | 105 | 112 | 6.3 | 12 | 81 | 93 | 12.9 | 23 | 306 | 329 | 7 | |
| Isolation of prior susceptible P. aeruginosa | 5 | 122 | 127 | 3.9 | 9 | 94 | 103 | 8.7 | 8 | 64 | 72 | 11.1 | 22 | 280 | 302 | 7.3 | |
| Coinfection with other microorganism c | 1 | 51 | 52 | 1.9 | 5 | 61 | 66 | 7.6 | 8 | 39 | 47 | 17 | 14 | 151 | 165 | 8.5 | |
| Malignancy | 1 | 34 | 35 | 2.9 | 3 | 20 | 23 | 13 | 2 | 14 | 16 | 12.5 | 6 | 68 | 74 | 8.1 | |
| End-stage renal disease | 2 | 26 | 28 | 7.1 | 3 | 20 | 23 | 13 | 5 | 26 | 31 | 16.1 | 10 | 72 | 82 | 12.2 | |
| Renal stones | 0 | 20 | 20 | 0 | 0 | 14 | 14 | 0 | 2 | 17 | 19 | 10.5 | 2 | 51 | 53 | 3.8 | |
| Heart failure | 4 | 18 | 22 | 18.2 | 2 | 9 | 11 | 18.2 | 3 | 16 | 19 | 15.8 | 9 | 43 | 52 | 17.3 | |
| Cystic fibrosis | 0 | 12 | 12 | 0 | 0 | 6 | 6 | 0 | 0 | 0 | 0 | 0 | 0 | 18 | 18 | 0 | |
| Chronic obstructive pulmonary disease | 2 | 13 | 15 | 13.3 | 2 | 19 | 21 | 9.5 | 0 | 7 | 7 | 0 | 4 | 39 | 43 | 9.3 | |
| Chronic lung disease | 1 | 13 | 14 | 7.1 | 4 | 44 | 48 | 8.3 | 1 | 15 | 16 | 6.3 | 6 | 72 | 78 | 7.7 | |
| Post transplantation | 0 | 7 | 7 | 0 | 0 | 4 | 4 | 0 | 1 | 1 | 2 | 50 | 1 | 12 | 13 | 7.7 | |
| Chronic liver disease | 0 | 4 | 4 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 100 | 1 | 4 | 5 | 20 | |
| Neutropenic | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 1 | 1 | 0 | |
| Total | 8 | 197 | 205 | 3.9 | 14 | 163 | 177 | 7.9 | 16 | 127 | 143 | 11.2 | 38 | 487 | 525 | 7.2 | |
Extensive healthcare contact involves regular visits to outpatient medical facilities, regular home visit by home care teams, hospitalization within the preceding 90 days, or residency in a long-term care facility.
Invasive devices involves exposure to breast implant, central line, colostomy bag, cardiac resynchronization therapy implantable cardioverter defibrillator, double J stent (ureteral stent), external ventricular drain, external fixation of the pelvis, Foley catheter, internal drain, inferior vena cava filter, mechanical ventilator, nephrostomy, nasogastric tube, peritoneal dialysis catheter, permanent pacemaker, right upper abdomen drain, suprapubic catheter, surgical drain, tibial artery stent, tracheotomy tube and ventriculo-peritoneal shunt.
Coinfection are associated with the following organisms: Achromoba xylosoxidans, Bacteroid fragilis, Bacteroid vugatus, Escherichia coli, Enterococcus fecalis, Candida glaberata, Candida spp, Candida tropicalis, Citrobacter froundi, Enterobacter cloacae, Klebsiella pneumonia, K. oxytoca, Proteus mirabilis, methicillin-resistant Staphylococcus aureus, methicillin-sensitive Staphylococcus aureus, Serratia marcescenes, Stenotrophomonas maltophilia, Streptococcus group C.
Pearson χ2 test of association.
Fisher exact test.