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Table 1 Clinical characteristic investigated for association with CR-GNB sepsis (Case group 1) in an adult clinical-surgical ICU

From: Predictive factors for sepsis by carbapenem resistant Gram-negative bacilli in adult critical patients in Rio de Janeiro: a case-case-control design in a prospective cohort study

Predictive Factors

Univariate analysis

Odds ratio

95% CI

Pt valor

CR-GNB (n = 60)

Controls (n = 94)

   

Demographic data

 Age in years, median (range)

62 (23–91)

62 (19–92)

1.00

0.98–1.02

0.95

 Male sex, n (%)

36 (60)

46 (49)

1.57

0.81–3.02

0.18

Comorbiditiesa, n (%)

 Diabetes mellitusb

21 (35)

35 (37)

0.91

0.46–1.78

0.78

 Renal failurec

30 (50)

38 (40)

1.47

0.77–2.83

0.25

 Hemodialysisd

22 (37)

18 (19)

2.44

1.17–5.10

0.02

 Chronic liver diseasee

2 (3)

9 (10)

0.33

0.07–1.56

0.16

 Immunossupressive conditionf

9 (15)

11 (12)

1.33

0.52–3.43

0.55

 Gastrointestinal disease

16 (27)

18 (19)

1.54

0.71–3.31

0.27

 Geniturinary disease

5 (8)

9 (10)

0.86

0.27–2.70

0.79

 Pulmonary disease

10 (17)

14 (15)

1.14

0.47–2.77

0.77

 AIDS or chronic infectious disease

3 (5)

3 (3)

1.60

0.31–8.18

0.56

 Surgeryg

26 (43)

46 (49)

0.80

0.42–1.53

0.50

 Infection/Colonization by CR-GNB

19 (32)

7 (7)

5.76

2.24–14.79

< 0.001

 Nosocomial diarrheah

17 (28)

6 (6)

5,.80

2.13–15.75

0.001

 Neutropeniai

5 (8)

4 (4)

2.05

0.53–7.94

0.30

 Neoplasm

23 (38)

28 (30)

1.47

0.74–2.90

0.27

 Infection

46 (77)

31 (33)

6.68

3.20–13.95

< 0.001

Prior ICU hospitalization, n (%)

7 (12)

5 (5)

2.35

0.71–7.78

0.26

Length of hospital stay (in days)

 Median (range)

26.5 (1–375)

10 (0–143)

1.04

1.02–1.06

< 0.001

ICU hospitalization reason, n (%)

 Elective or emergency surgery

10 (17)

28 (30)

0.47

0.21–1.06

0.07

 Respiratory tract disease

16 (27)

14 (15)

2.08

0.93–4.65

0.08

 Cardiovascular disease

6 (10)

8 (9)

1.19

0.39–3.63

0.75

 Neurological disease

2 (3)

11 (12)

0.26

0.06–1.22

0.09

 Gastrointestinal disease

3 (5)

5 (5)

0.94

0.22–4.07

0.93

 Renal pathology

5 (8)

11 (12)

0.69

0.23–2.08

0.51

 Sepsis

31 (52)

30 (32)

2.40

1.23–4.68

0.01

 Sepsis shock

23 (38)

27 (39)

1.63

0.82–3.24

0.17

Total SOFA scorej at ICU admission,

 Median (range)

6 (1–17)

6 (0–17)

1.06

0.98–1.15

0.16

SAPs 3 scorek, median (range)

65 (30–103)

64 (29–105)

1.01

0.99–1.03

0.39

Invasive devices, n (%)

 Mechanical ventilation

56 (93)

58 (62)

8.69

2.90–26.01

< 0.001

 Central vascular catheter

60 (100)

81 (86)

...

...

0.003

 Urinary catheter

55 (92)

72 (76)

3.16

1.12–8.92

0.03

Previous use of antimicrobials, n (%)

 Aminoglycosidesl

18 (30)

7 (7)

5.33

2.07–13.74

0.001

 Cephalosporins, 3rd and 4rd generationsm

8 (13)

16 (17)

0.75

0.30–1.88

0.54

 Carbapenemsn

48 (80)

32 (34)

7.75

3.61–16.62

< 0.001

 Glycopeptideso, linezolid and tigecycline

45 (75)

35 (37)

5.06

2.47–10.37

< 0.001

 Fluoroquinolonesp

14 (23)

15 (16)

1.60

0.71–3.62

0.26

 Metronidazole

11 (18)

13 (14)

1.40

0.58–3.37

0.46

 Piperacilin-tazobactam

30 (50)

21 (22)

3.48

1.72–7.01

< 0.001

 Polymyxinsq

22 (37)

9 (10)

5.47

2.30–12.98

< 0.001

 ATB with action for anaerobesr

56 (93)

59 (63)

8.31

2.77–24.88

< 0.001

 Antifungal agentss

26 (43)

13 (14)

4.77

2.19–10.36

< 0.001

  1. Abbreviations: AIDS Acquired Immunodeficiency Syndrome, ATB antibiotic agents, CI Confidence interval, CR-GNB Carbapenem resistant Gram-negative bacilli, ICU Intensive Care Unit
  2. aPrior comorbidities or conditions to investigated sepsis episode
  3. bDiagnosis of diabetes mellitus requiring oral or injectable hypoglycemic drug
  4. cCreatinine clearance < 30 cc/min
  5. dRequired in the last 90 days
  6. eLaboratory clinical evidence
  7. f Prednisone > 10 mg for more than 50 days, corticosteroid for > 7 days or immunomodulatory agents (examples: monoclonal agents, methotrexate)
  8. gIn the last 30 days
  9. hNosocomial diarrhea (3 or more daily episodes of stool for 2 or more days)
  10. iGranulocytes < 500 cells/mm3
  11. jSequential Organ Failure Assessment score
  12. kSimplified Acute Physiology Score III
  13. lAmikacin and gentamicin
  14. mCeftriaxone, ceftazidime and cefepime
  15. nErtapenem, imipenem-cilastatin and meropenem
  16. oDaptomycin, teicoplanin and vancomycin
  17. pCiprofloxacin, levofloxacin, moxifloxacin
  18. qPolymyxin B and colistin
  19. rAntibacterial agents with action for anaerobes – Amoxicilin-clavulanate, ampicillin-sulbactam, piperacilin-tazobactam, clindamycin, ertapenem, imipenem, meropenem and metronidazole
  20. sAmphotericin B family (standard, lipid complex or liposomal Amphotericin), echinocandins and azoles
  21. tPearson’s chi-square test or Fisher’s exact test or Mann-Whitney-Wilcoxon U test, as required, and considering statistically significant p < 0.05
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Antimicrobial Resistance & Infection Control

ISSN: 2047-2994

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