Background
Methods
Patient identification from database
Case–control design
Data on antimicrobial resistance
Statistical analysis
Results
Selection of cases and controls
Characteristics of cases and controls
Casesa
| Controlsb
|
p
| |
---|---|---|---|
Number of patients | 36 | 108 | |
Duration of uninterrupted meropenem use, days, median (IQR) | 34 (31–39) | 9 (7–11) | <0.001 |
Age in years, median (IQR) | 63 (51–71) | 66 (56–73) | 0.26 |
Female sex, n (%) | 13 (36.1) | 36 (33.3) | 0.76 |
Days on ICU, median (IQR) | 66 (51.5–92.5) | 35 (31–45) | <0.001 |
Malignancy, n (% of all pts) | 17 (47.2) | 22 (20.4) | 0.002 |
SAPS score at admission, median (IQR) | 42 (35–48) | 39 (33–47) | 0.36 |
Medical patients, n (% of all pts) | 4 (11.1) | 45 (42.7) | 0.001 |
Neurological patients, n (% of all pts) | 6 (16.7) | 30 (26.9) | 0.22 |
Surgical patients, n (% of all pts) | 26 (72.2) | 34 (31.5) | <0.001 |
Number of operations, median (IQR)c
| 14 (5–27) | 4 (3–7) | <0.001 |
Colonization/infection with carbapenem-susceptible, multidrug-resistant Enterobacteriaceae n (%) | 7 (19.4) | 7 (6.5) | 0.007 |
Type of infection, n (%) | |||
pneumonia | 4 (11.1) | 27 (25.0) | <0.001 |
peritonitis | 16 (44.4) | 5 (4.6) | |
mediastinitis | 6 (16.7) | 4 (3.7) | |
unclear focus | 10 (27.8) | 72 (66.7) | |
In-ICU-mortality, n (%) | 16 (44.4%) | 27 (25.0%) | 0.03 |
Risk factors for prolonged MT
Univariate logistic regression
|
Multivariate logistic regression
| ||||||
---|---|---|---|---|---|---|---|
OR
|
95 % CI
|
P-value
|
OR
|
95% CI
|
P-value
| ||
age | <50 | 1 | 0.44 | - | - | - | |
50-70 | 0.72 | 0.25–2.04 | |||||
≥70 | 0.49 | 0.16–1.53 | |||||
sex | male | 1 | 0.76 | - | - | - | |
female | 1.13 | 0.51–2.49 | |||||
malignancy | No | 1 | 0.002 | 1 | 0.84 | ||
Yes | 3.5 | 1.57–7.82 | 1.14 | 0.32–4.06 | |||
SAPS at admission | <40 | 1 | 0.33 | - | - | - | |
≥40 | 1.45 | 0.68–3.11 | |||||
patient group | medical | 1 | <0.001 | 1 | 0.31 | ||
neurological | 2.41 | 0.63–9.30 | 2.79 | 0.65 – 11.92 | |||
surgical | 8.36 | 2.67–26.17 | 2.46 | 0.50 – 11.98 | |||
colonization with carbapenem-susceptible, MDR bacteria | no | 1 | 0.01 | 1 | 0.004 | ||
yes | 4.12 | 1.38–12.35 | 7.52 | 1.88–30.14 | |||
type of infection | pneumonia | 1 | <0.001 | 1 | <0.001 | ||
peritonitis | 21.60 | 5.05–92.35 | 16.96 | 2.95 – 97.49 | |||
mediastinitis | 10.12 | 1.96–52.41 | 6.27 | 0.81 – 48.76 | |||
unclear focus | 0.94 | 0.27–3.24 | 0.77 | 0.21 – 2.84 |
Microbiological data
Intraoperative cultures (abdominal, thoracic) | blood cultures | CSF, brain tissue |
---|---|---|
Enterococcus faecium, n = 7
Enterococcus faecalis, n = 6
Stenotrophomonas maltophilia, n = 6 multidrug-resistant, carbapenem-susceptible Escherichia coli, n = 2a
Enterobacter cloacae complex, n = 2 Coagulase-negative staphylococci, n = 2
Pseudomonas aeruginosa, n = 1
Proteus mirabilis, n = 1
Proteus vulgaris, n = 1
Klebsiella pneumoniae, n = 1
Escherichia coli (non MRGN), n = 1
Staphylococcus aureus, n = 1
Enterococcus gallinarum, n = 1 |
E. faecalis, n = 1
E. faecium, n = 1 Vancomycin-resistant Enterococcus faecium, n = 1
E. aerogenes, n = 1
E. cloacae, n = 1
S. maltophilia, n = 1 multidrug-resistant, carbapenem-resistant P.aeruginosa, n = 1 |
Staphylococcus aureus, n = 1
Staphylococcus epidermidis, n = 1
Proteus mirabilis, n = 1
Bacteroides fragilis, n = 1 |