Volume 30, Number 5—May 2024
Research
Antimicrobial Resistance as Risk Factor for Recurrent Bacteremia after Staphylococcus aureus, Escherichia coli, or Klebsiella spp. Community-Onset Bacteremia
Salam Abbara
, Didier Guillemot, David R.M. Smith, Salma El Oualydy, Maeva Kos, Cécile Poret, Stéphane Breant, Christian Brun-Buisson, and Laurence Watier
, Didier Guillemot, David R.M. Smith, Salma El Oualydy, Maeva Kos, Cécile Poret, Stéphane Breant, Christian Brun-Buisson, and Laurence Watier
Table 1
Characteristics of patients and their incident stays with community-onset bacteremia attributable to Staphylococcus aureus, Escherichia coli, or Klebsiella spp., with and without recurrence, Assistance Publique–Hôpitaux de Paris university hospital group, Paris, France, 2017–2019*
| Characteristic | With recurrence, n = 291 | Without recurrence, n = 3,326 | p value |
|---|---|---|---|
| Patients | |||
| Sex | 0.004 | ||
| M | 165 (56.7) | 1,594 (47.9) | |
| F | 126 (43.3) | 1,732 (52.1) | |
| Age group, y | 0.0005 | ||
| 18–35 | 10 (3.4) | 227 (6.8) | |
| 35–50 | 34 (11.7) | 378 (11.4) | |
| 50–65 | 84 (28.9) | 765 (23.0) | |
| 65–80 | 110 (37.8) | 1,070 (32.2) | |
| >80 | 53 (18.2) | 886 (26.6) | |
| Charlson comorbidity index† | <0.0001 | ||
| 0 | 75 (26.6) | 1,389 (44.1) | |
| 1–2 | 109 (38.7) | 1,004 (31.9) | |
| >2 | 98 (34.7) | 7,59 (24.0) | |
| Underlying conditions† | |||
| Cancer | 106 (37.6) | 615 (19.5) | <0.0001 |
| Heart failure | 35 (12.4) | 423 (13.4) | 0.61 |
| Diabetes | 63 (22.3) | 730 (23.2) | 0.79 |
| Vascular disease | 23 (8.2) | 340 (10.8) | 0.18 |
| Renal disease | 63 (22.3) | 430 (13.6) | 0.002 |
| Liver disease | 39 (13.8) | 237 (7.5) | 0.0007 |
| Chronic pulmonary disease | 12 (4.3) | 189 (6.0) | 0.24 |
| Dementia | 9 (3.2) | 178 (5.7) | 0.06 |
| Paralysis (hemiplegia or paraplegia) | 4 (1.4) | 84 (2.7) | 0.21 |
| Systemic disease |
5 (1.8) |
32 (1.0) |
0.30 |
| Incident stays | |||
| Length of stay with bacteremia, days | |||
| Median (first quartile–third quartile) | 8.0 (4.0–15.5) | 7.0 (3.0–15.0) | |
| Duration, d | 0.30 | ||
| <7 | 139 (47.8) | 1,730 (52.0) | |
| 7–14 | 74 (25.4) | 706 (21.2) | |
| 14–30 | 50 (17.2) | 613 (18.4) | |
| >30 | 28 (9.0) | 277 (8.3) | |
| Surgery | 37 (12.7) | 426 (12.8) | 0.97 |
| ICU admission | 70 (24.1) | 718 (21.6) | 0.30 |
| Septic shock† | 27 (9.6) | 279 (8.9) | 0.68 |
| Infection source† | <0.0001 | ||
| None identified | 68 (24.1) | 442 (14.0) | |
| Multiple sites | 59 (20.9) | 747 (23.7) | |
| Urinary tract | 74 (26.2) | 1,125 (35.7) | |
| Lower respiratory tract | 14 (5.0) | 190 (6.0) | |
| Digestive tract | 34 (12.1) | 300 (9.5) | |
| Device-related | 22 (7.8) | 137 (4.4) | |
| Other | 11 (3.9) | 211 (6.7) | |
| Bacteria resistance | <0.0001 | ||
| MSSA | 54 (18.6) | 737 (22.2) | |
| MRSA | 4 (1.4) | 75 (2.2) | |
| 3GC-susceptible E. coli | 136 (46.7) | 1,889 (56.8) | |
| 3GC-resistant E. coli | 38 (13.05) | 253 (7.6) | |
| 3GC-susceptible Klebsiella spp. | 38 (13.05) | 310 (9.3) | |
| 3GC-resistant Klebsiella spp. | 21 (7.2) | 62 (1.9) |
*Values are no. (%) except as indicated. p values calculated by using likelihood ratio tests. 3GC, third-generation cephalosporin; ICU, intensive care unit; MRSA, methicillin-resistant S. aureus; MSSA, methicillin-susceptible S. aureus. †Missing data: 9 stays with recurrence, 174 stays without recurrence.
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