Volume 26, Number 6—June 2020
Research
Increased Risk for Carbapenem-Resistant Enterobacteriaceae Colonization in Intensive Care Units after Hospitalization in Emergency Department
Table 1
Characteristics of patients, bivariate analysis, and conditional logistic regression of variables potentially associated with colonization by carbapenem-resistant Enterobacteriaceae at ICU admission, Hospital das Clínicas, São Paulo, Brazil, September 2015–July 2017*
Covariate | Bivariate analysis |
Conditional logistic regression |
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---|---|---|---|---|---|---|---|
Cases | Controls | OR (95% CI) | p value | OR (95% CI) | p value | ||
Female sex | 34/103 (33) | 91/201 (45) | 0.58 (0.35–0.95) | 0.03 | |||
Mean age, y (range) |
50.55 (14–84) |
49.78 (4–89) |
1.00 (0.99–1.01) |
0.62 |
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Previous hospitalization at ICU admission | |||||||
Previous stay in another unit during hospitalization | 75/101 (74) | 163/201 (81) | 0.84 (0.44–1.60) | 0.60 | |||
Previous stay in the ED during hospitalization | 62/103 (60) | 125/201 (62) | 1.07 (0.65–0.77) | 0.78 | |||
Length of ED stay, d | 2 (0–55) | 1 (0–37) | 1.08 (1.01–1.15) | 0.02 | 1.10 (1.02–1.19) | 0.01 | |
ED stay >2 d | 34/103 (33) | 35/201 (17) | 2.45 (1.40–4.32) | 0.002 | |||
Days of hospitalization before surveillance culture, median (range) | 3 (1–95) | 2 (1–37) | 0.99 (0.99–0.99) | <0.001 | |||
Transfer from another hospital | 43/101 (43) | 51/193 (26) | 2.79 (1.26–3.68) | 0.005 | 2.52 (1.07–5.89) | 0.03 | |
Previous hospitalization |
52/85 (61) |
63/163 (38) |
2.91 (1.53–5.52) |
0.001 |
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Clinical characteristics at ICU admission | |||||||
Infection | 63/101 (63) | 82/140 (42) | 2.62 (1.52–4.54) | 0.001 | 1.76 (0.56–5.50) | 0.33 | |
Sepsis | 46/62 (74) | 54/81 (66) | 1.41 (0.52–3.85) | 0.50 | |||
Surgery before ICU admission | 53/102 (52) | 106/194 (55) | 0.92 (0.53–1.62) | 0.78 | |||
Trauma | 8/100 (8) | 25/194 (13) | 0.62 (0.28–1.40) | 0.25 | |||
Stroke |
5/100 (5) |
17/194 (9) |
0.61 (0.17–2.18) |
0.45 |
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Severity scores | |||||||
SAPS 3, % median (range) | 22 (4–92) | 16 (0–98) | 1.01 (1.002–1.02) | 0.01 | 1.01 (1.002–1.03) | 0.02 | |
SOFA, median (range) |
5 (0–19) |
5 (0–19) |
1.09 (0.95–1.07) |
0.77 |
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Invasive procedures and devices | |||||||
Dialysis | 14/100 (14) | 11/194 (6) | 2.50 (0.97–6.42) | 0.06 | |||
Tracheostomy | 2/99 (2) | 1/194 (0) | 4.92 (0.36–44.67) | 0.26 | |||
Colostomy | 2/99 (2) | 2/194 (1) | 2.00 (0.28–14.34) | 0.49 | |||
Upper digestive endoscopy | 10/101 (10) | 5/194 (3) | 3.70 (1.11–12.32) | 0.003 | 18.9 (1.83–195.98) | 0.01 | |
Colonoscopy | 2/101 (2) | 0/194 (0) | |||||
Parenteral nutrition |
2/101 (2) |
1/ 194 (1) |
3.77 (0.19–74.94) |
0.38 |
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Underlying conditions | |||||||
CCI score, mean (range) | 3.10 (0–9) | 2.98 (0–11) | 0.99 (0.96–1.02) | 0.48 | |||
Smoking | 25/62 (40) | 46/137 (34) | 1.17 (0.49–2.78) | 0.72 | |||
Diabetes mellitus | 20/102 (20) | 44/198 (22) | 0.86 (0.46–1.62) | 0.65 | |||
Malignant neoplasm | 9/102 (9) | 23/198 (12) | 0.77 (0.35–1.70) | 0.52 | |||
Rheumatologic or autoimmune disease | 11/102 (11) | 16/198 (8) | 1.44 (0.66–3.15) | 0.36 | |||
Cirrhosis | 15/102 (15) | 11/198 (5) | 2.25 (0.85–5.91) | 0.10 | |||
Chronic kidney disease | 12/102 (12) | 14/198 (7) | 1.51 (0.56–3.99) | 0.40 | |||
Solid organ transplant | 8/102 (8) | 16/198 (8) | 0.62 (0.23–1.64) | 0.33 | |||
HIV infection | 3/100 (3) | 7/198 (4) | 1.13 (0.27–4.76) | 0.86 | |||
Hematological malignancy | 2/102 (2) | 6/198 (3) | 0.59 (0.13–2.87) | 0.52 | |||
Hematopoietic stem cell transplant |
1/102 (1) |
1/198 (0) |
2.00 (0.12–32.42) |
0.63 |
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Antimicrobial drug use | |||||||
Any drug at ICU admission† | 81/99 (81) | 142/193 (71) | 1.56 (0.83–2.91) | 0.161 | |||
Carbapenem at ICU admission† | 25/80 (31) | 12/141 (9) | 3.92 (1.51–10.21) | 0.005 | 4.62 (1.30–16.40) | 0.02 | |
Any drug use in previous 3 mo | 50/72 (69) | 48/145 (33) | 5.38 (2.31–12.53) | <0.001 |
*Values are no. (%) except as indicated. CCI, Charlson Comorbidity Index; ED, emergency department; GCS, Glasgow Coma Scale; ICU, intensive care unit; OR, odds ratio; SAPS 3, Simplified Acute Physiology 3, presented as prediction of mortality risk in percentage; SOFA, Sequential Organ Failure Assessment.
†Initiated >48 h before ICU admission.