Impact of Cefotaxime Non-susceptibility on the Clinical Outcomes of Bacteremic Pneumococcal Pneumonia
Abstract
:1. Introduction
2. Methods
2.1. Ethics Statement
2.2. Study Design and Patients
2.3. Data Collection and Evaluation
2.4. Definitions
2.5. Microbiological Evaluation and Diagnostic Criteria
2.6. Statistical Analysis
3. Results
3.1. Patients’ Characteristics
3.2. Microbiology
3.3. Clinical Outcomes
3.4. Factors Associated with 30-Day Mortality
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Non-Susceptible to 3GC (N = 66) | Susceptible to 3GC (N = 624) | p-Value | |
---|---|---|---|
Age, years, mean (SD) | 67 (20) | 59 (19) | 0.001 |
Age > 65 years, n (%) | 42 (64) | 267 (43) | 0.001 |
Male, gender, n (%) | 38 (58) | 401 (64) | 0.28 |
Current alcohol user, n (%) | 4 (6) | 34 (5) | 0.78 |
Previous antimicrobials, n (%) | 4 (6) | 19 (3) | 0.26 |
Shock, n (%) | 8 (12) | 85 (14) | 0.73 |
Previous systemic steroids, n (%) | 4 (6) | 50 (8) | 0.54 |
Mechanical ventilation, n (%) | 0 | 4 (1) | >0.99 |
Fever, n (%) | 63 (95) | 605 (97) | 0.42 |
Comorbidities, n (%) | |||
COPD | 17 (26) | 128 (21) | 0.32 |
HIV | 14 (21) | 122 (20) | 0.75 |
Neoplasm | 14 (21) | 98 (16) | 0.25 |
Chronic cardiovascular disease | 9 (14) | 59 (9) | 0.28 |
Diabetes mellitus | 15 (23) | 96 (15) | 0.12 |
Chronic renal disease | 3 (5) | 30 (5) | >0.99 |
Chronic liver disease | 10 (15) | 74 (12) | 0.44 |
Empiric therapy | |||
Cephalosporin monotherapy | 19 (29) | 164 (26) | |
Cephalosporin + quinolone Cephalosporin + macrolide | 10 (15) 37 (56) | 147 (24) 313 (50) | 0.16 0.12 |
McCabe score | 0.73 | ||
1 | 43 (66) | 438 (71) | |
2 | 21 (32) | 174 (28) | |
3 | 1 (2) | 7 (1) | |
PSI score | 0.11 | ||
PSI I–III | 8 (32) | 140 (49) | |
PSI IV–V | 17 (68) | 147 (51) | |
30-day mortality, n (%) | 5 (8) | 42 (7) | 0.80 |
Variable | Univariate a | Multivariable b,c | ||||
---|---|---|---|---|---|---|
OR | 95% CI | p-Value | OR | 95% CI | p-Value | |
Non-susceptible to 3GC | 1.13 | 0.43–2.96 | 0.81 | 0.83 | 0.28–2.50 | 0.74 |
Age (+1 year) | 1.03 | 1.01–1.05 | 0.001 | 1.04 | 1.02–1.06 | <0.001 |
Septic shock | 13.01 | 6.89–24.59 | <0.001 | 17.54 | 8.72–35.27 | <0.001 |
Chronic renal disease | 3.89 | 1.05–14.46 | 0.042 | - | - | - |
Chronic liver disease | 2.37 | 1.16–4.86 | 0.019 | 2.33 | 0.94–5.75 | 0.068 |
McCabe score d | 0.009 | 0.061 | ||||
1 | 1.00 | - | - | 1.00 | - | - |
2 | 1.45 | 0.76–2.74 | 0.26 | 1.32 | 0.60–2.89 | 0.49 |
3 | 9.66 | 2.20–42.51 | 0.003 | 8.72 | 1.43–53.00 | 0.019 |
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Cillóniz, C.; de la Calle, C.; Dominedò, C.; García-Vidal, C.; Cardozo, C.; Gabarrús, A.; Marco, F.; Torres, A.; Soriano, A. Impact of Cefotaxime Non-susceptibility on the Clinical Outcomes of Bacteremic Pneumococcal Pneumonia. J. Clin. Med. 2019, 8, 1150. https://doi.org/10.3390/jcm8081150
Cillóniz C, de la Calle C, Dominedò C, García-Vidal C, Cardozo C, Gabarrús A, Marco F, Torres A, Soriano A. Impact of Cefotaxime Non-susceptibility on the Clinical Outcomes of Bacteremic Pneumococcal Pneumonia. Journal of Clinical Medicine. 2019; 8(8):1150. https://doi.org/10.3390/jcm8081150
Chicago/Turabian StyleCillóniz, Catia, Cristina de la Calle, Cristina Dominedò, Carolina García-Vidal, Celia Cardozo, Albert Gabarrús, Francesc Marco, Antoni Torres, and Alex Soriano. 2019. "Impact of Cefotaxime Non-susceptibility on the Clinical Outcomes of Bacteremic Pneumococcal Pneumonia" Journal of Clinical Medicine 8, no. 8: 1150. https://doi.org/10.3390/jcm8081150