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Table 1 Demographic and clinical characteristics of the study cohort

From: Clinical and epidemiological characteristics of KPC-producing Klebsiella pneumoniae from bloodstream infections in a tertiary referral center in Italy

Variables

30-days outcome

All, 112

Death, 39 (35%)

Survive, 73 (65%)

p-value

Patients variables

 Sex

  • Male

80 (72%)

27 (69%)

53 (73%)

0.875

  • Female

32 (28%)

12 (31%)

20 (27%)

 Age (years) median (IQR)

68 (55–76)

72 (58–78)

65 (54–75)

0.528

 Charlsons Comorbidity Index ≥3

93 (83%)

37 (95%)

56 (77%)

0.030

 Comorbidities

  • Diabetes

31 (28%)

9 (23%)

22 (30%)

0.566

  • COPD

18 (16%)

7 (18%)

11 (15%)

0.900

  • Haematological malignancies

16 (14%)

9 (23%)

7 (10%)

0.097

  • Solid tumors

37 (33%)

15 (39%)

22 (30%)

0.496

  • Chronic Hepatitis

10 (9%)

5 (13%)

5 (7%)

0.313

  • Cardiovascular disease

66 (54%)

23 (59%)

43 (59%)

0.994

  • Neurological disease

38 (34%)

6 (15%)

32 (44%)

0.005

  • Chronic kidney disease

32 (29%)

14 (36%)

18 (25%)

0.301

  • HIV

1 (1%)

0

1 (1%)

1.000

  • Neutropenia

12 (11%)

8 (21%)

4 (6%)

0.033

  • Gastrointestinal disease

23 (21%)

5 (13%)

18 (25%)

0.218

  • SOT

5 (5%)

3 (8%)

2 (3%)

0.226

  • Others

21 (19%)

5 (13%)

16 (22%)

0.357

 Apache II score ≥ 15

56 (50%)

32 (82%)

24 (33%)

< 0.001

 Acute comorbidities

  • Septic shock

40 (36%)

26 (67%)

14 (19%)

< 0.001

  • pneumonia

48 (43%)

21 (54%)

27 (37%)

0.129

  • Acute kidney failure

18 (16%)

8 (20%)

10 (14%)

0.506

  • Gastrointestinal perforation

5 (5%)

4 (10%)

1 (1%)

0.049

  • Trauma

10 (9%)

2 (5%)

8 (11%)

0.489

  • Others

53 (47%)

16 (41%)

37 (51%)

0.329

Hospitalization variables

 Nosocomial infection

104 (93%)

36 (92%)

68 (93%)

1.000

 Healthcare-related infectiona

8 (7%)

3 (8%)

5 (7%)

 Wards submitting index culture

  • Intensive care unit

45 (40%)

15 (38%)

30 (41%)

0.945

  • Surgery

27 (24%)

7 (18%)

20 (27%)

0.378

  • Medicine

32 (29%)

14 (36%)

18 (25%)

0.301

  • Other health care facilities

8 (7%)

3 (8%)

5 (7%)

1.000

 Time interval (days) from admission, median (IQR)

23,5 (11–39)

23,5 (11–39)

24,5 (11,5–39)

0.541

 Total previous hospitalization, median (IQR)b

30,5 (15–59.25)

33 (15–66)

27 (14.5–51.5)

0.352

Pre-infection variables

 Central venous catheter

99 (88%)

39 (100%)

60 (82%)

0.004

 Other devices

102 (91%)

38 (97%)

64 (88%)

0.161

 CVVH

8 (7%)

3 (8%)

5 (7%)

1.000

 Invasive proceduresc

31 (28%)

17 (44%)

14 (19%)

0.011

 Steroid therapyd

43 (38%)

18 (46%)

25 (34%)

0.303

 Immunosuppressive therapyd,e

29 (26%)

15 (39%)

14 (19%)

0.046

 Previous Surgeryf

60 (54%)

22 (56%)

51 (70%)

0.090

  • Gastrointestinal surgery

30 (27%)

11 (28%)

19 (26%)

0.981

  • Cardiovascular surgery

9 (8%)

5 (13%)

4 (6)

0.272

  • Urologic surgery

7 (6%)

3 (8%)

4 (6%)

0.693

  • Neurosurgery

13 (12%)

2 (5%)

11 (15%)

0.214

  • Orthopedic surgery

9 (8%)

1 (3%)

8 (11%)

0.158

  • Plastic surgery

3 (3%)

0

3 (4%)

0.550

  • Thoracic surgery

3 (3%)

1 (3%)

2 (3%)

1.000

Microbiologic variables

 KPC rectal swabg

32 (29%)

16 (41%)

16 (22%)

0.056

 Isolation of KPC from other sites

  • Urinary tract

30 (27%)

7 (18%)

23 (32%)

0.187

  • Bronchial / pleural fluid

36 (32%)

11 (28%)

25 (34%)

0.660

  • abdominal fluid

13 (9%)

6 (15%)

7 (10%)

0.370

  • wounds

15 (13%)

6 (15%)

9 (12%)

0.872

 Other infections, n° (%)

  • Previous infectionsh

35 (31%)

11 (28%)

24 (33%)

0.769

  • Concomitanti

26 (23%)

10 (26%)

16 (22%)

0.834

Treatment variables

 Previous antibiotic therapyd

91 (81%)

33 (85%)

58 (80%)

0.680

  • Penicillins

34 (30%)

12 (31%)

22 (30%)

1.000

  • Cephalosporins

8 (7%)

1 (3%)

7 (10%)

0.258

  • Carbapenems

51 (46%)

20 (51%)

31 (43%)

0.488

  • Fluoroquinolones

32 (29%)

12 (31%)

20 (27%)

0.875

  • Macrolides

4 (4%)

0

4 (6%)

0.296

  • Aminoglycosides

10 (9%)

1 (1%)

9 (12%)

0.161

  • Tigecycline

21 (19%)

8 (21%)

13 (18%)

0.924

  • Colistin

14 (13)

6 (15)

8 (11%)

0.708

  • Others

47 (42%)

19 (48%)

28 (38%)

0.391

 Adequate empiric antibiotic treatmentj

15 (13%)

6 (15%)

9 (12%)

0.872

 Post-antibiogram therapy

  • Colistin-including therapy

44 (39%)

11 (28%)

33 (45%)

0.121

  • Tigecycline-including therapy

57 (51%)

16 (41%)

41 (56%)

0.184

  • Gentamicin-including therapy

46 (41%)

9 (23%)

37 (51%)

0.009

  • Monotherapy

13 (12%)

3 (8%)

10 (14%)

0.537

  • Combination therapy

89 (80%)

29 (74%)

60 (82%)

0.328

  • Two-drug combinations

24 (21%)

10 (26%)

14 (19%)

0.581

  • Combinations with ≥ three drugs

66 (59%)

19 (49%)

47 (64%)

0.160

  • Carbapenem-excluding combinations

41 (37%)

16 (41%)

25 (34%)

0.615

  • Carbapenem-including combinations

71 (63%)

23 (59%)

48 (66%)

  • Double-carbapenem combinations

5 (5%)

2 (5%)

3 (4%)

1.000

  • Rifampin addition to combination

3 (3%)

2 (5%)

1 (1%)

0.240

  • Adequate antibiotic treatmentj

84 (74%)

21 (54%)

63 (85%)

< 0.001

   -with one active drug

49 (44%)

17 (44%)

32 (44%)

1.000

   -with two or three active drugs

35 (31%)

4 (10%)

31 (42%)

< 0.001

KPC-K isolate characteristics

 Colistin resistant

66 (59%)

22 (56%)

44 (60%)

0.846

 Tigecycline resistantk

27 (37%)

10 (45%)

17 (33%)

0.436

 Gentamicin resistant

14 (13%)

5 (13%)

9 (12%)

1.000

 Amikacin resistant

97 (86%)

33 (85%)

64 (88%)

0.872

 Fosfomycin resistant

72 (64%)

19 (49%)

53 (73%)

0.188

 Bactrim resistant

92 (82%)

30 (77%)

62 (85%)

0.426

 Meropenem MIC ≤8

4 (4%)

3 (8%)

1 (1%)

0.086

 Meropenem MIC≥16

108 (96%)

36 (87%)

72 (99%)

 Pulsotype A – ST512l

97 (91%)

33 (89%)

64 (91%)

0.705

 Pulsotype B – ST307l

10 (9%)

4 (11%)

6 (9%)

  1. Data are expressed as No. (%) unless otherwise specified
  2. Abbreviations: APACHE Acute Physiology and Chronic Health Evaluation, IQR interquartile range, COPD Chronic obstructive pulmonary disease, SOT solid organ transplantation, CVVH Continuous Veno-Venous Hemofiltration
  3. aHealthcare-associated infections are defined as described by Friedman, N. D. 2002. Health Care–Associated Bloodstream Infections in Adults: A Reason To Change the Accepted Definition of Community-Acquired Infections. Annals of Internal Medicine, 137 (10), 791. doi:https://doi.org/10.7326/0003-4819-137-10-200211190-00007
  4. bDuring the 12 months preceding BSI onset
  5. cDuring the 72 h preceding BSI onset
  6. dDuring the 30 days preceding BSI onset
  7. eExcluding therapy with steroids
  8. fDuring the 3 months preceding BSI onset
  9. gThe majority of rectal swabs was collected before the onset of KPC-Kp BSI, during of the same hospitalization
  10. hDuring the 30 days preceding BSI onset. Previous infections included: lung infections (n = 16), BSIs (n = 5), SSTIs (n = 3), CNS infections (n = 2), abdominal infections (n = 2), UTIs (n = 2), abdominal infection plus BSI (n = 1), UTI plus BSI (n = 1), lung infection plus BSI (n = 1), lung infection plus SSTI (n = 1), lung infection plus UTI (n = 1)
  11. iConcomitant infections included lung infections (n = 8), BSIs (n = 4), UTIs (n = 4), SSTIs (n = 2), abdominal infection (n = 1), BSIs plus lung infections (n = 3), BSI plus lung infection plus CNS infection plus SSTI (n = 1), abdominal infection plus BSI (n = 1), lung infection plus UTI (n = 1) and BSI plus UTI (n = 1). 10 BSI were polymicrobial
  12. jAdequate therapy is defined as the use of at least one drugs to which the isolate was susceptible in vitro
  13. kStrains showing tigecycline MIC ≥4 mg/L were considered non susceptible as stated by Marchaim et al. 2014. Major variation in MICs of tigecycline in Gram-negative bacilli as a function of testing method. J Clin Microbiol, 52:1617–21. doi:https://doi.org/10.1128/JCM.00001-14
  14. lPercentage of these variables are calculated only on the 107 patients from which bacterial strains were recovered
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BMC Infectious Diseases

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