Table 1 Demographic and clinical characteristics of patients infected by carbapenem resistant Gram-negative bacilli
Characteristic | Total | Pseudomonas aeruginosa | Klebsiella pneumoniae | Enterobacter cloacae |
|---|---|---|---|---|
No. (%) | No. (%) | No. (%) | No. (%) | |
Gender | ||||
Male | 33 (55.9) | 16 (66.7) | 13 (46.4) | 4 (57.1) |
Female | 26 (44.1) | 8 (33.3) | 15 (53.6) | 3 (42.9) |
Age (yrs) | ||||
< 1 | 24 (40.7) | 8 (33.3) | 12 (42.8) | 4 (57.1) |
1 a 4 | 13 (20.0) | 6 (25.0) | 7 (25.0) | 0 |
5 a 8 | 13 (20.0) | 5 (20.8) | 6 (21.4) | 2 (28.6) |
9 a 12 | 6 (10.2) | 3 (12.5) | 2 (7.1) | 1 (14.3) |
> 12 | 3 (5.1) | 2 (8.3) | 1 (3.6) | 0 |
Hospital stay (days) Me (RI) | 37 (16–76) | 33 (15–70) | 48 (25–77) | 29 (10–33) |
Hospital | ||||
A | 24 (40.7) | 16 (66.7) | 5 (17.9) | 3 (42.9) |
B | 16 (27.1) | 2 (8.3) | 11 (39.3) | 3 (42.9) |
C | 11 (18.6) | 3 (12.5) | 7 (25.0) | 1 (14.3) |
D | 7 (11.9) | 3 (12.5) | 4 (14.3) | 0 |
E | 1 (1.7) | 0 | 1 (3.6) | 0 |
History in past 6 months | ||||
Hospitalization | 44 (74.6) | 15 (62.5) | 25 (89.3) | 4 (57.1) |
Surgery | 37 (62.7) | 15 (62.5) | 19 (67.9) | 3 (42.9) |
Stay in ICU | 30 (50.8) | 13 (54.2) | 15 (53.6) | 2 (28.6) |
Immunosuppressive therapy | 16 (27.1) | 8 (33.3) | 6 (21.4) | 2 (28.6) |
Dialysis | 8 (13.56) | 3 (12.5) | 5 (17.9) | 0 |
Antimicrobial use in past | 56 (94.9) | 23 (95.8) | 27 (96.4) | 6 (85.7) |
Carbapenems | 22 (37.3) | 7 (29.2) | 13 (46.4) | 2 (28.6) |
Piperacillin-tazobactam | 22 (37.3) | 3 (12.5) | 15 (53.6) | 4 (57.1) |
Glycopeptides | 18 (30.5) | 7 (29.2) | 10 (35.7) | 1 (14.3) |
1st-generation cephalosporin | 17 (28.8) | 6 (25.0) | 8 (28.6) | 3 (42.9) |
Aminoglycosides | 13 (22.0) | 5 (20.8) | 8 (28.6) | 0 |
4th-generation cephalosporin | 10 (16.9) | 3 (12.5) | 6 (21.4) | 1 (14.3) |
Penicillin | 9 (15.3) | 5 (20.8) | 3 (10.7) | 1 (14.3) |
Fluoroquinolones | 9 (15.3) | 0 | 7 (25.0) | 2 (28.6) |
3rd-generation cephalosporin | 8 (13.6) | 6 (25.0) | 2 (7.1) | 0 |
TMP-SMX | 7 (11.9) | 2 (8.3) | 5 (17.9) | 0 |
Macrolides | 2 (3.4) | 2 (8.3) | 0 | 0 |
Lincosamides | 2 (3.4) | 0 | 2 (7.1) | 0 |
Oxazolidinones | 2 (3.4) | 0 | 2 (7.1) | 0 |
2nd-generation cephalosporin | 1 (1.7) | 1 (4.2) | 0 | 0 |
Colistin | 1 (1.7) | 0 | 1 (3.6) | 0 |
Monobactams | 1 (1.7) | 0 | 1 (3.6) | 0 |
Lipopeptides | 1 (1.7) | 1 (4.2) | 0 | 0 |
Infection type | ||||
Health care associated | 57 (96.6) | 23 (95.8) | 28 (100) | 6 (85.7) |
Community associated | 2 (3.4) | 1 (4.2) | 0 | 1 (14.3) |
Hospitalization in ICU at time of isolate | 25 (42.4) | 10 (41.7) | 12 (42.9) | 3 (42.9) |
Medical device | 46 (78.0) | 20 (83.3) | 20 (71.4) | 6 (85.7) |
Central venous catheter | 29 (49.2) | 12 (50.0) | 14 (50.0) | 3 (42.9) |
Enteral nutrition | 28 (47.5) | 12 (50.0) | 12 (42.9) | 4 (57.1) |
Urinary catheter | 20 (33.9) | 6 (25.0) | 12 (42.9) | 2 (28.6) |
Invasive mechanical ventilation | 17 (28.8) | 9 (37.5) | 6 (21.4) | 2 (28.6) |
Parenteral nutrition | 8 (13.6) | 3 (12.5) | 5 (17.9) | 0 |
Comorbidities | 56 (94.9) | 22 (91.7) | 28 (100.0) | 6 (85.7) |
Cardiovascular disease | 12 (20.3) | 4 (16.7) | 7 (25.0) | 1 (14.3) |
Neurologic disease | 7 (11.9) | 3 (12.5) | 3 (10.7) | 1 (14.3) |
Lung disease | 6 (10.2) | 3 (12.5) | 1 (3.6) | 2 (28.6) |
Chronic renal disease | 5 (8.5) | 4 (16.7) | 1 (3.6) | 0 |
Transplant | 5 (8.5) | 2 (8.3) | 2 (7.1) | 1 (14.3) |
Trauma | 3 (5.1) | 1 (4.2) | 2 (7.1) | 0 |
Burns | 3 (5.1) | 2 (8.3) | 1 (3.6) | 0 |
Cancer | 2 (3.4) | 0 | 2 (7.1) | 0 |
Leukemia | 2 (3.4) | 1 (4.2) | 1 (3.6) | 0 |
Cystic fibrosis | 1 (1.7) | 1 (4.2) | 0 | 0 |
Immunosuppression | 1 (1.7) | 1 (4.2) | 0 | 0 |
Infection site | ||||
Urinary tract infection (UTI) | 18 (31) | 5 (20.8) | 10 (37.0) | 3 (42.9) |
Catheter-associated UTI | 9 (15.5) | 3 (12.5) | 6 (22.2) | 0 |
Ventilator-associated pneumonia | 7 (12.2) | 2 (8.3) | 3 (11.1) | 2 (28.6) |
Bloodstream | 6 (10.3) | 1 (4.2) | 4 (14.8) | 1 (14.3) |
Pneumonia | 6 (10.3) | 5 (20.8) | 1 (3.7) | 0 |
Catheter-related bloodstream | 3 (5.2) | 2 (8.3) | 1 (3.7) | 0 |
Skin and soft tissue | 2 (3.4) | 2 (8.3) | 0 | 0 |
Surgical site | 1 (1.7) | 0 | 0 | 1 (14.3) |
Intra-abdominal | 1 (1.7) | 0 | 1 (3.7) | 0 |
Empirical therapy | 51 (86.4) | 19 (79.2) | 25 (89.3) | 7 (100.0) |
Carbapenems | 16 (27.1) | 4 (16.7) | 11 (39.3) | 1 (14.3) |
Piperacilin-tazobactam | 16 (27.1) | 7 (29.2) | 6 (21.4) | 3 (42.9) |
Glycopeptides | 13 (22) | 6 (25.0) | 5 (17.9) | 2 (28.6) |
Aminoglycosides | 13 (22) | 2 (8.3) | 9 (32.1) | 2 (28.6) |
4th-generation cephalosporin | 7 (11.9) | 4 (16.7) | 1 (3.6) | 2 (28.6) |
Fluoroquinolones | 3 (5.1) | 1 (4.2) | 2 (7.1) | 0 |
Monobactams | 2 (3.4) | 2 (8.3) | 0 | 0 |
3rd-generation cephalosporin | 2 (3.4) | 2 (8.3) | 0 | 0 |
1st-generation cephalosporin | 1 (1.7) | 0 (0) | 1 (3.6) | 0 |
Penicillin | 1 (1.7) | 0 | 0 | 1 (14.3) |
Oxazolidinones | 1 (1.7) | 0 | 1 (3.6) | 0 |
TMP-SMX | 1 (1.7) | 0 | 1 (3.6) | 0 |
Colistin | 1 (1.7) | 0 | 1 (3.6) | 0 |
Targeted therapy | 53 (89.8) | 20 (83.3) | 27 (96.4) | 6 (85.7) |
Colistin | 16 (27.1) | 2 (8.3) | 14 (50.0) | 0 |
Aminoglycosides | 16 (27.1) | 6 (25.0) | 9 (32.1) | 1 (14.3) |
Carbapenems | 14 (23.7) | 3 (12.5) | 10 (35.7) | 1 (14.3) |
Fluoroquinolones | 10 (16.9) | 6 (25.0) | 3 (10.7) | 1 (14.3) |
4th-generation cephalosporin | 9 (15.3) | 5 (20.8) | 2 (7.1) | 2 (28.6) |
Piperacilin-tazobactam | 4 (6.8) | 3 (12.5) | 0 | 1 (14.3) |
Monobactams | 2 (3.4) | 1 (4.2) | 1 (3.6) | 0 |
3rd-generation cephalosporin | 2 (3.4) | 2 (8.3) | 0 | 0 |
Glycopeptides | 1 (1.7) | 0 | 1 (3.6) | 0 |
Oxazolidinones | 1 (1.7) | 0 | 1 (3.6) | 0 |
TMP-SMX | 1 (1.7) | 0 | 1 (3.6) | 0 |
Surgical Treatment | 6 (10.2) | 3 (12.5) | 3 (10.7) | 0 |
Outcome | ||||
Cure | 38 (69.1) | 13 (59.1) | 20 (76.9) | 5 (71.4) |
Death | 9 (16.4) | 4 (18.2) | 4 (15.4) | 1 (14.3) |
Improvement | 7 (12.7) | 4 (18.2) | 2 (7.7) | 1 (14.3) |
Voluntary discharge | 1 (1.8) | 1 (4.5) | 0 | 0 |