Background
Results
Identification of Haemophilus bacteremia episodes
Clinical features of Haemophilus bacteremia
Antibiotic treatment
Definitive antibiotic therapy | |||||
---|---|---|---|---|---|
Median (interquartile range) or percentage | Benzylpenicillin | Cefuroxime | Aminopenicillins | Broadspectrum antibiotics | |
n = 26 | n = 50 | n = 12 | n = 16 | ||
Combination therapy with gentamicin or ciprofloxacin | 34.6% (9/26) | 22.0% (11/50) | 25.0% (3/12) | 43.8% (7/16) | |
Gender (female) | 46.2% (12/26) | 40.0% (20/50) | 58.3% (7/12) | 37.5% (6/16) | |
Age | 73 (58–84) (n = 26) | 69 (52–76) (n = 50) | 62 (26–82) (n = 12) | 68 (56–79) (n = 16) | |
Charlson index | |||||
Low (0) | 57.7% (15/26) | 36.0% (18/50) | 58.3% (7/12) | 25.0% (4/16) | |
Medium (1–2) | 30.8% (8/26) | 48.0% (24/50) | 25.0% (3/12) | 56.2% (9/16) | |
High (>2) | 11.5% (3/26) | 16.0% (8/50) | 16.7% (2/12) | 18.8% (3/16) | |
Smoking | 45.8% (11/24) | 49.0% (24/49) | 45.5% (5/11) | 43.8% (7/16) | |
Alcohol abuse | 26.1% (6/23) | 21.7% (10/46) | 9.1% (1/11) | 25.0% (4/16) | |
Immunosuppression | 3.8% (1/26) d f
| 30.0% (15/50) | 16.7% (2/12) | 31.2% (5/16) | |
Haemophilus species
| |||||
Non-typeable | 69.2% (18/26) | 76.0% (38/50) | 75.0% (9/12) | 62.5% (10/16) | |
Typeable | 15.4% (4/26) | 14.0% (7/50) | 16.7% (2/12) | 25.0% (4/16) | |
Other types | 15.4% (4/26) | 14.0% (7/50) | 8.3% (1/12) | 12.5% (2/16) | |
Polymicrobial bacteremia | 19.2% (5/26) d
| 4.0% (2/50) | 0% (0/12) | 6.2% (1/16) | |
Acquisition of bacteremia | |||||
Community-acquired | 65.4% (17/26) | 56.0% (28/50) g
| 91.7% (11/12) i
| 31.2% (5/16) | |
Healthcare-related | 23.1% (6/26) | 34.0% (17/50) | 8.3% (1/12) | 43.8% (7/16) | |
Hospital-acquired | 11.5% (3/26) | 10.0% (5/50) | 0% (0/12) | 25.0% (4/16) | |
Focus of infection | |||||
Lung | 38.5% (10/26) | 52.0% (26/50) | 58.3% (7/12) | 43.8% (7/16) | |
Upper respiratory tract | 3.8% (1/26) | 6.0% (3/50) | 16.7% (2/12) | 0.0% (0/16) | |
Meningitis | 0% (0/26) f
| 0% (0/50) h
| 0% (0/12) | 25.0% (4/16) | |
Endocarditis | 3.8% (1/26) | 2.0% (1/50) | 0% (0/12) | 6.2% (1/16) | |
Hepato-billiary | 11.5% (3/26) | 8.0% (4/50) | 0% (0/12) | 6.2% (1/16) | |
Miscellaneous | 11.5% (3/26) | 12.0% (6/50) | 16.7% (2/12) | 0.0% (0/16) | |
Unknown | 30.8% (8/26) | 20.0% (10/50) | 8.3% (1/12) | 18.8% (3/16) | |
Hospital specialty | |||||
Medical department | 69.2% (18/26) | 70.0% (35/50) | 41.7% (5/12) | 75.0% (12/16) | |
Surgical department | 26.9% (7/26) | 16.0% (8/50) | 8.3% (1/12) | 12.5% (2/16) | |
Intensive care unit | 0.0% (0/26) | 4.0% (2/50) | 16.7% (2/12) | 12.5% (2/16) | |
Other departments b
| 3.8% (1/26) | 10.0% (5/50) | 33.3% (4/12) | 0.0% (0/16) | |
Altered mental state | 26.9% (7/26) | 24.0% (12/50) | 25.0% (3/12) | 53.3% (8/15) | |
Temp. <38 °C | 30.8% (8/26) | 26.0% (13/50) | 9.1% (1/11) | 14.3% (2/14) | |
Mean blood pressure (mmHg) | 90 (82–102) (n = 25) | 91 (84–100) (n = 48) | 92 (71–109) (n = 10) | 94 (73–103) (n = 15) | |
Heart rate | 100 (79–108) (n = 25) | 95 (80–108) (n = 47) | 105 (89–136) (n = 10) | 94 (84–106) (n =15) | |
B-hgb (mmol/L) | 6.8 (6.4-8.3) (n = 23) | 7.3 (6.3-8.3) (n = 43) | 7.9 (6.9-8.7) (n = 9) | 7.7 (6.0-9.0) (n = 14) | |
B-WBC (109 cells/L) | 13.3 (10.5-16.6) (n = 23) | 15.5 (9.7-20.5) (n = 49) | 10.6 (7.5-17.7) (n = 10) | 8.2 (2.1-18.8) (n = 15) | |
P-creatinine (μmol/L) | 79 (58–137) (n =19) | 90 (62–133) (n = 43) | 69 (56–99) (n = 9) | 105 (71–240) (n = 14) | |
Abnormal liver parameters c
| 72.2% (13/18) | 54.1% (20/37) | 40.0% (2/5) | 40.0% (4/10) | |
P-CRP (mg/L) | 145 (45–214) (n = 24) d
| 184 (105–262) (n = 48) | 186 (55–241) (n = 10) | 173 (119–271) (n = 14) | |
Transfer to ICU | 11.5% (3/26) | 12.2% (6/49) h
| 25.0% (3/12) | 37.5% (6/16) | |
Septic shock | 11.5% (3/26) | 0% (0/48) h
| 8.3% (1/12) | 26.7% (4/15) | |
Mechanical ventilation | 7.7% (2/26) f
| 8.2% (4/49) h
| 8.3% (1/12) | 37.5% (6/16) | |
Hemodialysis | 3.8% (1/26) | 2.1% (1/48) h
| 0% (0/12) | 18.8% (3/16) | |
Death | 38.5% (10/26) d e
| 12.0% (6/50) h
| 0% (0/12) i
| 37.5% (6/16) |
Mortality
Median (interquartile range) or percentage | Non-survivors | Survivors | OR | P-value | ||
---|---|---|---|---|---|---|
n = 23 | n = 82 | |||||
Gender (female) | 47.8% (11/23) | 41.5% (34/82) | 1.29 (0.51-3.28) | 0.64 | ||
Age | 69 (60–83) | 69 (50–77) | 1.03 (1.00-1.05) | 0.07 | ||
0-64 years | 34.8% (8/23) | 46.3% (38/82) | 1 (reference) | |||
65-80 years | 26.1% (6/23) | 35.4% (29/82) | 0.98 (0.31-3.15) | 0.98 | ||
>80 years | 39.1% (9/23) | 18.3% (15/82) | 2.85 (0.93-8.77) | 0.07 | ||
Haemophilus species | ||||||
Nontypeable | 82.6% (19/23) | 69.5% (57/82) | 1 (reference) | |||
Typeable | 8.7% (2/23) | 18.3% (15/82) | 0.40 (0.08-1.91) | 0.25 | ||
Others | 8.7% (2/23) | 12.2% (10/82) | 0.60 (0.12-2.99) | 0.53 | ||
Polymicrobial bacteremia | 21.7% (5/23) | 3.7% (3/82) | 7.32 (1.60-33.5) |
0.01
| ||
Charlson index | ||||||
Low (0) | 30.4% (7/23) | 45.1% (37/82) | 1 (reference) | |||
Medium (1–2) | 52.2% (12/23) | 39.0% (32/82) | 1.98 (0.70-5.64) | 0.20 | ||
High (>2) | 17.4% (4/23) | 15.9% (13/82) | 1.63 (0.41-6.47) | 0.49 | ||
Smoking | 50.0% (11/22) | 46.8% (37/79) | 1.14 (0.44-2.92) | 0.81 | ||
Alcohol abuse | 45.0% (9/20) | 16.9% (13/77) | 4.03 (1.40-11.67) |
0.01
| ||
Immunosuppression | 13.6% (3/22) | 24.1% (20/83) | 0.50 (0.13-1.86) | 0.39 | ||
Focus of infection | ||||||
Lung | 52.2% (12/23) | 46.3% (38/82) | 1.29 (0.50-3.19) | 0.64 | ||
Upper respiratory tract | 0.0% (0/23) | 7.3% (6/82) | 0.25 (0.01-4.62) | 0.34 | ||
Meningitis | 8.7% (2/23) | 2.4% (2/82) | 3.81 (0.51-28.67) | 0.21 | ||
Endocarditis | 0.0% (0/23) | 3.7% (3/82) | 0.48 (0.02-9.70) | >0.99 | ||
Hepato-billiary | 4.3% (1/23) | 9.8% (8/82) | 0.42 (0.05-3.55) | 0.68 | ||
Miscellaneous | 4.3% (1/23) | 12.2% (10/82) | 0.33 (0.04-2.70) | 0.45 | ||
Unknown | 30.4% (7/23) | 19.5% (16/82) | 1.81 (0.64-5.12) | 0.27 | ||
Acquisition of bacteremia | ||||||
Community-acquired | 43.5% (10/23) | 62.2% (51/82) | 1 (reference) | |||
Healthcare-related | 26.1% (6/23) | 30.5% (25/82) | 1.22 (0.40-3.75) | 0.72 | ||
Hospital-acquired | 30.4% (7/23) | 7.3% (6/82) | 5.95 (1.65-21.48) |
<0.01
| ||
Hospital specialty | ||||||
Medical | 56.5% (13/23) | 69.5% (57/82) | 1 (reference) | |||
Surgical | 21.7% (5/23) | 15.9% (13/82) | 1.69 (0.51-5.57) | 0.39 | ||
Intensive care unit | 17.4% (4/23) | 2.4% (2/82) | 8.78 (1.45-53.1) |
0.02
| ||
Othersa
| 4.3% (1/23) | 12.2% (10/82) | 0.44 (0.05-3.73) | 0.45 | ||
Altered mental state | 65.2% (15/23) | 18.5% (15/81) | 8.25 (2.96-23.00) |
<0.01
| ||
Temp. <38 | 40.9% (9/22) | 20.0% (16/80) | 2.77 (1.01-7.61) |
<0.05
| ||
Mean blood pressure (mmHg) | 97 (86–113) (n = 22) | 90 (81–100) (n = 76) | 1.03 (1.00-1.06) | 0.15 | ||
Heart rate | 100 (84–112) (n = 22) | 95 (80–108) (n = 76) | 1.01 (0.99-1.03) | 0.46 | ||
B-hgb (mmol/L) | 7.3 (6.3-9.0) (n = 21) | 7.3 (6.5-8.4) (n = 69) | 1.08 (0.75-1.55) | 0.7 | ||
B-WBC (109 cells/L) | 13.3 (11.6-17.6) (n = 23) | 14.2 (8.3-20) (n = 75) | 0.99 (0.93-1.05) | 0.61 | ||
P-creatinine (μmol/L) | 91 (61–141) (n = 21) | 82 (61–120) (n = 64) | 1.00 (0.99-1.01) | 0.97 | ||
Abnormal liver parametersb
| 58.8% (10/17) | 54.7% (29/53) | 1.18 (0.39-3.58) | >0.99 | ||
P-CRP (mg/L) | 175 (96–270) (n = 21) | 175 (97–257) (n = 76) | 1.00 (1.00-1.01) | 0.97 | ||
Transfer to ICU | 30.4% (7/23) | 13.6% (11/81) | 2.78 (0.93-8.30) | 0.11 | ||
Shock | 22.7% (5/22) | 3.75% (3/80) | 7.55 (1.64-34.68) |
0.01
| ||
Mechanical ventilation | 26.1% (6/23) | 8.6% (7/81) | 3.73 (1.11-12.53) |
0.04
| ||
Hemodialysis | 4.5% (1/22) | 4.9% (4/81) | 0.92 (0.10-8.64) | >0.99 | ||
Inadequate empiric antibiotic therapy | 8.7% (2/23) | 12.2% (10/82) | 0.69 (0.14-3.38) | >0.99 | ||
Definitive antibiotic therapy | ||||||
Benzylpenicillin | 45.5% (10/22) | 19.5% (16/82) | 1 (reference) | |||
Aminopenicillin | 0% (0/22) | 14.6% (12/82) | Not determinedc
|
<0.02
d
| ||
Cefuroxime | 27.2% (6/22) | 53.7% (44/82) | 0.22 (0.07-0.70) |
0.01
| ||
Broadspectrum antibiotics | 27.2% (6/22) | 12.2% (10/82) | 0.96 (0.27-3.47) | 0.95 |