Factors Associated with Multi-Drug-Resistant Non-Typhoidal Salmonella in the Invasive Disease, Thailand

Figures & data

Table 1 The Binary Logistic Regression Analysis of the Risk Factors Associated with MDR-NTS in Invasive Patients (n=166).

Characteristic	Non-MDR-NTS** (n=65)	MDR-NTS (n=101)	Statistics	p-value	Univariate Analysis	Multivariate Analysis
	n(%)	n(%)			p-value	Adjusted OR	95% CI^β	p-value
Sex			0.007a	0.933
Male (n=92)	37(40.2)	55(59.7)			0.933
Female (n=74)	28(37.8)	46(62.1)
Age group			0.005b	0.014	0.014
<15 yr. (n=87)	42(72)	45(44.5)				6.7	0.324–14.789	0.002*
15–60yr. (n=42)	19(45.2)	23(54.8)				Ref.	0.981–015.984
>60 yr. (n=37)	4(10)	33(89)				2.5	1.223–9.892
Type of hospital			1.137a	0.566	0.954
Tertiary hospital (n=107)	41(38.3)	66(61.7)
District hospital (n=19)	8(42.1)	11(57.9)
Private hospital (n=40)	15(37.5)	25(62.5)
Salmonella serogroup			0.22a	0.143	0.408
Salmonella serogroup A (n=5)	2(40)	3(60)
Salmonella serogroup B (n=46)	16(34.7)	30(65.2)
Salmonella serogroup C (n=66)	22(33.3)	44(66.7)
Salmonella serogroup D (n=32)	18(56.3)	14(43.7)
Salmonella serogroup E (n=17)	7(41.2)	10(58.8)
Underlying disease(n=66)
Hematologic (n=25)	17(68)	8(32)	1.735a	0.188	0.199	4.8	0.885–6.556
Gastrointestinal (n=12)	7(58.3)	5(41.7)	0.166b	0.09	0.111	8.5	0.691–9.586
Immunological (n=5)	3(60)	2(40)	0.029b	0.864	0.866	3.3	0.908–9.656
Neurological (n=9)	6(66.7)	3(33.3)	0.075b	0.417	0.436	5.3	0.660–2.056
Cardiovascular disease(n=9)	7(77.8)	2(22.2)	−0.002b	0.978	0.978	1.1	0.181–4.660
Dyslipidemia (n=8)	5(62.5)	3(37.5)	0.094b	0.291	0.317	3.4	0.4501–7.656
Diabetes mellitus (33)	7(16.2)	26(83.8)	0.038b	0.022*	0.047	2.1	1.811–9.656	0.051
Other (n=5)	2(40)	3(60)	−0.021b	0.587	0.473	Ref.
Complete Blood Counts					0.375
White Blood Cell: WBC
<5000 cells/uL(n=39)	15(38.5)	24(61.5)	1.965a	0.374
5000–15,000 cells/uL(n=29)	11(72.4)	8(27.6)
>15,000 cells/uL(n=98)	57(58.2)	41(41.8)
Neutrophil			2.103a	0.349	0.359
<40% (n=27)	18(66.6)	9(33.3)
40–70%(n=45)	17(37.7)	28(62)
>70%(n=94)	30(31.9)	64(68.1)
Lymphocyte			0.797a	0.671	0.666
<20% (n=58)	27(46.6)	31(53.4)
20–50%(n=38)	10(26.4)	26(68.4)
>50%(n=70)	26(37.1)	44(62.9)
Monocyte			−0.04b	0.113	0.186
<4%(n=56)	29(51.8)	27(48.2)				Ref.
4–13%(n=67)	27(40.3)	40(59.7)				2.5	0.801–7.656	0.115
>13%(n=43)	9(20.9)	34(79)				6.6	0.727–60.741	0.093
Haemoglobin			1.277a	0.258	0.256
<12 g/dl (n=99)	33(33.3)	66(66.6)
12–17 g/dl (n=67)	32(47.7)	35(52.2)
Platelet Count			0.016b	0.182	0.255
<150,000 cells/uL(n=39)	26(66.6)	13(33.3)
150,000–400,000 cells/uL(n=84)	24(28.6)	60(71.4)
>400,000 cells/uL (n=43)	15(34.2)	28(65.1)
Stool examination(n=98)					0.982
Colour
Yellow (n=36)	15(46.7)	21(58.3)
Green (n=44)	19(43.2)	25(56.8)
Brown (n=18)	9(50)	9(50)
White Blood Cell: WBC			0.04b	0.764	0.728
< 5 cells (n=25)	13(52)	12(48)
5–20 cells (n=35)	21(60)	14(40)
≥ 20 cells (n=38)	21(55.3)	17(44.7)
Red Blood Cell: RBC			0.105a	0.473	0.481
< 5 cells (n=35)	27(77.1)	8(22.9)
>5 cells (n=12)	8(66.7)	4(33.3)
Occult Blood(n=21)			−0.102b	0.459	0.436
Positive (n=8)	3(37.5)	5(62.5)
Negative (n=13)	8(61.1)	5(38.4)
The peak of fever
≥ 39.0 C° (n=152)	47(31)	105(69)	1.49a	0.222	0.225	2.4	0.87–6.678	0.34
< 39.0 C° (n=18)	5(27.8)	13(72.2)				Ref.
Onset time symptoms before admission
≥3 day (n=77)	13(16.8)	64(83.2)	1.68a	0.011*	0.048	3.1	1.01–9.459	0.001*
<3 day (n=22)	12(54.5)	10(45.5)			0.032	Ref.

Notes: ^aPearson Chi-square test. ^bChi-square test for independence. ^βStatistically significant (95% CI does not include 1.0). *p < 0.05 is statistically significant. **Non-MDR-NTS included non-DR-NTS and NTS which had drug-resistant less than 3 classes of antimicrobials.

Table 2 The Binary Logistic Regression Study of the Factors Related to Invasive Patients in All NST Patients (n=433).

Characteristic	Non-Invasive (n=267)	Invasive (n=166)	Statistics	p-value	Univariate Analysis	Multivariate Analysis		p-value
	n(%)	n(%)			p-value	Adjusted OR	95% CI^β
Sex			0.556a	0.456
Male (n=195)	71(59.7)	48(40.3)			0.453
Female (n=238)	(69(64.5)	38(35.5)
Age group			0.463a	0.977	0.941
6–15 yr (n=232)	30(63.8)	17(36.2)
16 −60 yr. (n=106)	36(60)	24(40)
>60 yr. (n=95)	33(62.3)	20(37.7)
Type of hospital			19.212a	0.456	0.456
Tertiary hospital (n=207)	44(45.4)	53(54.6)				2	0.869to5.084	0.099
District hospital (n=135)	72(75)	24(25)				0.6	0.277to1.642	0.386
Private hospital (n=91)	35(68.6)	16(31.4)				Ref.
Salmonella serogroup			3.730a	0.444	0.438
Salmonella serogroup A (n=52)	46(88.5)	6(37.5)
Salmonella serogroup B (n=108)	83(73.2)	25(23.1)
Salmonella serogroup C (n=124)	24(19.3)	100(80.6)
Salmonella serogroup D (n=95)	70(73.7)	25(26.3)
Salmonella serogroup E (n=54)	41(81.4)	10(18.5)
Underlying disease(n=143)
Hematologic (n=36)	28(52.8)	25(47.2)	2.354a	0.125	0.128
Gastrointestinal (n=24)	10(45.5)	12(54.5)	2.768a	0.096	0.101
Immunological (n=14)	5(38.5)	8(61.5)	3.194b	0.07	0.079	2.7	0.707to10.326	0.146
Neurological (n=12)	7(43.8)	9(56.3)	2.387a	0.122	0.129
Cardiovascular disease(n=8)	3(37.5)	5(62.5)	0.004a	0.948	0.948
Dyslipidemia (n=27)	14(63.6)	8(36.4)	0.031a	0.859	0.859
Diabetes mellitus (46)	17(60.7)	11(39.3)	0.018a	0.982	0.892
Other (n=12)	7(87.5)	1(12.5)	2.301a	0.129	0.101
Complete Blood Counts(n=249)
White Blood Cell: WBC			30.96a	<0.001*	<0.001*
<5000 cells/uL (n=64)	25(39.1)	39(60.9)				4.2	1.534to11.541	0.005*
5000–15,000 cells/uL (n=77)	48(62.3)	29(37.6)				Ref.
>15,000 cells/uL (n=108)	10(9.3)	98(90.7)				4.7	2.296to9.686	<0.001*
Neutrophil					0.47
<40% (n=58)	31(53.4)	27(46.6)	5.524a	0.47
40–70% (n=80)	35(43.7)	45(56.3)
>70% (n=111)	17(15.3)	94(84.7)
Lymphocyte			1.999a	0.149	0.051
<15% (n=96)	38(39.6)	58(60.4)				1.1	0.535to2.066	0.885
15–50% (n=65)	27(41.5)	38(58.5)				Ref.
>50% (n=88)	18(20.4)	70(79.6)				1.7	0.608to4.979	0.302
Monocyte					0.163
<5% (n=89)	33(37)	56(63)
5–15% (n=99)	32(32.3)	67(67.6)
>15% (n=61)	18(29.5)	43(70.5)
Hemoglobin			10.065a	0.001*	0.001*
<12 g/dl (n=115)	16(13.9)	99(86.1)				3.2	0.987to23.876	0.085
≥12 g/dl (n=134)	67(50)	67(50)
Platelet Count			1.018b	0.081	0.081
<150,000 cells/uL (n=39)	0(0)	39(100)
150,000–400,000 cells/uL (n=151)	67(44.3)	84(55.7)				Ref.
>400,000 cells/uL (n=59)	16(27.1)	43(72.9)				3.2	1.175to8.866	0.123
Stool examination (n=362)
Colour			0.05a	0.975	0.975
Yellow (n=135)	99(73.4)	36(26.6)
Green (n=177)	133(75.2)	44(24.8)
Brown (n=50)	32(64)	18(36)
White Blood Cell: WBC			2.472a	0.291	0.281
< 5 cells (n=65)	40(61.5)	25(38.4)
5–20 cells (n=203)	168(82.7)	35(17.3)
> 20 cells (n=94)	56(59.6)	38(40.4)
Red Blood Cell: RBC			0.029b	0.689	0.506
<5 cells (n=136)	101(78.5)	35(21.4)
> 5 cells (n=199)	136(68.3)	63(31.7)
Occult Blood			2.19a	0.139	0.126
Positive (n=14)	6(42.9)	8(57.1)
Negative (n=42)	29(69)	13(31)
The peak of fever					<0.001*			0.001
< 39 C° (n=225)	217(87.6)	28(2.4)
≥ 39 C° (n=198)	50(25.3)	148(74.7)	1.498a	<0.001*		1.56	2.657to12.895
Onset time symptoms before admission (>3 day) (n=92)
< 3 days (n=45)	22(48.8)	23(51.1)
≥3 days (n=92)	15(16.3)	77(83.6)	3.079a	0.009*	0.009*	1.9	1.974to4.806	0.035*

Notes: ^aPearson Chi-square test. ^bChi-square test for independence. ^βStatistically significant (95% CI does not include 1.0). *p < 0.05 is statistically significant.

Table 3 Binary Logistic Regression Analysis of the Factor Associated with MDR-NTS Compared to Non-MDR-NTS

	MDR-NTS		Univariate Analysis	Multivariate Analysis		p-value
	Non-MDR** (n=204)	MDR (n=229)	p-value	Adjusted OR	95% CI^β
	n(%)	n(%)
Sex			0.605
Male (n=195)	97(81.5)	22(18.5)
Female (n=238)	90(84.1)	17(15.9)
Age group			0.218
6–15 yr (n=232)	43(91.5)	4(8.5)
16 −60 yr. (n=106)	47(78.3)	13(21.7)
>60 yr. (n=95)	47(88.7)	6(11.3)
Type of hospital			0.141
Tertiary hospital (n=207)	78(37.7)	129(62.3)		Ref
District hospital (n=135)	87(64.5)	48(35.5)		0.5	0204–1.207	0.122
Private hospital (n=91)	39(42.9)	52(57.1)		1.5	0.648–3.606	0.33
Type of infection			0.023*
Non-invasive (n=267)	139(52.1)	128(47.9)		Ref
Invasive (n=166)	65(39.1)	101(60.8)		0.6	0.745–3.33	0.024*
Salmonella serogroup
Salmonella serogroup A (n=52)	29(55.8)	23(44.2)	0.459	Ref
Salmonella serogroup B (n=108)	67(62)	41(38)	0.087
Salmonella serogroup C (n=124)	34(27.4)	90(72.6)	0.038*	0.5	0.9875–32.651	0.046*
Salmonella serogroup D (n=95)	39(56)	56(55)	0.753
Salmonella serogroup E (n=54)	35(64.8)	19(35.2)	0.098
Underlying disease (n=143)
Hematologic (n=69)	41(77.4)	36(22.6)	0.178
Gastrointestinal (n=24)	17(77.3)	15(22.7)	0.419
Immunological (n=14)	7(50)	7(50)	0.522
Neurological (n=25)	18(72)	7(28)	0.796
Cardiovascular disease (n=8)	3(37.5)	5(20.8)	0.548
Dyslipidemia (n=27)	12(44.4)	15(55.6)	0.419
Diabetes mellitus (46)	9(19.5)	37(80.5)	0.014*	0.9	0.987–21.879	0.119
Other (n=12)	5(41.6)	7(58.3)	0.528	Ref
Complete Blood Counts
White Blood Cell: WBC			0.214
<5000 cells/uL (n=64)	23(35.9)	41(64.1)
5000–15,000 cells/uL (n=77)	33(42.9)	44(57.1)
>15,000 cells/uL(n=108)	70(64.8)	38(35.2)
Neutrophil			0.943
<40% (n=58)	19(32.8)	38(67.2)
40–70% (n=80)	35(43.7)	45(56.3)
>70% (n=111)	78(70.2)	33(29.8)
Lymphocyte			0.765
<15% (n=96)	73(76)	23(4)
15–50% (n=65)	28(43)	37(57)
>50% (n=88)	34(38.6)	54(61.4)
Monocyte			0.248
<5% (n=89)	66(74.1)	23(25.9)
5–15% (n=99)	73(73.7)	26(26.2)
>15% (n=61)	39(64)	22(36)
Hemoglobin			0.409
<12 g/dl (n=115)	84(73.1)	31(26.9)
≥12 g/dl (n=134)	78(58.2)	56(41.7)
Platelet Count			0.082*
<150,000 cells/uL(n=39)	24(61.5)	15(38.4)		0.7	0.277–1.544	0.654
150,000–400,000 cells/uL(n=151)	99(66.66)	52(33.4)		0.3	0.124–0.848	0.325
>400,000 cells/uL (n=59)	36(61)	23(39)
Stool examination (n=362)			0.537
Color
Yellow (n=135)	45(33.4)	90(66.6)
Green (n=177)	77(43.5)	100(56.5)
Brown (n=50)	31(62)	19(38)
White Blood Cell: WBC			0.133
< 5 cells (n=65)	33(50.8)	32(49.3)
5–20 cells (n=203)	133(65.5)	70(34.5)
> 20 cells (n=94)	27(28.7)	67(71.3)
Red Blood Cell: RBC			0.705
< 5 cells (n=136)	78(57.3)	58(42.6)
5–20 cells (n=199)	129(64.8)	70(35.1)
>20 cells (n=2)	1(50)	1(50)
Occult Blood				0.842
Positive (n=14)	5(35.7)	9(64.3)
Negative (n=42)	23(54.7)	19(45.2)
The peak of fever
< 39 C° (n=235)	151(64.3)	84(35.7)	0.708
≥ 39 C° (n=198)	53((26.7)	145(73.3)	0.053	0.9	0.897–9.786	0.065
Onset time symptoms before admission (>3 day) (n=92)
< 3 days (n=45)	34(75.5)	11(24.4)	0.86
≥3 days (n=92)	10(10.9)	82(89.1)	0.12	1.3	0.67–21.908	0.861

Notes: ^βStatistically significant (95% CI does not include 1.0). *p < 0.05 is statistically significant. **Non-MDR-NTS included non-DR-NTS and NTS which ant less than 3 classes of antimicrobials.