Skip to main content

Advertisement

Table 4 Univariate analysis of risk factors for intrahospital death among 1632 children* with suspected systemic infection

From: Antimicrobial resistance predicts death in Tanzanian children with bloodstream infections: a prospective cohort study

Risk factor CFR % (n) OR 95% CI P
Overall 17.0 (277/1632)    
Male sex 15.5 (143/920) 0.79 0.61 to 1.03 0.084
Neonate (< 1 m) 14.8 (70/473) 0.80 0.59 to 1.07 0.146
Underlying conditions     
Malnutrition 29.3 (71/242) 2.37 1.73 to 3.25 < 0.001
HIV infection (laboratory confirmed) 31.7 (46/145) 2.40 1.60 to 3.59 < 0.001
Other infectious underlying conditions 30.6 (33/108) 2.29 1.48 to 3.52 < 0.001
- Tuberculosis 30.5 (29/95) 2.26 1.43 to 3.58 0.001
- Hepatitis 44.4 (4/9) 3.92 1.04 to 14.67 0.052
- Congenital syphilis 50.0 (1/2) 4.85 0.30 to 77.79 0.313
Other non-infectious underlying conditions 17.1 (20/117) 1.00 0.60 to 1.64 1.000
- Sickle cell disease 3.0 (1/33) 0.15 0.02 to 1.09 0.032
- Neoplasia 60.0 (3/5) 7.32 1.22 to 44.05 0.038
- Congenital heart disease 27.3 (9/33) 1.77 0.82 to 3.83 0.156
Malaria (laboratory confirmed) 20.2 (67/331) 1.29 0.95 to 1.76 0.102
Growth in blood culture of:     
Any pathogen 34.9 (80/229) 3.29 2.41 to 4.48 < 0.001
Any GNR 43.5 (64/147) 4.60 3.22 to 6.60 < 0.001
Any Enterobacteriaceae 45.6 (52/114) 4.82 3.25 to 7.15 < 0.001
- E. coli 50.0 (15/30) 5.11 2.47 to 10.59 < 0.001
- Klebsiella spp. 48.9 (22/45) 5.00 2.74 to 9.10 < 0.001
- All non-typhoid Salmonellae 36.4 (12/33) 2.88 1.40 to 5.92 0.007
- Salmonella Enteritidis 21.1 (4/19) 1.31 0.43 to 3.97 0.548
- Salmonella Typhimurium 53.9 (7/13) 5.83 1.94 to 17.48 0.003
- Enterobacter spp. 71.4 (5/7) 12.43 2.40 to 64.43 0.002
Any non-Enterobacteriaceae GNR 40.6 (13/32) 3.46 1.69 to 7.10 0.001
- Pseudomonas aeruginosa 66.7 (8/12) 10.04 3.00 to 33.59 < 0.001
- Acinetobacter spp. 9.1 (1/11) 0.49 0.06 to 3.82 0.702
Gram-positive pathogen† 16.7 (11/66) 0.98 0.50 to 1.89 1.000
- Enterococci 19.4 (7/36) 1.19 0.51 to 2.73 0.655
- E. faecium 6.7 (1/15) 0.35 0.05 to 2.65 0.490
- E. faecalis 28.6 (4/14) 1.97 0.61 to 6.33 0.275
- S. aureus 7.1 (2/28) 0.37 0.09 to 1.58 0.208
Candida 33.3 (8/24) 2.49 1.05 to 5.87 0.049
Polymicrobial infection 41.4 (12/29) 3.56 1.68 to 7.55 0.002
Inappropriate antimicrobial therapy due to:     
- ESBL-producing, multiresistant isolates 71.4 (15/21) 12.87 4.95 to 33.48 < 0.001
- Other bacterial resistance (non-ESBL) 37.8 (17/45) 3.14 1.69 to 5.83 0.001
- Any bacterial resistance (ESBL + other) 47.7 (31/65) 5.01 3.02 to 8.31 < 0.001
- Any antimicrobial resistance (including fungi) 43.8 (39/89) 4.39 2.82 to 6.83 < 0.001
Hospital-acquired infection 35.5 (44/124) 3.01 2.03 to 4.46 < 0.001
Readmission stay 15.2 (14/92) 0.87 0.49 to 1.56 0.775
  1. CFR, case-fatality rate; OR, odds ratio; 95%CI: 95% confidence interval; P, p-value calculated with two-sided Fisher's exact test; GNR, Gram-negative rod; ESBL, extended-spectrum beta-lactamase. *The outcome was known for 1632 among a total of 1828 admissions. † Anaerobes, coagulase-negative staphylococci and bacterial isolates of uncertain pathogenicity were not included. ‡ Blood culture obtained > 2 days after admission.