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Table 4 Risk of unfavourable outcome after Enterobacterales infection in solid organ transplant recipients

From: Temporal trends, risk factors and outcomes of infections due to extended-spectrum β-lactamase producing Enterobacterales in Swiss solid organ transplant recipients between 2012 and 2018

  Favourable (N = 69) Unfavourable (N = 33) Univariate Multivariable
OR [95%-CI] (p value) aOR [95%-CI] (p value)
ESBL infection, N (%) 27 (37.9) 24 (74.3) 4.1 [1.7–10.7] (< 0.01) 3.1 [0.8–12.5] (0.10)
Age, mean (SD) 54.2 (13.7) 53.8 (13.1) 1.0 [0.9–1.0] (0.89)  
Malea, N (%) 32 (46.4) 13 (39.4) 0.8 [0.3–1.7] (0.51) 0.5 [0.1–1.5] (0.20)
BMI at transplant (mean, SD) 25.0 (3.8) 25.9 (4.8) 1.0 [0.9–1.2] (0.33)  
Ethnicity: caucasian 66 (95.7) 29 (87.9) 0.3 [0.1–1.6] (0.16)  
Year of infection, N (%)
 2012 8 (11.6) 6 (18.2) –  
 2013 17 (24.6) 7 (21.2) 0.6 [0.1–2.2] (0.39)  
 2014 18 (26.1) 6 (18.2) 0.4 [0.1–1.8] (0.26)  
 2015 17 (24.6) 9 (27.3) 0.7 [0.2–2.7] (0.61)  
 2016 9 (13.0) 5 (15.2) 0.7 [0.2–3.4] (0.70)  
Transplanted organ, N (%)
 Kidney 41 (59.4) 25 (75.8) –  
 Non-Kidney 28 (40.6) 8 (24.2) 0.4 [0.2–1.1] (0.09)  
Comorbidities, N (%)
 Cardiopulmonary disease 9 (13.0) 5 (15.2) 1.2 [0.5–2.9] (0.62)  
 Metabolic/endocrine disease 34 (49.3) 18 (54.5) 1.2 [0.5–3.5] (0.70)  
 Cancer 52 (75.4) 26 (78.8) 1.2 [0.4–3.8] (0.77)  
 Other 43 (62.3) 20 (60.6) 0.9 [0.4–2.2] (0.87)  
Causing pathogen, N (%)
 Escherichia coli 54 (78.3) 23 (69.7) –  
 Klebsiella spp. 7 (10.1) 9 (27.3) 3.0 [1.0–9.4] (0.05)  
 Other 8 (11.6) 1 (3.0) 0.3 [0.1–1.7] (0.26)  
Time to infection, median (IQR) 70 (31–256) 61 (14–203) 1.0 [1.0–1.0] (0.24)  
Type of infection, N (%)
 Urinary tract (vs. other) 50 (72.5) 27 (81.8) 1.7 [0.6–5.2] (0.31)  
 Bacteremia 19 (27.5) 8 (24.2) 0.8 [0.3–2.1] (0.72)  
Hospital-onset, N (%) 26 (38.2) 13 (39.4) 1.1 [0.4–2.5] (0.91)  
LOS after infectionb, median (IQR) 14 (4–26) 16 (7.2–33) 0.9 [0.9–1.0] (0.58)  
On ICU after infectiona, N (%) 10 (21.3) 7 (31.8) 1.7 [0.5–5.4] (0.35) 2.3 [0.6–8.1] (0.20)
Antibiotic therapyc, N (%) 60 (87.0) 28 (84.8) 0.8 [0.3–2.9] (0.77)  
 Treatment with carbapenems 23 (33.3) 17 (51.5) 2.1 [0.9–5.0] (0.08)  
Treatment duration, median (IQR) 13 (7–19) 13 (7–18) 1.0 [0.9–1.0] (0.95)  
Adequate empiric therapya,d, N (%) 39 (65.0) 11 (39.3) 0.3 [0.1–0.9] (0.03) 0.5 [0.1–1.7] (0.27)
Infectious diseases consult, N (%) 36 (52.2) 13 (39.4) 0.6 [0.3–1.4] (0.23)  
 Initially 27 (39.1) 10 (30.3) 0.7 [0.3–1.6] (0.39)  
 Upon microbiology results 27 (39.1) 10 (30.3) 0.7 [0.3–1.6] (0.39)  
  1. BMI body mass index, ESBL extended-spectrum beta-lactamase, (a)OR (adjusted) odds ratio, CI confidence interval, IQR interquartile range, LOS length of stay, ICU Intensive Care Unit
  2. aIncluded in multivariable analysis based on individual impact on key predictor variable "ESBL infection"[13]
  3. bVariable dropped from final model because of parsimony reasons; inclusion does not alter results
  4. cWithin 30 days after diagnosis
  5. dWithin 2 days after diagnosis
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Antimicrobial Resistance & Infection Control

ISSN: 2047-2994

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