Risk Factors for 30-Day Mortality of Community-Acquired Bloodstream Infection Patients in Changsha City, Hunan Province, China

Figures & data

Figure 1 Flow gram of patients included.

Table 1 Causative Pathogen of CA-BSI Patients

Causative Pathogen	Non-Survivors		Survivors
	n	%	n	%
Gram-negative bacteria	27	2.87	480	51.06
Escherichia coli	11	1.17	190	20.21
Klebsiella pneumoniae	7	0.74	107	11.38
Salmonella para-typhi C	1	0.11	30	2.13
Stenotrophomonas maltophilia	0	0.00	24	2.34
Pseudomonas aeruginosa	3	0.32	20	2.13
Acinetobacter baumannii	0	0.00	22	2.34
Burkholderia cepacia	3	0.32	16	1.70
Enterobacter cloacae	0	0.00	11	1.17
Salmonella minster serotype	0	0.00	7	0.74
Other Salmonella	0	0.00	8	0.85
Other gram-negative bacteria	2	0.21	45	4.79
Gram-positive bacteria	22	2.34	371	39.74
Staphylococcus hominis	10	1.06	83	8.83
Staphylococcus epidermidis	2	0.21	91	9.68
Staphylococcus aureus	3	0.32	70	7.45
Enterococcus faecium	0	0.00	21	2.23
Staphylococcus haemolyticus	1	0.11	20	2.13
Streptococcus agalactiae	0	0.00	16	1.70
Streptococcus pneumoniae	1	0.11	12	1.28
Enterococcus faecalis	0	0.00	9	0.96
Staphylococcus warneri	1	0.11	5	0.53
Streptococcus	1	0.00	5	0.53
Other gram- positive bacteria	3	0.32	39	4.15
Fungi	3	0.32	37	3.94
Total	52	5.53	888	94.47

Table 2 Demographic Characteristics Between Good Prognosis Group and Poor Prognosis Group

	Total (n=940)	Survivors (n=888)	Non-Survivors (n=52)	P value
		Number (Percentage)	Number (Percentage)
Age	66.00 [54.00,75.00]	65.00 [54.00, 75.00]	73.00 [62.00, 81.25]	0.001
Male	533	495 (55.7%)	38 (73.1%)	0.021
Smoking	203	193 (21.7%)	10 (19.2%)	0.800
Drinking	123	117 (13.2%)	6 (11.5%)	0.898
Hypertension	288	289 (32.5%)	16 (30.8%)	0.910
Diabetes	235	224 (25.2%)	11 (21.2%)	0.621
Cardiopathy	202	185 (20.8%)	17 (32.7%)	0.064
Chronic obstructive pulmonary disease (COPD)	59	54 (6.1%)	5 (9.6%)	0.467
Tumor	50	47 (5.3%)	3 (5.8%)	1.000
Hemopathy	72	67 (7.5%)	5 (9.6%)	0.781
Community treatment or hospitalization (within 1 month)	277	263 (29.6%)	14 (26.9%)	0.797
Surgery (within 1 month)	21	21 (2.4%)	0 (0.00%)	0.523
Other invasive operations (within 1 month)	106	97 (10.9%)	9 (17.3%)	0.234
Skin injury (within 1 month)	47	45 (5.1%)	2 (3.8%)	0.948
BSI (within 3 months)	30	28 (3.2%)	2 (3.8%)	1.000
Antibiotic usage (within 3 months)	163	154 (17.3%)	9 (18.4%)	1.000
Bacterial infections in other systems (within 3 months)	55	53 (6.0%)	2 (3.8%)	0.742
Multi drug resistance (MDR)	198	187 (21.1%)	11 (21.2%)	1.000
Transfusion	758	712 (80.2%)	46 (88.5%)	0.269
Hemodialysis	130	120 (13.5%)	18 (34.6%)	<0.001
Immunosuppression	16	16 (1.7%)	0 (0.00%)	0.671
Glucocorticoid (GC) usage	449	404 (45.5%)	45 (86.5%)	<0.001
Catheter placement	255	231 (26.0%)	24 (46.2%)	0.003
Antibiotic combination	813	764 (86.0%)	49 (94.2%)	0.141
SOFA score	4.00 [2.00, 6.00]	4.00 [2.00, 6.00]	7.00 [4.00, 10.00]	<0.001
Antibacterial cost (RMB)	3197.88 [1435.95, 6354.26]	3136.75 [1405.93, 6053.53]	5965.57 [1803.12, 15,397.10]	<0.001
Total cost (RMB)	22910.67 [13,619.28, 43,781.82]	21,640.33 [13,253.26, 40,017.36]	74,828.96 [38,596.68, 105,914.77]	<0.001

Table 3 Laboratory Indicators Between the Good Prognosis Group and Poor Prognosis Group

	Survivors (n=888)	Non-Survivors (n=52)	P value
White blood cell (WBC) (*10^9/L)	9.68 [6.47, 14.49]	9.82 [6.45, 15.29]	0.739
Red blood cell (RBC) (*10^9/L)	3.74 [3.14, 4.34]	3.62 [2.86, 4.26]	0.320
Platelet count (PLT) (*10^9/L)	172.00 [111.00, 243.25]	151.50 [104.25, 229.25]	0.19
Neutrophilic granulocyte count (NE) (*10^9/L)	8.09 [4.73, 12.70]	8.25 [4.55, 13.33]	0.860
Lymphocyte count (LYM) (*10^9/L)	0.71 [0.40, 1.20]	0.71 [0.50, 1.10]	0.830
Hemoglobin (Hb) (g/L)	111.00 [92.00, 127.00]	112.00 [84.50, 124.50]	0.580
Eosinophil count (EOS) (*10^9/L)	0.15 [0.10, 0.30]	0.10 [0.10, 0.23]	0.750
Basophil count (BAS) (*10^9/L)	0.02 [0.01, 0.03]	0.02 [0.01, 0.03]	1.000
Procalcitonin (PCT) (pg/mL)	3.30 [0.44, 26.60]	7.80 [1.23, 38.94]	0.038
Total protein (Tp) (g/L)	63.60 (58.00, 70.00)	59.50 (51.00, 70.00)	0.020
Albumin (ALB) (g/L)	32.24 (± 6.64)	28.72 (± 7.57)	<0.001
Globulin (GLB) (g/L)	31.00 [26.37, 35.00]	29.65 [23.45, 35.17]	0.200
Alanine aminotransferase (ALT) (U/L)	22.00 [13.00, 40.00]	20.55 [11.00, 57.25]	0.82
Glutamic oxaloacetic transaminase (AST) (U/L)	27.90 [19.00, 49.10]	31.50 [21.75, 77.50]	0.090
Creatinine (Cr) (μmol/L)	90.00 [63.00, 165.50]	165.00 [83.00, 290.75]	<0.001
Uric acid (UA) (μmol/L)	340.00 [246.00, 445.25]	397.00 [312.00, 476.00]	0.005

Table 4 Univariate and Multivariate Cox Regression Analyses of 30-Day Mortality in CA-BSI Patients

		All	HR (Univariable)	HR (Multivariable)
Age	Medium [IQR]	66.00 [54.00,75.00]	1.03 (1.01–1.05, p=0.010)	1.02 (1.00–1.05, p=0.021)
Gender	Male	533 (56.7%)	1.88 (1.02–3.48, p=0.044)	1.81 (0.97–3.36, p=0.062)
Smoking	Yes	203 (21.6%)	0.79 (0.40–1.57, p=0.500)
Drinking	Yes	123 (13.1%)	0.80 (0.34–1.87, p=0.605)
Hypertension	Yes	305 (32.4%)	0.97 (0.54–1.76, p=0.931)
Diabetes	Yes	235 (25.0%)	0.78 (0.40–1.51, p=0.456)
Cardiopathy	Yes	202 (21.5%)	1.65 (0.93–2.95, p=0.089)
Chronic obstructive pulmonary disease (COPD)	Yes	59 (6.3%)	1.55 (0.62–3.91, p=0.348)
Tumor	Yes	50 (5.3%)	1.09 (0.34–3.50, p=0.885)
Hemopathy	Yes	72 (7.7%)	1.25 (0.50–3.15, p=0.634)
Community treatment or hospitalization (within 1 month)	Yes	277 (29.5%)	0.86 (0.46–1.58, p=0.619)
Surgery (within 1 month)	Yes	21 (2.2%)
Other invasive operations (within 1 month)	Yes	106 (11.3%)	1.44 (0.70–2.95, p=0.324)
Skin injury (within 1 month)	Yes	47 (5.0%)	0.70 (0.17–2.87, p=0.617)
BSI (within 3 months)	Yes	30 (3.2%)	1.32 (0.32–5.43, p=0.701)
Antibiotic usage (within 3 months)	Yes	163 (17.3%)	0.94 (0.46–1.93, p=0.869)
Bacterial infections in other systems (within 3 months)	Yes	55 (5.9%)	0.52 (0.13–2.14, p=0.365)
Multi drug resistance (MDR)	Yes	198 (21.1%)	1.03 (0.53–2.00, p=0.930)
Transfusion	Yes	758 (80.6%)	1.63 (0.69–3.82, p=0.262)
Hemodialysis	Yes	138 (14.7%)	2.80 (1.58–4.96, p<0.001)	1.94 (0.91–4.16, p=0.087)
Immunosuppression	Yes	16 (1.7%)
Glucocorticoid (GC) usage	Yes	449 (47.8%)	5.39 (2.42–12.02, p<0.001)	3.69 (1.62–8.37, p=0.002)
Catheter placement	Yes	255 (27.1%)	1.64 (0.94–2.86, p=0.083)
Antibiotic combination	Yes	813 (86.5%)	1.80 (0.56–5.79, p=0.326)
SOFA	Medium [Q1, Q3]	4.00 [2.00, 6.00]	1.16 (1.09–1.23, p<0.001)	1.10 (1.03–1.18, p=0.004)
WBC	Medium [Q1, Q3]	9.68 (6.47, 14.52)	1.00 (0.98–1.03, p=0.687)
RBC	Medium [Q1, Q3]	3.73 (3.14, 4.32)	0.83 (0.61–1.11, p=0.209)
PLT	Medium [Q1, Q3]	171 (110.75, 242.25)	1.00 (0.99–1.00, p=0.076)
NE	Medium [Q1, Q3]	8.09 (4.72, 12.75)	1.01 (0.97–1.05, p=0.661)
LYM	Medium [Q1, Q3]	0.71 (0.4, 1.2)	0.97 (0.78–1.19, p=0.742)
Hb	Medium [Q1, Q3]	111 (91.75, 127)	1.00 (0.99–1.01, p=0.373)
EOS	Medium [Q1, Q3]	0.1 (0.1, 0.3)	0.75 (0.18–3.15, p=0.691)
BAS	Medium [Q1, Q3]	0.02 (0.01, 0.03)	0.00 (0.00–1313.11, p=0.379)
PCT	Medium [Q1, Q3]	3.42 (0.47, 27.21)	1.00 (1.00–1.01, p=0.130)
TP	Medium [Q1, Q3]	63.4 (57.15, 70)	0.96 (0.94–0.99, p=0.012)	1.00 (0.96–1.03, p=0.828)
ALB	Mean ± SD	32.05 ± 6.74	0.93 (0.89–0.97, p=0.001)	0.95 (0.90–1.01, p=0.108)
GLB	Medium [Q1, Q3]	31 (26, 35)	1.00 (0.96–1.04, p=0.835)
ALT	Medium [Q1, Q3]	22 (13, 41)	1.00 (1.00–1.00, p=0.003)	1.00 (1.00–1.00, p=0.168)
AST	Medium [Q1, Q3]	28 (19, 50)	1.00 (1.00–1.00, p=0.058)
Cr	Medium [Q1, Q3]	92 (64, 172.02)	1.00 (1.00–1.00, p=0.009)	1.00 (1.00–1.00, p=0.636)
UA	Medium [Q1, Q3]	343 (248, 450)	1.00 (1.00–1.00, p<0.001)	1.00 (1.00–1.00, p=0.147)

Note: n=940, events=52, Likelihood ratio test=63.71 on 10 df (p<0.001).

Figure 2 Forest plot for multivariate Cox regression analyses of patients’ 30-day mortality.

Abbreviations: GC, glucocorticoid; TP, total protein; ALB, albumin; ALT, glutamic pyruvic transaminase; Cr, creatinine; UA, uric acid contents; SOFA, Sequential Organ Failure Assessment.

Data Sharing Statement

All data generated or analyzed during this study are included in this published article are not publicly available due to ethical restriction, but are available from the corresponding author upon reasonable request.