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
Table 2
Univariable and multivariable analyses of risk factors for bacteremia recurrence at 1 year after an incident stay with community-onset bacteremia attributable to Staphylococcus aureus, Escherichia coli, or Klebsiella spp., Assistance Publique–Hôpitaux de Paris university hospital group, Paris, France, 2017–2019*
Characteristic | Univariable analyses |
Multivariable analyses |
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---|---|---|---|---|---|
HR (95% CI) | p value | HR (95% CI) | p value | ||
Patients | |||||
Sex; referent male | 0.71 (0.57–0.90) | 0.004 | 0.94 (0.73–1.20) | 0.59 | |
Age group, y; referent 35–50 y | 0.0005 | 0.075 | |||
>18–35 | 0.51 (0.25–1.03) | 0.66 (0.31–1.38) | |||
50–65 | 1.23 (0.82–1.83) | 1.15 (0.76–1.74) | |||
65–80 | 1.14 (0.78–1.69) | 1.13 (0.76–1.69) | |||
>80 | 0.68 (0.44–1.05) | 0.77 (0.49–1.20) | |||
Charlson comorbidity index; referent 0 | <0.0001 | ||||
1–2 | 1.95 (1.46–2.62) | ||||
>2 | 2.31 (1.71–3.12) | ||||
Underlying conditions | |||||
Cancer | 2.36 (1.86–3.00) | <0.0001 | 2.03 (1.58–2.62) | <0.0001 | |
Heart failure | 0.91 (0.64–1.30) | 0.61 | |||
Diabetes | 0.96 (0.73–1.27) | 0.79 | |||
Vascular disease | 0.75 (0.49–1.14) | 0.18 | |||
Renal disease | 1.60 (1.20–2.13) | 0.002 | 1.72 (1.28–2.31) | 0.0007 | |
Liver disease | 1.89 (1.35–2.65) | 0.0007 | 1.66 (1.17–2.35) | 0.007 | |
Chronic pulmonary disease | 0.71 (0.40–1.26) | 0.24 | |||
Dementia | 0.56 (0.29–1.09) | 0.06 | |||
Paralysis (hemiplegia / paraplegia) | 0.53 (0.20–1.43) | 0.21 | |||
Systemic disease |
1.70 (0.70–4.12) |
0.30 |
|||
Incident stays | |||||
Length of stay with bacteremia; referent 7–14 d | 0.30 | ||||
≤7 | 0.78 (0.59–1.03) | ||||
14–30 | 0.79 (0.55–1.13) | ||||
>30 | 0.97 (0.63–1.50) | ||||
Surgery | 1.01 (0.71–1.42) | 0.97 | |||
ICU admission | 1.15 (0.89–1.51) | 0.30 | |||
Septic shock | 1.09 (0.73–1.62) | 0.68 | |||
Infection source; referent urinary tract | <0.0001 | 0.0002 | |||
None identified | 2.25 (1.62–3.13) | 2.26 (1.60–3.19) | |||
Multiple sites | 1.19 (0.85–1.68) | 1.22 (0.85–1.75) | |||
Lower respiratory tract | 1.12 (0.63–1.98) | 1.26 (0.70–2.26) | |||
Digestive tract | 1.69 (1.13–2.54) | 1.57 (1.03–2.38) | |||
Device-related | 2.32 (1.44–3.74) | 1.93 (1.16–3.23) | |||
Other | 0.80 (0.43–1.51) | 0.98 (0.51–1.75) | |||
Bacteria resistance; referent MSSA | <0.0001 | <0.0001 | |||
MRSA | 0.74 (0.27–2.04) | 0.79 (0.29–2.19) | |||
3GC-susceptible E. coli | 0.99 (0.72–1.36) | 1.16 (0.81–1.66) | |||
3GC-resistant E. coli | 1.99 (1.31–3.01) | 2.35 (1.50–3.68) | |||
3GC-susceptible Klebsiella spp. | 1.64 (1.09–2.49) | 1.41 (0.91–2.21) | |||
3GC-resistant Klebsiella spp. | 4.11 (2.48–6.81) | 3.91 (2.32–6.59) |
*p values calculated by using Gray’s test of the subdistribution function for univariable analyses, and Fine–Gray regression models for multivariable analyses. 3GC, third-generation cephalosporin; HR, subdistribution hazard ratio; ICU, intensive care unit; MRSA, methicillin-resistant S. aureus; MSSA, methicillin-susceptible S. aureus.