TABLE 1

Baseline and infection characteristics of patients receiving MT, NVCT, and VCT

CharacteristicResult for the following treatment arm:P value
MT (n = 58)NVCT (n = 203)VCT (n = 30)
Demographics
    Median (range) age (yr)63 (16–93)58 (16–87)59 (21–92)0.389
    No. (%) of male patients37 (63.8)137 (67.5)19 (63.3)0.815
No. (%) of patients with the following comorbidities:
    Ischemic heart disease14 (24.1)45 (22.2)5 (16.7)0.721
    Congestive heart failure6 (10.3)15 (7.4)6 (20.0)0.081
    Cerebrovascular disease6 (10.3)18 (8.9)7 (23.3)0.056
    Diabetes mellitus29 (50.0)72 (35.5)11 (36.7)0.131
    Chronic kidney disease19 (32.8)52 (25.6)6 (20.0)0.387
    Hepatic disease4 (6.9)17 (8.4)4 (13.3)0.582
    Malignancy disease9 (15.5)42 (20.7)12 (40.0)0.025
    Autoimmune disease1 (1.7)4 (2.0)3 (10.0)0.037
    Immunocompromised5 (8.6)13 (6.4)10 (33.3)0.037
Median (range) CCI2 (0–8)2 (0–10)4.5 (0–14)<0.001
Median (range) APACHE II score12 (0–23)14 (0–29)16 (5–31)0.023
No. (%) of patients with the following primary infection or site of infectiona:
    Central nervous system0 (0.0)1 (0.5)0 (0.0)0.805
    Nosocomial pneumonia18 (31.0)89 (43.8)11 (36.7)0.194
    Tracheobronchitis1 (1.7)3 (1.5)0 (0.0)0.784
    Skin and soft tissue21 (36.2)84 (41.4)1 (3.3)<0.001
    Bone and joint4 (6.9)15 (7.4)4 (13.3)0.504
    Gastrointestinal system1 (1.7)11 (5.4)2 (6.7)0.450
    Urinary tract11 (19.0)25 (12.3)0 (0.0)0.038
    Blood13 (22.4)62 (30.5)13 (43.3)0.127
    Secondary bacteremia4 (6.9)39 (19.2)11 (36.7)0.003
No. (%) of patients in whom the following XDR GNB was responsible for infectionb:
    A. baumannii47 (81.0)170 (83.7)11 (36.7)<0.001
    P. aeruginosa9 (15.5)38 (18.7)14 (46.7)<0.001
    K. pneumoniae2 (3.4)7 (3.4)5 (16.7)0.006
    Other XDR-GNBc2 (3.4)5 (2.5)0 (0.0)0.289
Details of polymyxin used
    Median (range) duration between XDR culture and treatment (days)3 (0–55)3 (0–79)3 (1–39)0.046
    No. (%) of patients who received polymyxin B44 (21.7)162 (79.8)30 (100)0.016
    Median (range) avg no. of IU of polymyxin B/kg/day administered to each patient18,006 (2,315–33,846)21,467 (3,163–45,977)25,000 (25,000–25,000)<0.001
    No. (%) of patients who received i.v. CMS7 (12.1)39 (19.2)1 (3.3)0.056
    Median (range) avg no. of IU of i.v. CMS/day administered to each patient2,500,000 (1,000,000–3,500,000)4,090,000 (1,530,000–9,000,000)9,000,0000.009
    No. (%) of patients who received nebulized CMS16 (27.6)81 (39.9)11 (36.7)0.231
    Median (range) avg no. of IU of nebulized CMS/day administered to each patient6,000,000 (3,000,000–6,000,000)6,000,000 (2,860,000–9,000,000)6,000,000 (6,000,000–6,000,000)0.122
    Median (range) proportion of treatment days with adequate i.v. polymyxin dosese0.00 (0.00–1.00)0.52 (0.00–1.00)1.00 (1.00–1.00)<0.001
    Median (range) proportion of treatment days with adequate nebulized CMS dosese1.00 (1.00–1.00)1.00 (0.86–1.00)1.00 (1.00–1.00)0.845
    Median (range) duration (days) of polymyxin treatment9.5 (3–27)15 (3–139)16.5 (6–126)<0.001
  • a There may be multiple primary sites of XDR GNB infection per patient.

  • b There may be multiple XDR GNB cultured at each site of infection.

  • c Other GNB included Stenotrophomonas maltophilia (n = 1), Enterobacter cloacae (n = 2), Pseudomonas putida (n = 2), a Citrobacter species (n = 1), and an Enterobacter species (n = 1).

  • d The patient may have received ≥1 polymyxin in the course of treatment.

  • e Defined as the proportion of i.v. polymyxin B or i.v. CMS treatment days on which each patient received adequate doses of the respective polymyxin.