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Table 1 Baseline clinical characteristics and treatment outcomes of patients admitted with hemodialysis-associated pneumonia

From: Proposed risk factors for infection with multidrug-resistant pathogens in hemodialysis patients hospitalized with pneumonia

Characteristics Overall patients (n = 105) MDR pathogens group (n = 24) Non-MDR pathogens group (n = 81) P Value
Age (years) 71 (61–76) 73 (62–79) 71 (61–76) 0.199
Male 68 (64.8%) 15 (62.5%) 53 (65.4%) 0.792
Female 37 (35.2%) 9 (37.5) 28 (34.6%) 0.792
Time interval between dialysis and pneumonia (months) 30 (11–69) 21 (10–74) 34 (12–69) 0.541
Etiology of dialysisa     
 Diabetes mellitus 60 (57.1%) 14 (58.3%) 46 (56.7%) 0.344
 Hypertension 57 (54.2%) 11 (45.8%) 46 (56.7%) 0.893
 Glomerulonephropathy 6 (5.7%) 1 (4.1%) 5 (6.1%) 1.000
 Idiopathic 7 (6.6%) 2 (8.3%) 5 (6.1%) 0.658
 Others 13 (12.3%) 1 (4.1%) 12 (14.8%) 0.289
Tube feeding 9 (8.5%) 5 (20.8%) 4 (4.9%) 0.028
HCAP criteria other than HDAP   17 (70.8%) 27 (33.3%) 0.001
 Recent hospitalization 42 (40.0%) 16 (66.6%) 26 (32.0%) 0.002
 NHAP 10 (9.5%) 5 (20.8%) 5 (6.1%) 0.047
 Recent intravenous therapy 10 (9.5%) 3 (12.5%) 7 (8.6%) 0.692
Clinical parameters     
 Severe pneumonia 37 (35.2%) 13 (54.1%) 24 (29.6%) 0.027
 Confusion 15 (14.2%) 6 (25.0%) 9 (11.1%) 0.103
 Respiratory failure 47 (44.7%) 14 (58.3%) 33 (40.7%) 0.128
 Sepsis or septic shock at onset 15 (14.2%) 7 (29.1%) 8 (9.8%) 0.040
 ICU admission 22 (20.9%) 10 (41.6%) 12 (14.8%) 0.005
 Need for ventilator 6 (5.7%) 3 (12.5%) 3 (3.7%) 0.131
Radiological findings     
 Multi-lobar involvement 73 (69.5%) 20 (83.3%) 53 (65.4%) 0.094
 Pleural effusion 33 (31.4%) 6 (25.0%) 27 (33.3%) 0.440
Laboratory findings     
 WBC (/mm3) 11,200 (7400–15,015) 13,210 (8200–18,600) 10,680 (7150–14,960) 0.104
 CRP (mg/dl) 8.5 (3.7–15.1) 9.4 (4.8–16.0) 7.1 (3.7–14.7) 0.364
 Procalcitonin, n = 62, (mg/dl) 1.1 (0.4–5.9) 1.7 (0.5–6.8) 0.9 (0.3–5.6) 0.571
Indices for disease severity     
 CURB-65 score 2 (1–2) 2 (1–3) 2 (1–2) 0.095
 CURB-65 score ≥ 3 19 (18.0%) 7 (29.1%) 12 (14.8%) 0.133
 PSI score 123 (105–145) 148 (120–181) 118 (99–139) 0.001
 PSI class IV or V 91 (86.6%) 23 (95.8%) 68 (83.9%) 0.181
Initial antibiotic therapy     
 as CAP 47 (44.7%) 4 (16.6%) 43 (53.0%) 0.002
 as HAP 58 (55.2%) 20 (83.3%) 38 (46.9%) 0.002
 Use of Anti-MRSA agents 7 (6.6%) 4 (16.6%) 3 (3.7%) 0.046
Clinical outcomes     
 Use of inappropriate antibiotics 21 (20.0%) 15 (62.5%) 6 (7.4%) <0.001
 Change of initial antibiotics 40 (38.0%) 13 (54.1%) 27 (33.3%) 0.065
 Failure of initial antibiotics therapy 29 (27.6%) 11 (45.8%) 18 (22.2%) 0.254
 Duration of antibiotic therapy (days) 12 (10–15) 12 (9–22) 12 (10–15) 0.401
 Length of hospital stay (days) 11 (7–17) 14 (9–25) 11 (7–16) 0.093
 Pneumonia-related mortality rate 8 (7.6%) 6 (25.0%) 2 (2.4%) 0.002
 Hospital mortality rate 11 (10.4%) 6 (25.0%) 5 (6.1%) 0.016
  1. Data are presented as median (interquartile range) or number (%)
  2. MDR multidrug-resistant, HCAP healthcare-associated pneumonia, HDAP hemodialysis-associated pneumonia, NHAP nursing home-acquired pneumonia, ICU intensive care unit, WBC white blood cell, CRP C-reactive protein, CAP community-acquired pneumonia, MRSA methicillin-resistant Staphylococcus aureus, CURB-65 Confusion, Urea, Respiratory rate, Blood pressure, Age ≥ 65, PSI Pneumonia Severity Index
  3. aallowed for overlap