Background
Methods
Study setting and patients
Definitions
Microbiologic analyses
Statistical analyses
Results
Rate of follow-up blood culture and incidence of persistent KpB
Risk factors for persistent KpB
Variables | Cases (n = 62) | Controls (n = 186) | OR (95% CI) |
P
|
---|---|---|---|---|
Age (± SD) | 63.77 (± 14.58) | 63.58 (± 14.34) | ||
Male sex | 45 (72.6) | 135 (72.6) | ||
Urinary tract infection | 7 (11.3) | 20 (10.8) | 1.05 (0.43-2.58) | 0.908 |
Intra-abdominal infection | 12 (19.4) | 22 (11.8) | 1.82 (0.83-4.00) | 0.136 |
Biliary tract infection | 13 (21.0) | 53 (28.5) | 0.65 (.032-1.32) | 0.236 |
Liver abscess | 8 (12.9) | 31 (16.7) | 0.73 (0.31-1.72) | 0.469 |
Pneumonia | 8 (12.9) | 18 (9.7) | 1.36 (0.57-3.20) | 0.487 |
Primary bacteremia | 9 (14.5) | 34 (18.3) | 0.73 (0.31-1.72) | 0.474 |
Central venous catheter related infection | 2 (3.2) | 4 (2.2) | 1.50 (0.28-8.19) | 0.640 |
Charlson’s CWI score (± SD)
| 6.29 (± 3.05) | 5.52 (± 2.94) | 1.14 (1.01-1.28) |
0.037
|
ICU admission
| 18 (29.0) | 30 (16.1) | 2.12 (1.08-4.16) |
0.029
|
Presentation with septic shock | 22 (35.5) | 53 (28.5) | 1.35 (0.75-2.44) | 0.316 |
APACHE-II score (± SD) | 18.97 (± 9.28) | 17.09 (± 8.16) | 1.03 (0.99-1.06) | 0.140 |
Pitt bacteremia score (± SD) | 2.45 (± 2.67) | 2.17 (± 2.45) | 1.04 (0.94-1.16) | 0.452 |
Nosocomial infection
| 34 (54.8) | 55 (29.6) | 2.96 (1.61-5.43) |
<0.001
|
Previous antibiotic use ≤ 1 year | 37 (59.7) | 95 (51.1) | 1.42 (0.79-2.54) | 0.240 |
Immunosuppressive therapy ≤ 1 year
| 5 (8.1) | 4 (2.2) | 4.46 (1.05-18.95) |
0.043
|
History of solid organ transplantation
| 4 (6.5) | 2 (1.1) | 10.18 (1.11-93.02) |
0.040
|
Invasive procedure ≤ 72 hours before initial BC
| 20 (32.3) | 30 (16.1) | 2.56 (1.29-5.07) |
0.007
|
Neutropenia ≤ 72 hours before initial BC | 11 (17.7) | 31 (16.7) | 1.08 (0.50-2.33) | 0.843 |
Presence of metastatic infection | 5 (8.1) | 9 (4.8) | 1.67 (0.56-4.97) | 0.360 |
Inappropriate drainage | 11 (17.7) | 20 (10.8) | 1.81 (0.80-4.07) | 0.154 |
Fever on the 2
nd
day after initial BC
| 38 (61.3) | 46 (24.7) | 5.18 (2.64-10.16) |
<0.001
|
Leukocytosis on the 2nd day after initial BC | 23 (37.1) | 60 (32.3) | 1.22 (0.68-2.19) | 0.499 |
Lack of CRP decrease on the 2
nd
day after initial BC
| 26 (41.9) | 43 (23.1) | 2.38 (1.29-4.39) |
0.010
|
Unfavorable treatment response on the 2
nd
day after initial BC
| 27 (43.5) | 30 (16.1) | 4.69 (2.27-9.69) |
<0.001
|
ESBL-producing
Klebsiella pneumoniae
bacteremia
| 28 (45.2) | 31 (16.7) | 3.99 (2.09-7.63) |
<0.001
|
Inappropriate empirical antibiotic use
| 22 (35.5) | 24 (12.9) | 4.02 (1.95-8.31) |
<0.001
|
Length of time to empirical antibiotic administration from initial BC (minute, ± SD) | 182.8 (± 221.3) | 228.4 (± 434.8) | 1.00 (0.99-1.00) | 0.430 |
In-hospital mortality
| 19 (30.6) | 34 (18.3) | 1.96 (1.02-3.78) |
0.044
|
Length of hospital stay (day, ± SD) | 45.1 (± 43.0) | 38.6 (± 74.9) | 1.00 (0.99-1.01) | 0.524 |
Variables | Adjusted OR (95% CI) |
P
|
---|---|---|
Intra-abdominal infection
| 2.99 (1.07-8.31) |
0.036
|
Charlson’s CWI score (± SD)
| 1.18 (1.01-1.36) |
0.032
|
ICU admission | 1.98 (0.80-4.87) | 0.139 |
Nosocomial infection | 2.05 (0.81-5.21) | 0.130 |
Immunosuppressive therapy ≤ 1 year | 0.36 (0.02-8.90) | 0.533 |
History of solid organ transplantation
| 92.23 (1.27-6689.96) |
0.038
|
Invasive procedure ≤ 72 hours before initial BC | 0.77 (0.27-2.19) | 0.618 |
Unfavorable treatment response on the 2
nd
day after initial BC
| 4.79 (1.89-12.14) |
0.001
|
ESBL-producing Klebsiella pneumoniae bacteremia | 1.72 (0.63-4.69) | 0.293 |
Inappropriate empirical antibiotic use | 2.76 (0.93-8.23) | 0.068 |
Percentage of persistent KpBaccording to clinical score
Variables | OR | Log (OR) | Adjusted weighted score |
---|---|---|---|
Intra-abdominal infection | 1.87 | 0.63 | 1 |
Nosocomial infection | 3.24 | 1.18 | 2 |
Fever on the 2nd day after initial blood culture | 8.30 | 2.12 | 3 |
Lack of CRP decrease on the 2nd day after initial blood culture | 3.10 | 1.13 | 2 |