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Table 4 Risk of unfavourable outcome after Enterobacterales infection in solid organ transplant recipients

From: Temporal trends, risk factors and outcomes of infections due to extended-spectrum β-lactamase producing Enterobacterales in Swiss solid organ transplant recipients between 2012 and 2018

 

Favourable (N = 69)

Unfavourable (N = 33)

Univariate

Multivariable

OR [95%-CI] (p value)

aOR [95%-CI] (p value)

ESBL infection, N (%)

27 (37.9)

24 (74.3)

4.1 [1.7–10.7] (< 0.01)

3.1 [0.8–12.5] (0.10)

Age, mean (SD)

54.2 (13.7)

53.8 (13.1)

1.0 [0.9–1.0] (0.89)

 

Malea, N (%)

32 (46.4)

13 (39.4)

0.8 [0.3–1.7] (0.51)

0.5 [0.1–1.5] (0.20)

BMI at transplant (mean, SD)

25.0 (3.8)

25.9 (4.8)

1.0 [0.9–1.2] (0.33)

 

Ethnicity: caucasian

66 (95.7)

29 (87.9)

0.3 [0.1–1.6] (0.16)

 

Year of infection, N (%)

 2012

8 (11.6)

6 (18.2)

–

 

 2013

17 (24.6)

7 (21.2)

0.6 [0.1–2.2] (0.39)

 

 2014

18 (26.1)

6 (18.2)

0.4 [0.1–1.8] (0.26)

 

 2015

17 (24.6)

9 (27.3)

0.7 [0.2–2.7] (0.61)

 

 2016

9 (13.0)

5 (15.2)

0.7 [0.2–3.4] (0.70)

 

Transplanted organ, N (%)

 Kidney

41 (59.4)

25 (75.8)

–

 

 Non-Kidney

28 (40.6)

8 (24.2)

0.4 [0.2–1.1] (0.09)

 

Comorbidities, N (%)

 Cardiopulmonary disease

9 (13.0)

5 (15.2)

1.2 [0.5–2.9] (0.62)

 

 Metabolic/endocrine disease

34 (49.3)

18 (54.5)

1.2 [0.5–3.5] (0.70)

 

 Cancer

52 (75.4)

26 (78.8)

1.2 [0.4–3.8] (0.77)

 

 Other

43 (62.3)

20 (60.6)

0.9 [0.4–2.2] (0.87)

 

Causing pathogen, N (%)

 Escherichia coli

54 (78.3)

23 (69.7)

–

 

 Klebsiella spp.

7 (10.1)

9 (27.3)

3.0 [1.0–9.4] (0.05)

 

 Other

8 (11.6)

1 (3.0)

0.3 [0.1–1.7] (0.26)

 

Time to infection, median (IQR)

70 (31–256)

61 (14–203)

1.0 [1.0–1.0] (0.24)

 

Type of infection, N (%)

 Urinary tract (vs. other)

50 (72.5)

27 (81.8)

1.7 [0.6–5.2] (0.31)

 

 Bacteremia

19 (27.5)

8 (24.2)

0.8 [0.3–2.1] (0.72)

 

Hospital-onset, N (%)

26 (38.2)

13 (39.4)

1.1 [0.4–2.5] (0.91)

 

LOS after infectionb, median (IQR)

14 (4–26)

16 (7.2–33)

0.9 [0.9–1.0] (0.58)

 

On ICU after infectiona, N (%)

10 (21.3)

7 (31.8)

1.7 [0.5–5.4] (0.35)

2.3 [0.6–8.1] (0.20)

Antibiotic therapyc, N (%)

60 (87.0)

28 (84.8)

0.8 [0.3–2.9] (0.77)

 

 Treatment with carbapenems

23 (33.3)

17 (51.5)

2.1 [0.9–5.0] (0.08)

 

Treatment duration, median (IQR)

13 (7–19)

13 (7–18)

1.0 [0.9–1.0] (0.95)

 

Adequate empiric therapya,d, N (%)

39 (65.0)

11 (39.3)

0.3 [0.1–0.9] (0.03)

0.5 [0.1–1.7] (0.27)

Infectious diseases consult, N (%)

36 (52.2)

13 (39.4)

0.6 [0.3–1.4] (0.23)

 

 Initially

27 (39.1)

10 (30.3)

0.7 [0.3–1.6] (0.39)

 

 Upon microbiology results

27 (39.1)

10 (30.3)

0.7 [0.3–1.6] (0.39)

 
  1. BMI body mass index, ESBL extended-spectrum beta-lactamase, (a)OR (adjusted) odds ratio, CI confidence interval, IQR interquartile range, LOS length of stay, ICU Intensive Care Unit
  2. aIncluded in multivariable analysis based on individual impact on key predictor variable "ESBL infection"[13]
  3. bVariable dropped from final model because of parsimony reasons; inclusion does not alter results
  4. cWithin 30 days after diagnosis
  5. dWithin 2 days after diagnosis
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Antimicrobial Resistance & Infection Control

ISSN: 2047-2994

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