Antimicrobial Susceptibility Characteristics and Risk Factors Associated with Adult Sepsis in Wenzhou, China

Figures & data

Table 1 General Information on Patients with Sepsis

Indicators	Grouping	Number of Cases (%)	Outcomes		χ^2/t	P
			Amelioration (n=257)	Aggravation/Death (n=72)
Gender	Male	174 (52.9)	140 (54.5)	34 (47.2)	1.187	0.276
	Female	155 (47.1)	117 (45.5)	38 (52.8)
Age			58.98±17.67	61.18±16.44	−0.948	0.344
Smoking	No	298 (90.9)	234 (91.1)	64 (90.1)	0.055	0.814
	Yes	30 (9.1)	23 (8.9)	7 (9.9)
Alcohol drinking	No	299 (91.2)	234 (91.1)	65 (91.5)	0.017	0.896
	Yes	29 (8.8)	23 (8.9)	6 (8.5)
Hypertension	No	186 (56.7)	146 (56.8)	40 (56.3)	0.005	0.943
	Yes	142 (43.3)	111 (43.2)	31 (43.7)
Diabetes	No	250 (76.2)	196 (76.3)	54 (76.1)	0.001	0.971
	Yes	78 (23.8)	61 (23.7)	17 (23.9)
Consciousness	Clear	317 (96.4)	251 (97.7)	66 (91.7)	5.759	0.016
	Not clear /vague	12 (3.6)	6 (2.3)	6 (8.3)

Table 2 Association of Clinical Features with Patient Prognosis

Indicators	Outcomes		t/z	P
	Amelioration (n=257)	Aggravation/Death (n=72)
Body temperature	37.35 (36.90, 38.20)	37.50 (36.80, 38.10)	−0.346	0.729
Systolic blood pressure	123.32±21.78	119.94±22.22	1.157	0.248
Diastolic blood pressure	73.15±13.18	71.71±11.83	0.837	0.403
Mean arterial pressure	89.57±15.23	87.05±15.05	1.246	0.214
SOFA score	12.42±1.65	13.11±2.25	−2.429	0.017

Table 3 Association of Laboratory Indicators with Patient Prognosis

Indicators/Reference Range	Outcomes		t/z	P
	Amelioration (n=257)	Aggravation/Death (n=72)
HB (135~175g/L)	123.67±23.80	118.19±22.62	1.742	0.082
PLT (125~350×10^9/L)	169.00 (133.00, 239.75)	155.00 (92.25, 238.00)	−1.944	0.052
PT (12~15 seconds)	14.70 (13.70, 15.90)	15.00 (14.10, 18.00)	−2.919	0.004
APTT (30~45 seconds)	42.80 (36.70, 49.08)	44.00 (38.20, 51.08)	−1.544	0.123
INR (0.85–1.15)	1.17 (1.08, 1.29)	1.20 (1.13, 1.50)	−2.962	0.003
FIB (2~4g/L)	5.63 (4.23, 6.96)	4.83 (3.71, 6.65)	−2.203	0.028
D-D (0~0.5μg/mL)	1.53 (0.78, 3.31)	3.46 (1.27, 8.66)	−4.129	<0.001
CRP (In hospital) (0~8mg/L)	117.51 (62.50, 190.07)	107.27 (52.90, 210.00)	−0.010	0.992
WBC (3.5~9.5×10^9/L)	10.40 (6.71, 15.02)	10.73 (6.60, 14.91)	−0.472	0.637
NEU (0.4~0.75)	0.84 (0.75, 0.90)	0.83 (0.76, 0.88)	−0.895	0.371
LYM (0.2~0.5)	0.10 (0.05, 0.16)	0.10 (0.05, 0.16)	−0.646	0.518
PCT (0~0.046ng/mL)	1.50 (0.38, 7.50)	5.89 (0.32, 27.31)	−1.689	0.091
PA (250~400mg/L)	134.17±62.21	118.78±63.88	1.706	0.089
ALT (9~50U/L)	24.00 (14.00, 50.00)	34.50 (16.00, 73.75)	−1.730	0.084
AST (15~40U/L)	34.00 (19.00, 72.00)	47.00 (26.75, 130.25)	−3.063	0.002
Crea (57~97μmol/L)	69.15 (53.28, 88.78)	67.45 (54.43, 118.10)	−0.679	0.497

Table 4 Comparison of Blood Culture Results of Patients with Sepsis

Indicators	Grouping	Number of Cases (%)	Outcomes		χ^2/t	P
			Amelioration (n = 257)	Aggravation/Death (n = 72)
Blood culture	Negative	283 (86.0)	223 (86.8)	60 (83.3)	0.552	0.457
	Positive	46 (14.0)	34 (13.2)	12 (16.7)
G - bacteria	No	311 (94.5)	246 (95.7)	65 (90.3)	3.221	0.073
	Yes	18 (5.5)	11 (4.3)	7 (9.7)
G + bacteria	No	301 (91.5)	234 (91.1)	67 (93.1)	0.290	0.590
	Yes	28 (8.5)	23 (8.9)	5 (6.9)

Table 5 Isolation Number and Composition Ratio of Pathogens in Blood Culture

Pathogen	Frequency (n)	Percentages (%)
G - bacteria	18	38.3
Klebsiella pneumoniae	8	17.1
E. coli	5	10.7
Acinetobacter baumannii	1	2.1
Proteus mirabilis	1	2.1
Vibrio vulnificus	1	2.1
Anaerobic gram-negative bacteria	1	2.1
Gram-negative cocci	1	2.1
G + bacteria	29	61.7
Staphylococcus aureus	6	12.8
Staphylococcus hominis	6	12.8
Staphylococcus epidermidis	5	10.6
Staphylococcus haemolyticus	2	4.3
Staphylococcus capitis	2	4.3
Staphylococcus kongi	2	4.3
Pseudomonas aeruginosa	1	2.1
Listeria monocytogenes	1	2.1
Staphylococcus coli	1	2.1
Urealyticum	1	2.1
Gram-positive streptococcus	1	2.1
Anaerobic gram-positive cocci	1	2.1

Table 6 Susceptibility Rates of Clinically Isolated Gram-Positive Cocci to Antibiotics (%)

Antimicrobial Drugs	Gram-Positive (n=22)
	S	I	R
Clindamycin	36.4	0.0	63.6
Erythromycin	18.2	0.0	81.8
Penicillin	0.0	0.0	100.0
Rifampicin	100.0	0.0	0.0
Tetracycline	81.8	4.6	13.6
Gentamicin	86.3	4.6	9.1
Ciprofloxacin	31.8	0.0	68.2
Levofloxacin	31.8	0.0	68.2
Cotrimoxazole	50.0	0.0	50.0
Vancomycin	100.0	0.0	0.0
Oxacillin	63.6	0.0	36.4
Linezolid	100.0	0.0	0.0

Table 7 Susceptibility Rate of Main Isolated Gram-Negative Bacteria to Antibiotics (%)

Antimicrobial Drugs	Gram-Negative (n=13)
	S	I	R
Amikacin	100.0	0.0	0.0
Cefazolin	61.5	0.0	38.5
Cefepime	61.5	15.4	23.1
Gentamicin	61.5	0.0	38.5
Ciprofloxacin	23.0	0.0	77.0
Aztreonam	53.8	0.0	46.2
Levofloxacin	38.4	7.6	54.0
Imipenem	69.2	0.0	30.7
Cotrimoxazole	61.5	0.0	38.5
Ampicillin/sulbactam	38.4	15.4	46.2
Piperacillin/tazobactam	69.2	0.0	31.8
Ceftriaxone	37.5	0.0	62.5
Tobramycin	53.8	0.0	46.2

Table 8 Multivariate Logistic Regression Analysis Results of Sepsis in Patients with Sepsis

Independent Variable	B	OR	95% CI	P
Consciousness	1.027	2.792	0.725–10.745	0.135
SOFA	0.140	1.150	0.992–1.333	0.064
PT	−0.003	0.997	0.966–1.029	0.846
INR	0.251	1.285	0.693–2.385	0.426
FIB	−0.103	0.902	0.789–1.030	0.128
D-D	0.091	1.096	1.030–1.166	0.004
AST	0.000	1.000	0.999–1.001	0.954

Table 9 ROC Curve Analysis Results for D-Dimer Levels

Indicators	D-D
AUC (95% CI)	0.661 (0.586–0.736)
The critical value	3.36 μg/mL
The sensitivity	52.11%
Specific degrees	76.23%
Positive likelihood ratio	2.19
Negative likelihood ratio	0.63

Figure 1 ROC curve of D-dimer levels for predicting sepsis outcome.