|
Univariate analysis of risk factors for intrahospital death among 1632 children* with suspected systemic infection |
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| Risk factor |
CFR % (n) |
OR |
95% CI |
P |
|
|
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| Overall |
17.0 (277/1632) |
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| Male sex |
15.5 (143/920) |
0.79 |
0.61 to 1.03 |
0.084 |
| Neonate (< 1 m) |
14.8 (70/473) |
0.80 |
0.59 to 1.07 |
0.146 |
| Underlying conditions |
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| Malnutrition |
29.3 (71/242) |
2.37 |
1.73 to 3.25 |
< 0.001 |
| HIV infection (laboratory confirmed) |
31.7 (46/145) |
2.40 |
1.60 to 3.59 |
< 0.001 |
| Other infectious underlying conditions |
30.6 (33/108) |
2.29 |
1.48 to 3.52 |
< 0.001 |
| - Tuberculosis |
30.5 (29/95) |
2.26 |
1.43 to 3.58 |
0.001 |
| - Hepatitis |
44.4 (4/9) |
3.92 |
1.04 to 14.67 |
0.052 |
| - Congenital syphilis |
50.0 (1/2) |
4.85 |
0.30 to 77.79 |
0.313 |
| Other non-infectious underlying conditions |
17.1 (20/117) |
1.00 |
0.60 to 1.64 |
1.000 |
| - Sickle cell disease |
3.0 (1/33) |
0.15 |
0.02 to 1.09 |
0.032 |
| - Neoplasia |
60.0 (3/5) |
7.32 |
1.22 to 44.05 |
0.038 |
| - Congenital heart disease |
27.3 (9/33) |
1.77 |
0.82 to 3.83 |
0.156 |
| Malaria (laboratory confirmed) |
20.2 (67/331) |
1.29 |
0.95 to 1.76 |
0.102 |
| Growth in blood culture of: |
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| Any pathogen |
34.9 (80/229) |
3.29 |
2.41 to 4.48 |
< 0.001 |
| Any GNR |
43.5 (64/147) |
4.60 |
3.22 to 6.60 |
< 0.001 |
| Any Enterobacteriaceae |
45.6 (52/114) |
4.82 |
3.25 to 7.15 |
< 0.001 |
| - E. coli |
50.0 (15/30) |
5.11 |
2.47 to 10.59 |
< 0.001 |
| - Klebsiella spp. |
48.9 (22/45) |
5.00 |
2.74 to 9.10 |
< 0.001 |
| - All non-typhoid Salmonellae |
36.4 (12/33) |
2.88 |
1.40 to 5.92 |
0.007 |
| - Salmonella Enteritidis |
21.1 (4/19) |
1.31 |
0.43 to 3.97 |
0.548 |
| - Salmonella Typhimurium |
53.9 (7/13) |
5.83 |
1.94 to 17.48 |
0.003 |
| - Enterobacter spp. |
71.4 (5/7) |
12.43 |
2.40 to 64.43 |
0.002 |
| Any non-Enterobacteriaceae GNR |
40.6 (13/32) |
3.46 |
1.69 to 7.10 |
0.001 |
| - Pseudomonas aeruginosa |
66.7 (8/12) |
10.04 |
3.00 to 33.59 |
< 0.001 |
| - Acinetobacter spp. |
9.1 (1/11) |
0.49 |
0.06 to 3.82 |
0.702 |
| Gram-positive pathogen† |
16.7 (11/66) |
0.98 |
0.50 to 1.89 |
1.000 |
| - Enterococci |
19.4 (7/36) |
1.19 |
0.51 to 2.73 |
0.655 |
| - E. faecium |
6.7 (1/15) |
0.35 |
0.05 to 2.65 |
0.490 |
| - E. faecalis |
28.6 (4/14) |
1.97 |
0.61 to 6.33 |
0.275 |
| - S. aureus |
7.1 (2/28) |
0.37 |
0.09 to 1.58 |
0.208 |
| Candida |
33.3 (8/24) |
2.49 |
1.05 to 5.87 |
0.049 |
| Polymicrobial infection |
41.4 (12/29) |
3.56 |
1.68 to 7.55 |
0.002 |
| Inappropriate antimicrobial therapy due to: |
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| - ESBL-producing, multiresistant isolates |
71.4 (15/21) |
12.87 |
4.95 to 33.48 |
< 0.001 |
| - Other bacterial resistance (non-ESBL) |
37.8 (17/45) |
3.14 |
1.69 to 5.83 |
0.001 |
| - Any bacterial resistance (ESBL + other) |
47.7 (31/65) |
5.01 |
3.02 to 8.31 |
< 0.001 |
| - Any antimicrobial resistance (including fungi) |
43.8 (39/89) |
4.39 |
2.82 to 6.83 |
< 0.001 |
| Hospital-acquired infection |
35.5 (44/124) |
3.01 |
2.03 to 4.46 |
< 0.001 |
| Readmission stay |
15.2 (14/92) |
0.87 |
0.49 to 1.56 |
0.775 |
|
CFR, case-fatality rate; OR, odds ratio; 95%CI: 95% confidence interval; P, p-value calculated with two-sided Fisher's exact test; GNR, Gram-negative rod; ESBL, extended-spectrum beta-lactamase. *The outcome was known for 1632 among a total of 1828 admissions. † Anaerobes, coagulase-negative staphylococci and bacterial isolates of uncertain pathogenicity were not included. ‡ Blood culture obtained > 2 days after admission. | ||||
Blomberg et al. BMC Infectious Diseases 2007 7:43 doi:10.1186/1471-2334-7-43 |
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