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Table 3 The timing and clinical efficacy of antibiotics for infected patients after colonization

From: Active surveillance of carbapenem-resistant gram-negative bacteria to guide antibiotic therapy: a single-center prospective observational study

 

Empirically sensitive antibiotic therapy groups, N = 88

Standard antibiotic therapy groups, N = 64

P

OR (95%CI)

Age-year, mean (SD)

61.2 (9.8)

59.8 (10.3)

0.60

/

Male sex, no. (%)

66 (75.0%)

46 (71.8%)

0.66

0.85 (0.41–1.76)

APACHE II scores, median (IQR)

17.0 (8.0–28.0)

16.4 (7.0–32.0)

0.20

/

Cerebrovascular accidents, no. (%)

22 (25.0%)

16 (25.0%)

1.00

1.00 (0.47–2.10)

Cardiac insufficiency, no. (%)

9 (10.2%)

7 (10.9%)

0.88

0.93 (0.32–2.63)

Trauma, no. (%)

38 (43.2%)

23 (35.9%)

0.36

1.35 (0.69–2.62)

Infection, no. (%)

24 (27.3%)

25 (39.1%)

0.12

0.58 (0.29–1.16)

Malignant tumor, no. (%)

9 (10.2%)

2 (3.1%)

0.09

3.52 (0.73–16.94)

Diabetes mellitus, no. (%)

9 (10.2%)

5 (7.8%)

0.61

1.34 (0.42–4.22)

Intubation or tracheotomy, no. (%)

45 (51.1%)

31 (48.4%)

0.74

1.11 (0.58–2.12)

Invasive operation, no. (%)

72 (81.8%)

51 (79.6%)

0.74

1.14 (0.51–2.59)

Operation History, no. (%)

10 (11.3%)

10 (15.6%)

0.44

0.69 (0.27–1.77)

Immunocompromise, no. (%)

46 (52.2%)

26 (40.6%)

0.15

1.60 (0.83–3.06)

Septic shock, no. (%)

44 (50.0%)

40 (62.5%)

0.12

0.60 (0.31–1.15)

Acute kidney injury, no. (%)

40 (45.5%)

34 (53.1%)

0.35

0.73 (0.38–1.40)

Infection sites, no. (%)

    

 Pulmonary infection

64 (72.7%)

50 (78.1%)

0.45

0.74 (0.35–1.59)

 Bloodstream infection

35 (39.8%)

10 (15.6%)

0.001

3.56 (1.60–7.92)

 Urinary tract infection

26 (29.5%)

16 (25.0%)

0.53

1.25 (0.61–2.60)

 Gastrointestinal infection

21 (23.9%)

16 (25.0%)

0.87

0.94 (0.45–1.99)

 Other sites infections

37 (42.0%)

25 (39.1%)

0.71

1.13 (0.58–2.18)

CRGNB types, no. (%)

    

 CRKP

38 (43.2%)

22 (34.4%)

0.27

1.45 (0.74–2.82)

 CRPA

31 (35.2%)

25 (39.1%)

0.63

0.84 (0.43–1.65)

 CRAB

17 (19.3%)

15 (23.4%)

0.54

0.78 (0.35–1.71)

 Other CRE

2 (2.3%)

2 (3.1%)

1.00

0.72 (0.10–5.25)

Antibiotic therapy, no. (%)

    

 Combinations with Tigecycline

25 (28.4%)

14 (21.8%)

0.36

1.41 (0.67–3.01)

 Combinations with Polymyxin B

14 (15.9%)

10 (15.6%)

0.96

1.02 (0.42–2.47)

 Ceftazidime–avibactam monotherapy

13 (14.7%)

4 (6.2%)

0.10

2.60 (0.81–8.39)

 Other therapies

36 (40.9%)

36 (56.3%)

0.06

0.53 (0.28–1.03)

Timing of antibiotic intervention, hours, median (IQR)

8.4 (3.6–17.2)

45.6 (15.4–69.4)

0.001

/

Duration from colonization to infection, day, median (IQR)

13.5 (4.0–19.0)

12.8 (4.0–17.5)

0.54

/

Length of ICU stay after infection, day, median (IQR)

16.7 (7.5–32.5)

16.8 (6.0–35.5)

0.61

/

Length of hospital stay after infection, day, median (IQR)

32.8 (10.5–75.0)

24.2 (6.0–65.0)

0.22

/

Death, no. (%)

15 (17.0%)

24 (37.5%)

0.004

0.34 (0.16–0.73)

  1. CRGNB: carbapenem-resistant gram-negative bacteria; CRKP: carbapenem-resistant Klebsiella pneumoniae; CRAB: carbapenem-resistant Acinetobacter baumannii; CRPA: carbapenem-resistant Pseudomonas aeruginosa; CRE: carbapenem-resistant enterobacteria; SD: standard deviation; APACHE II: acute physiology and chronic health evaluation; IQR: interquartile range; ICU: intensive care unit; OR: odds ratio; CI: confidence interval