Table 2.
Differences in the clinical characteristics of persistent bacteremia caused by gram-positive cocci, gram-negative rods, and Candida species.
| GPC Group (n = 220) | GNR Group (n = 100) |
Candida spp. Group (n = 67) |
p-Value | Corrected p-Value | |||
|---|---|---|---|---|---|---|---|
| GPC Group vs. GNR Group | GPC Group vs. Candida spp. Group | GNR Group vs. Candida spp. Group |
|||||
| Demography | |||||||
| Sex (male, %) | 138 (62.7) | 67 (67.0) | 40 (59.7) | ||||
| Age, years, median (IQR) | 59.0 (51.5–67.5) | 67.0 (50.0–69.0) | 68.0 (57.0–68.0) | 0.004 | 0.005 | 0.021 | |
| Comorbidities | |||||||
| Diabetes mellitus | 41 (18.6) | 15 (15.0) | 11 (16.4) | ||||
| Renal failure | 112 (50.9) | 58 (58.0) | 30 (44.8) | ||||
| ESDR on hemodialysis | 24 (10.9) | 6 (6.0) | 1 (1.5) | 0.026 | 0.039 | ||
| Liver cirrhosis | 23 (10.5) | 5 (5.0) | 4 (6.0) | ||||
| Solid malignancy | 62 (28.2) | 29 (29.0) | 29 (43.3) | ||||
| Hematologic malignancy | 20 (9.1) | 6 (6.0) | 4 (6.0) | ||||
| Neutropenia | 9 (4.1) | 4 (4.0) | 5 (7.5) | ||||
| Immunosuppression | 43 (19.5) | 16 (16.0) | 14 (20.9) | ||||
| Severities | |||||||
| Respiratory failure | 61 (27.7) | 44 (44.0) | 17 (25.4) | <0.001 | 0.014 | 0.030 | |
| Shock | 21 (9.5) | 15 (15.0) | 4 (6.0) | ||||
| Vital signs | |||||||
| BMI, kg/m2, median (IQR) | 21.8 (18.7–24.3) | 21.4 (19.0–24.8) | 19.8 (17.3–23.2) | ||||
| Body temperature, °C, median (IQR) | 38.1 (37.5–39.0) (n = 200) | 38.7 (37.9–39.2) (n = 96) | 38.6 (37.6–39.1) (n = 59) | ||||
| Laboratory markers | |||||||
| White blood cell count, 10⁹/L, median (IQR) | 9000.0 (5900.0–11,900.0) | 9300.0 (5750.0–13,625.0) | 7300.0 (5500.0–12,750.0) | ||||
| Neutrophil count, 10⁹/L, median (IQR) | 7255.0 (4595.0–10,555.0) (n = 208) | 8470.0 (4422.5–12,675.0) | 6255.0 (4145.0–10,977.5) (n = 66) | ||||
| C-reactive protein, mg/dL, median (IQR) | 6.8 (3.1–12.8) | 8.9 (3.8–14.7) | 7.7 (3.1–11.6) | ||||
| Devices | |||||||
| Intravascular device | 137 (62.3) | 64 (64.0) | 56 (83.6) | 0.003 | 0.003 | 0.016 | |
| Intravascular device removal | 111 (81.0) | 52 (81.3) | 47 (83.9) | ||||
| CIED | 22 (10.0) | 5 (5.0) | 0 (0) | 0.005 | 0.010 | 0.021 | |
| Ventricular assist device | 9 (4.1) | 8 (8.0) | 1 (1.5) | ||||
| Valve replacement | 26 (11.8) | 7 (7.0) | 2 (3.0) | ||||
| Vascular graft | 16 (7.3) | 20 (20.0) | 6 (9.0) | 0.004 | 0.005 | ||
| ECMO | 3 (1.4) | 3 (3.0) | 7 (10.4) | 0.031 | 0.006 | ||
| Continuous hemodiafiltration | 37 (16.8) | 24 (24.0) | 14 (20.9) | ||||
| Mechanical ventilation | 57 (25.9) | 43 (43.0) | 21 (31.3) | 0.010 | 0.008 | ||
| Status of persistent bacteremia | |||||||
| The period until FUBC is carried out, median (IQR) | 3.0 (2.0–4.0) | 3.0 (1.0–4.0) | 4.0 (2.0–5.5) | 0.014 | 0.016 | 0.028 | |
| Duration of bacteremia, median (IQR) | 3.0 (2.0–7.0) | 4.0 (2.0–7.0) | 5.0 (3.0–7.5) | 0.003 | 0.002 | 0.019 | |
| The ratio of persistent bacteremia | 220 (11.1) | 100 (12.1) | 67 (29.6) | <0.001 | <0.001 | <0.001 | |
| Site of infection | |||||||
| CRBSI | 115 (40.9) | 37 (31.9) | 47 (58.8) | <0.001 | 0.112 | 0.010 | 0.001 |
| Infectious endocarditis | 31 (11.0) | 2 (1.7) | 1 (1.3) | <0.001 | 0.004 | 0.007 | |
| Septic embolism | 15 (5.3) | 2 (1.7) | 1 (1.3) | ||||
| Endovascular devices infections | 18 (6.4) | 5 (4.3) | 3 (3.8) | ||||
| Thrombophlebitis | 15 (5.3) | 10 (8.6) | 5 (6.3) | ||||
| Pyogenic spondylitis | 14 (5.0) | 1 (0.9) | 0 (0) | 0.023 | |||
| Abscess | 18 (6.4) | 6 (5.2) | 3 (3.8) | ||||
| Pneumonia | 0 (0) | 2 (1.7) | 0 (0) | ||||
| Intra-abdominal infections | 3 (1.1) | 4 (3.4) | 1 (1.3) | ||||
| Urinary tract infections | 2 (0.7) | 10 (8.6) | 2 (2.5) | <0.001 | <0.001 | ||
| Biliary tract infections | 1 (0.4) | 2 (1.7) | 0 (0) | ||||
| Skin and soft tissue infections | 5 (1.8) | 1 (0.9) | 1 (1.3) | ||||
| Surgical site infection | 6 (2.1) | 7 (6.0) | 0 (0) | 0.028 | |||
| Others | 11 (3.9) | 2 (1.7) | 6 (7.5) | ||||
| Primary | 27 (9.6) | 25 (21.6) | 10 (12.5) | 0.007 | 0.008 | ||
| Hospital stays | |||||||
| Duration of hospitalization, days, median (IQR) | 64.0 (38.0–114.0) (n = 219) | 76.0 (37.5–150.3) | 71.5 (43.3–112.0) (n = 66) | ||||
| Presence of ICU | 86 (39.1) | 57 (57.0) | 28 (41.8) | 0.011 | 0.011 | ||
| Duration of ICU stay, days, median (IQR) | 0 (0–10.3) | 4.0 (0–45.0) | 0 (0–15.0) | 0.001 | <0.001 | 0.034 | |
| Presence of HCU | 14 (6.4) | 13 (13.0) | 5 (7.5) | ||||
| Duration of HCU stay, days, median (IQR) | 0 (0–0) | 0 (0–0) | 0 (0–0) | ||||
| Presence of CCU | 9 (4.1) | 3 (3.0) | 1 (1.5) | ||||
| Duration of CCU stay, days, median (IQR) | 0 (0–0) | 0 (0–0) | 0 (0–0) | ||||
| Intervention | |||||||
| The use of antibiotics (Appropriate) | 191 (86.8) | 89 (89.0) | 62 (92.5) | ||||
| Source control | 136 (61.8) | 52 (52.0) | 45 (67.2) | ||||
Data are presented as number (%) unless indicated otherwise. p-value: p-value of Kruskal-Wallis tests for continuous variables and Fisher’s exact tests for categorical variables. Corrected p-value: p-value of Steel-Dwass tests for continuous variables and Fisher’s exact test for categorical variables corrected by Holm-Bonferroni method. p-values were listed only for those that showed significant differences. Immunosuppression was considered in the presence of neutropenia, hematopoietic stem cell transplantation, solid organ transplantation, and corticosteroid therapy (prednisone 16 mg/day for 15 days). Intravascular devices contain a central line, such as conventional central venous catheter, peripherally inserted central catheter, tunneled central venous catheter, and implanted central venous port. BMI, body mass index; CCU, coronary care unit; CIED, cardiac implantable electronic devices; CRBSI, catheter-related blood stream infection; ECMO, extracorporeal membrane oxygenation; ESDR, end-stage renal disease; FUBC, follow-up blood culture; GPC, gram-positive cocci; GNRs, gram-negative rods; HCU, high care unit; ICU, intensive care unit; IQR, interquartile range.