Background
Patients and methods
Selection of patients
Data collection
Definitions
Statistical analysis
Results
Characteristics upon ICU admission
Characteristic | All n = 151 | TIVAP-related infection n = 68 | No TIVAP-related infection n = 83 | p value |
---|---|---|---|---|
Age, year | 58 ± 14 | 57 ± 14 | 58 ± 14 | 0.58 |
Female gender, n (%) | 58 (38) | 30 (44) | 28 (34) | 0.19 |
Transfer from the emergency room, n (%) | 47 (31) | 21 (31) | 26 (31) | 1.00 |
Transfer from the ward, n (%) | 104 (69) | 47 (69) | 57 (69) | 1.00 |
SAPS2 | 52 ± 17 | 47 ± 15 | 56 ± 17 | < 0.01 |
SOFA | 9 ± 4 | 7 ± 4 | 10 ± 4 | < 0.01 |
TIVAP-related infection risk factors, n (%) | ||||
Immunosuppression | 148 (98) | 66 (97) | 82 (99) | 0.44 |
Hematological malignancies | 72 (48) | 28 (41) | 44 (53) | 0.14 |
Solid organ cancer | 71 (47) | 35 (51) | 36 (43) | 0.32 |
Metastatic cancer | 44 (29) | 24 (35) | 20 (24) | 0.13 |
Recent chemotherapy (< 6 months) | 131 (87) | 58 (85) | 73 (88) | 0.63 |
Parenteral nutrition | 18 (12) | 14 (21) | 4 (5) | < 0.01 |
Clinical signs | ||||
Temperature < 36 or ≥ 38.3 °C, n (%) | 111 (74) | 55 (81) | 56 (67) | 0.08 |
Systolic blood pressure, mmHg | 98 ± 27 | 97 ± 29 | 99 ± 25 | 0.54 |
Mean blood pressure, mmHg | 69 ± 20 | 69 ± 23 | 70 ± 18 | 0.77 |
Glasgow Score Scale | 13 ± 3 | 14 ± 3 | 13 ± 4 | 0.04 |
Local sign of infection, n (%) | 15 (10) | 12 (18) | 3 (4) | < 0.01 |
Biological signs | ||||
White blood cells < 1 Giga/l, n (%) | 50 (33) | 19 (28) | 31 (37) | 0.22 |
Platelet counts, Giga/l | 116 ± 113 | 124 ± 99 | 110 ± 123 | 0.45 |
Prothrombin time, % | 64 ± 17 | 69 ± 17 | 60 ± 17 | < 0.01 |
Serum creatinine, μmol/l | 142 ± 119 | 126 ± 113 | 155 ± 123 | 0.13 |
Bicarbonate, mmol/l | 20 ± 5 | 21 ± 5 | 20 ± 6 | 0.05 |
Arterial lactate, mmol/l | 3.4 ± 3.2 | 3.3 ± 3.0 | 3.6 ± 3.3 | 0.61 |
Proportion and features of TIVAP-related infection
All n = 68 | Alive n = 54 | Dead n = 14 | p value | |
---|---|---|---|---|
Gram-negative bacilli, n (%) | 36 (53) | 32 (59) | 4 (29) | 0.07 |
Enterobacteriaceae | 27 (40) | 25 (46) | 2 (14) | 0.03 |
Escherichia coli | 8 (12) | 8 (15) | 0 (0) | 0.19 |
Klebsiella pneumoniae | 7 (10) | 6 (11) | 1 (7) | 0.99 |
Enterobacter cloacae | 7 (10) | 7 (13) | 0 (0) | 0.33 |
Other Enterobacteriaceae | 6 (9) | 5 (9) | 1 (7) | 0.99 |
Pseudomonas aeruginosa | 8 (12) | 6 (11) | 2 (14) | 0.99 |
Stenotrophomonas maltophilia | 1 (2) | 1 (2) | 0 (0) | 0.99 |
Acinetobacter sp. | 1 (2) | 1 (2) | 0 (0) | 0.99 |
Gram-positive cocci, n (%) | 30 (44) | 21 (39) | 9 (64) | 0.13 |
Staphylococcus aureus | 9 (13) | 5 (9) | 4 (29) | 0.09 |
Coagulase-negative staphylococci | 19 (28) | 15 (28) | 4 (29) | 0.99 |
Enterococcus sp. | 2 (3) | 1 (2) | 1 (7) | 0.37 |
Other Gram-positive cocci | 1(2) | 1 (2) | 0 (0) | 0.99 |
Candida sp., n (%) | 5 (7) | 2 (4) | 3 (21) | 0.06 |
Polymicrobial, n (%) | 6 (9) | 4 (7) | 2 (14) | 0.59 |
All n = 83 | Alive n = 43 | Dead n = 40 | p value | |
---|---|---|---|---|
Gram-negative bacilli, n (%) | 34 (41) | 17 (40) | 17 (43) | 0.83 |
Enterobacteriaceae | 26 (31) | 15 (35) | 11 (28) | 0.49 |
Escherichia coli | 14 (17) | 7 (16) | 7 (18) | 0.99 |
Klebsiella pneumoniae | 7 (9) | 4 (9) | 3 (8) | 0.99 |
Enterobacter cloacae | 3 (4) | 2 (5) | 1 (3) | 0.99 |
Other Enterobacteriaceae | 9 (11) | 7 (16) | 2 (5) | 0.16 |
Pseudomonas aeruginosa | 6 (7) | 1 (2) | 5 (13) | 0.10 |
Acinetobacter sp. | 2 (3) | 1 (2) | 1 (3) | 0.99 |
Gram-positive cocci, n (%) | 22 (27) | 8 (19) | 14 (35) | 0.13 |
Staphylococcus aureus | 4 (5) | 2 (5) | 2 (5) | 0.99 |
Coagulase-negative staphylococci | 4 (5) | 0 (0) | 4 (10) | 0.05 |
Enterococcus sp. | 10 (12) | 3 (7) | 7 (18) | 0.18 |
Other Gram-positive cocci | 5 (6) | 3 (7) | 2 (5) | 0.99 |
Other bacteria, n (%) | 4 (5) | 4 (9) | 0 (0) | 0.12 |
Candida sp., n (%) | 8 (10) | 4 (9) | 4 (10) | 0.99 |
Polymicrobial, n (%) | 16 (19) | 7 (16) | 9 (23) | 0.58 |
Characteristics of the patients according to the presence or absence of TIVAP-related infections
Therapeutic management and outcome
Characteristic | All patients n = 151 | TIVAP-related infections n = 68 | No TIVAP-related infections n = 83 | p value |
---|---|---|---|---|
Time between ICU admission and TIVAP withdrawal, days | 1 (0–2) | 1 (0–1) | 1 (0–2) | 0.09 |
Antibiotics | ||||
Beta lactam antibiotic, n (%) | 143 (95) | 63 (93) | 80 (96) | 0.49 |
Glycopeptide/linezolid, n (%) | 78 (52) | 38 (57) | 40 (48) | 0.29 |
Use of MV, n (%) | 74 (49) | 24 (35) | 50 (60) | < 0.01 |
MV duration, days | 0 (0–5) | 0 (0–3) | 2 (0–7) | 0.26 |
Vasopressors, n (%) | 103 (68) | 37 (55) | 66 (80) | < 0.01 |
Vasopressors, days | 2 (0–3) | 1 (0–2) | 2 (1–4) | 0.04 |
ICU length of stay, days | 5 (3–10) | 4 (3–6) | 6 (3–12) | 0.40 |
ICU mortality, n (%) | 39 (26) | 6 (9) | 33 (40) | < 0.01 |
28-day mortality, n (%) | 54 (36) | 14 (20.5) | 40 (48) | < 0.01 |
6-Month mortality, n (%) | 89 (59) | 34 (50) | 55 (66) | 0.04 |
All n = 151 | Alive n = 97 | Dead n = 54 | p value | |
---|---|---|---|---|
Age, year | 58 ± 14 | 57 ± 15 | 59 ± 13 | 0.40 |
Female gender, n (%) | 58 (38) | 41 (43) | 17 (32) | 0.71 |
SAPS2 | 52 ± 17 | 47 ± 13 | 62 ± 19 | < 0.01 |
SOFA | 9 ± 4 | 7 ± 3.5 | 11 ± 4.5 | < 0.01 |
TIVAP-related infection | 68 (45) | 55 (57) | 13 (24) | < 0.05 |
TIVAP-related infection risk factors, n (%) | ||||
Immunosuppression | 148 (98) | 97 (100) | 51 (95) | 0.99 |
Hematological malignancies | 72 (48) | 43 (44) | 29 (54) | < 0.05 |
Solid organ cancer | 71 (47) | 52 (54) | 19 (35) | 0.12 |
Metastatic cancer | 44 (29) | 31 (32) | 13 (24) | 0.55 |
Recent chemotherapy (< 6 months) | 131 (87) | 88 (91) | 43 (80) | 0.85 |
Parenteral nutrition | 18 (12) | 13 (14) | 5 (9) | 0.34 |
Initial presentation | ||||
Systolic blood pressure, mmHg | 98 ± 27 | 98 ± 27 | 101 ± 28 | 0.55 |
Mean blood pressure, mmHg | 69 ± 20 | 69 ± 19 | 72 ± 24 | 0.44 |
Glasgow Score Scale | 13 ± 3 | 14 ± 3 | 13 ± 3 | 0.20 |
White blood cells, Giga/l | 7.6 ± 13.2 | 7.6 ± 15.6 | 7.6 ± 10.2 | 0.98 |
Platelet counts, Giga/l | 116 ± 113 | 128 ± 110 | 91 ± 114 | < 0.05 |
Prothrombin time, % | 64 ± 17 | 68 ± 15 | 55 ± 19 | < 0.01 |
Serum creatinine, μmol/l | 142 ± 119 | 125 ± 106 | 176 ± 137 | 0.01 |
Bicarbonate, mmol/l | 20 ± 5 | 21 ± 6 | 19 ± 5 | < 0.01 |
Arterial blood lactate, mmol/l | 3.4 ± 3.2 | 2.7 ± 2.2 | 5 ± 4 | < 0.01 |
Treatments | ||||
Time between ICU admission and device withdrawal, days | 1.8 ± 3.5 | 1.6 ± 2.8 | 2.2 ± 4.5 | 0.35 |
Use of MV, n (%) | 74 (49) | 37 (38) | 37 (69) | < 0.01 |
MV duration, days | 4 ± 7 | 4 ± 7 | 5 ± 5 | 0.32 |
Use of vasopressors, n (%) | 103 (68) | 62 (64) | 41 (76) | < 0.01 |
Vasopressors duration, days | 3 ± 4 | 2 ± 3 | 4 ± 5 | < 0.01 |
ICU stay, days | 8 ± 9 | 9 ± 10 | 8 ± 7 | 0.53 |