Clinical Usefulness of the 2010 Clinical and Laboratory Standards Institute Revised Breakpoints for Cephalosporin Use in the Treatment of Bacteremia Caused by Escherichia coli or Klebsiella spp.
Table 3
Clinical characteristics and outcomes of patients with bacteremia caused by ESBL-nonproducing Enterobacteriaceaetreated with a cephalosporin according to the new CLSI breakpoints.
Variables
Number (%) of patients with bacteremia
Number (%) of patients with bacteremia
caused by E. coli:
caused by Klebsiella spp.:
Appropriate Tx.
Inappropriate Tx.
value
Appropriate Tx.
Inappropriate Tx.
value
( = 300)
( = 53)
( = 172)
( = 38)
Age (years), mean ± SD
66.06 ± 12.81
63.58 ± 13.59
0.199
65.21 ± 11.72
65.87 ± 11.72
0.753
Male
122 (40.7)
24 (45.3)
0.529
104 (60.5)
29 (76.3)
0.032
Hospital acquired
43 (14.3)
9 (17.0)
0.616
43 (25.0)
5 (13.2)
0.116
Community acquired
257 (85.7)
44 (83.0)
0.616
129 (75.0)
33 (86.8)
0.116
Underlying disease
Malignancy
Solid
120 (40.0)
22 (41.5)
0.836
89 (51.7)
14 (36.8)
0.096
Hematologic
7 (2.3)
1 (1.9)
1.000
3 (1.7)
1 (2.6)
0.717
Transplantation
Solid
4 (1.3)
1 (1.9)
0.558
0 (0.0)
0 (0.0)
Hematopoietic stem cell
0 (0.0)
0 (0.0)
0 (0.0)
0 (0.0)
Diabetes
90 (30.0)
11 (20.8)
0.170
56 (32.6)
10 (26.3)
0.453
Cardiovascular disease
147 (49.0)
26 (49.1)
0.994
69 (40.1)
16 (42.1)
0.821
Chronic lung disease
1 (0.3)
0 (0.0)
1.000
3 (1.7)
0 (0.0)
1.000
Chronic renal disease
11 (3.7)
1 (1.9)
0.701
5 (2.9)
3 (7.9)
0.146
Chronic liver disease
28 (9.3)
4 (7.5)
0.800
24 (14.0)
2 (5.3)
0.179
HIV infection
1 (0.3)
0 (0.0)
1.000
0 (0.0)
0 (0.0)
Charlson index
2.53 ± 2.24
2.28 ± 1.98
0.446
2.97 ± 2.47
2.21 ± 2.04
0.078
Source of infection
Urinary tract infection
118 (39.3)
21 (39.6)
0.968
15 (8.7)
6 (15.8)
0.189
Liver abscess
7 (2.3)
1 (1.9)
1.000
26 (15.1)
7 (18.4)
0.612
Pancreatobiliary infection
132 (44.0)
24 (45.3)
0.862
88 (51.2)
18 (47.4)
0.672
Pulmonary infection
4 (1.3)
1 (1.9)
0.559
8 (4.7)
4 (10.5)
0.236
Peritonitis
7 (2.3)
2 (3.8)
0.629
9 (5.2)
0 (0.0)
0.369
Primary bacteremia
26 (8.7)
3 (5.7)
0.595
20 (11.6)
3 (7.9)
0.774
Others
6 (2.0)
1 (1.9)
4 (2.3)
0 (0.0)
SOFA score, mean ± SD
2.75 ± 2.316
2.79 ± 2.315
0.910
3.39 ± 2.737
3.47 ± 2.275
0.860
Antimicrobials
Ceftazidime
7 (2.3)
0 (0.0)
0.600
2 (1.2)
1 (2.6)
0.452
Cefpiramide
104 (34.7)
17 (32.1)
0.806
72 (41.9)
11 (28.9)
0.141
Cefotaxime
18 (6.0)
4 (7.5)
0.756
16 (9.3)
5 (13.2)
0.549
Ceftriaxone
171 (57.0)
32 (60.4)
0.660
82 (47.7)
21 (55.3)
0.397
Clinical outcomes
Treatment failure after 72 hr
31 (10.3)
8 (15.1)
0.308
24 (14.0)
9 (23.7)
0.136
28-day mortality
8 (2.7)
4 (7.5)
0.089
15 (8.7)
1 (2.6)
0.315
CLSI, Clinical and Laboratory Standards Institute; ESBL, extended-spectrum beta lactamase; E. coli, Escherichia coli; HIV, human immunodeficiency syndrome; ICU, intensive care unit; SOFA, Sequential Organ Failure Assessment; SD, standard deviation; Tx., treatment.
