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Table 2 Patient characteristics and risk factor analysis for community-onset bloodstream infection caused by a MDR organism

From: Community-onset bloodstream infection with multidrug-resistant organisms: a matched case-control study

Risk factors Cases Controls Univariate analysis Multivariate analysis
  (n = 180) (n = 180) OR (95% CI) P value AOR (95% CI) P value
Age, mean (SD), years 64.1 (19.4) 65.0 (20.4) 1.00 (0.99-1.01) 0.7   
Female, no (%) 69 (38.3) 74 (41.1) 0.94 (0.75-1.18) 0.59   
Source of BSI, low riskb, no (%) 94 (52.2) 83 (46.1) 1.32 (0.85-2.03) 0.22   
Invasive device in-situ, no (%) 55 (30.6) 21 (11.7) 3.62 (1.96-6.68) <0.001a   
  Indwelling catheter 25 (13.9) 8 (4.4) 3.43 (1.48-7.96) <0.01   
  Vascular catheter 27 (15.0) 12 (6.7) 2.67 (1.24-5.74) 0.01   
  Percutaneous feeding tube 7 (3.9) 1 (0.6) 7.00 (0.86-56.89) 0.07   
Friedman et al. HCA risk factors, no (%) 148 (82.2) 72 (40.0) 6.81 (3.81-12.19) <0.001   
  Prior hospitalisation (≥2d) last 90d 113 (62.8) 44 (24.4) 4.62 (2.81-7.58) <0.001a   
  Residence in long-term care facilities 51 (28.3) 23 (12.8) 2.79 (1.57-4.94) <0.001a 4.94 (2.11-11.59) <0.001
  Home intravenous therapy last 30d 27 (15.0) 9 (5.0) 2.89 (1.35-6.17) 0.006a   
  Home wound care last 30d 35 (19.4) 5 (2.8) 6.96 (2.72-17.80) <0.001a 5.48 (1.61-18.69) <0.01
  Haemodialysis last 30d 5 (2.8) 12 (6.7) 0.42 (0.15-1.18) 0.100   
  Intravenous chemotherapy last 30d 32 (17.8) 15 (8.3) 2.31 (1.20-4.42) 0.012a   
Underlying immunosuppression, no (%) 77 (42.8) 35 (19.4) 3.73 (2.11-6.60) <0.001a 3.49 (1.58-7.71) <0.01
  Neutropenia 23 (12.8) 11 (6.1) 2.20 (1.04-4.65) 0.04   
  Active or metastatic cancer 45 (25.0) 25 (13.9) 2.11 (1.21-3.70) 0.01   
  Concurrent immunosuppressant agents 31 (17.2) 8 (4.4) 4.14 (1.82-9.46) <0.01   
Surgery last 30d, no (%) 38 (21.1) 9 (5.0) 6.60 (2.58-16.91) <0.001a 3.52 (1.06-11.64) 0.04
Bacterial infection last 3mo, no (%) 99 (55.0) 34 (18.9) 5.32 (3.06-9.23) <0.001c   
Presence of BSI last 3mo, no (%) 36 (20.0) 7 (3.9) 6.80 (2.66-17.39) <0.001a   
Prior antibiotic exposure last 3mo, no (%) 127 (70.6) 39 (21.7) 7.73 (4.34-13.78) <0.001a 5.49 (2.84-10.61) <0.001
  Prolonged exposure >14d 78 (43.3) 27 (15.0) 4.38 (2.50-7.68) <0.001   
  Fluoroquinolone 43 (23.9) 9 (5.0) 5.86 (2.63-13.06) <0.001   
  Extended-spectrum cephalosporin 32 (17.8) 5 (2.8) 7.95 (2.80-22.55) <0.001   
  Penicillin + beta lactamase inhibitor 44 (24.4) 15 (8.3) 3.64 (1.87-7.09) <0.001   
  Vancomycin 27 (15.0) 10 (5.6) 2.78 (1.30-5.95) 0.01   
Diabetic mellitus, no (%) 45 (25.0) 28 (15.6) 1.95 (1.12-3.39) 0.018a   
Cardiovascular disease, no (%) 50 (27.8) 40 (22.2) 1.36 (0.85-2.16) 0.200   
Cerebrovascular disease, no (%) 30 (16.7) 27 (15.0) 1.10 (0.63-1.94) 0.74   
Lung disease, no (%) 47 (26.1) 32 (17.8) 1.66 (0.97-2.82) 0.062a   
Renal disease, no (%) 25 (13.9) 28 (15.6) 0.89 (0.51-1.54) 0.68   
Liver disease, no (%) 21 (11.7) 18 (10.0) 1.20 (0.61-2.38) 0.6   
Malignancy, no (%) 71 (39.4) 48 (26.7) 1.71 (1.10-2.66) 0.018a   
Charlson co-morbidity index, mean (SD) 3.4 (2.6) 2.0 (2.0) 1.24 (1.13-1.36) <0.001a   
  1. NOTE. OR, odds ratio; AOR, adjusted odds ratio; CI, confidence interval; SD, standard deviation; BSI, bloodstream infections; HCA, healthcare-associated.
  2. aVariables eligible for inclusion in the multivariate analysis.
  3. bLow risk sites are BSI secondary to urinary, skin & soft tissue and catheter-related sites.
  4. cPairwise correlation >0.7 with prior antibiotic exposure last 3mo.