Relationship Between Multidrug-Resistant Enterobacterales and Obesity in Older Adults

Figures & data

Table 1 Baseline Characteristics Stratified by Obesity Status (Total n=366)

Characteristics	Non-Obese (n=238)	Obese (n=128)	P value
BMI (kg/m^2)	24.8 (21.4–27.3)	34.1 (32.2–38.4)	<0.001
Age (years)	79.3 (66–86)	75.1 (63.4–84.1)	0.067
Age >65 years, n (%)	182 (76.5)	93 (72.7)	0.421
Female, n (%)	147 (62)	82 (65.1)	0.566
Race/ethnicity, n (%)
White, non-Hispanic	160 (67.2)	94 (73.4)	0.219
Black	23 (9.7)	16 (12.5)	0.402
Asian	19 (8.0)	4 (3.1)	0.068
Hispanic	19 (8.0)	7 (5.5)	0.372
Other or unknown	17 (7.1)	7 (5.5)	0.537
SCr (mg/dL)	1 (0.7–1.4)	1 (0.8–1.5)	0.189
CrCl (mL/min)	48.2 (34.2–80.5)	71.9 (46–117.6)	<0.001
Length of stay (days)	2 (0–7)	1 (0–6)	0.167
Charlson–Deyo index, median (range)	2 (1–4)	2 (1–4)	0.180
Hospital, n (%)
A	115 (71.4)	46 (28.6)	0.023
B	123 (60)	82 (40)	0.023
Culture from ICU, n (%)	32 (13.5)	21 (16.4)	0.443
On hemodialysis, n (%)	4 (1.7)	1 (0.8)	0.482
Antibiotic allergy, n (%)	50 (22)	32 (26)	0.400
History of antibiotics, n (%)
Within 30 days	20 (8.7)	13 (10.7)	0.541
Greater than 30 days	43 (18.2)	27 (21.1)	0.507
History of corticosteroids, n (%)
Within 30 days	11 (5.4)	5 (4.2)	0.634
Greater than 30 days	20 (9.8)	7 (5.9)	0.224
Immunosuppressants, n (%)	2 (1)	3 (2.5)	0.283
Diabetes mellitus, n (%)	74 (31.1)	53 (41.4)	0.048
Transfer from healthcare facility, n (%)	42 (17.8)	28 (21.9)	0.346
History of cancer, n (%)	23 (9.7)	23 (18)	0.022

Notes: All continuous variables presented as median (interquartile range) and categorical variables presented as n (%).

Abbreviations: BMI, body mass index; SCr, serum creatinine; CrCl, creatinine clearance; ICU, intensive care unit.

Table 2 Comparison of Culture Source and Organism Present on the First Culture Obtained

Source/Organism	Non-Obese, n (%)	Obese, n (%)	P value
Urine	175 (73.5)	95 (74.2)	0.112
E. coli	117 (66.9)	61 (64.2)	0.661
Klebsiella spp.	24 (13.7)	21 (22.1)	0.077
Proteus spp.	22 (12.6)	0 (0.0)	<0.001
Other	12 (6.9)	13 (13.7)	0.066
Blood	42 (17.6)	21 (22.1)	0.764
E. coli	29 (69.0)	12 (57.1)	0.350
Klebsiella spp.	7 (16.0)	6 (28.6)	0.272
Other	6 (14.3)	3 (14.3)	>0.999
Abscess	12 (5.0)	8 (6.3)	0.628
E. coli	7 (58.3)	4 (50.0)	>0.999
Klebsiella spp.	1 (8.3)	2 (25.0)	0.686
Other	4 (33.3)	2 (25.0)	>0.999
Respiratory	6 (2.5)	4 (4.2)	0.735
E. coli	2 (33.3)	2 (50.0)	>0.999
Klebsiella spp.	3 (50.0)	2 (50.0)	>0.999
Other	1 (16.7)	0 (0.0)	>0.999

Table 3 Unadjusted Gram-Negative MDR Bacteria Rates Stratified by Obesity Status

Organism	Overall, n (%)	Non-Obese, n (%)	Obese, n (%)	P value
ESBL or CRE on culture	51 (13.9)	27 (11.3)	24 (18.8)	0.057
ESBL	48 (13.1)	25 (10.5)	23 (17.9)	0.049
Enterobacterales
E. coli	235 (64.2)	156 (65.6)	79 (61.7)	0.468
Klebsiella spp.	71 (19.4)	38 (15.9)	33 (25.8)	0.027
Other^a	60 (13.4)	44 (18.5)	16 (12.5)	0.141

Notes: ^aProteus mirabilis, Enterobacter cloacae, Morganella morganii, Providencia spp., Citrobacter spp.

Abbreviations: MDR, multidrug-resistance; ESBL, extended-spectrum beta-lactamase-producing Enterobacterales; CRE, carbapenem-resistant Enterobacterales.