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Table 1

Patient Characteristics

 

 

Total Number of Patients 102 (100%)

Patients with Bacterial Infections 37 (36.3%)

 

Males : Females 50 (49%) : 52 (51%)

Mean Age (SD) years 72.3 (11.1) : 73.1 (13.2)

Range Age years M:F (42.8-89.6 : 31.6-96.2)

 

Admission Diagnosis Malignant 94 (92.2%)

Admission Diagnosis Non Malignant 8 (7.8%)

Median overall patient survival (IQR)* 12 (4-29) days

Median patient survival with infections 22 (6-39) days

 

Patient survival < 7 days 40 (39.2%)

Patient survival 7-14 days 15 (14.7%)

Patient survival >14 days 47 (46.1%)

 

 

* IQR = inter-quartile range (25%-75%)


 

Table 2

General Diagnosis on Admission

 

Diagnosis n % 95%CI

Digestive tract cancer

28

27.5%

19.1-37.2%

Lung cancer

20

19.6%

12.4-28.6%

Genitourinary cancer

16

15.7%

9.2-24.2%

Haematological malignancies

7

6.8%

2.8-13.6%

Skin cancer

6

5.9%

2.2-12.4%

1Brain cancer

5

4.9%

1.6-11.1%

Carcinoma unknown primary site

5

4.9%

1.6-11.1%

Breast cancer

4

3.9%

1.1-9.70%

Mesothelioma pleura

3

2.9%

0.6-8.40%

Non Malignant Disease

8

7.8%

3.5-14.9%

Total:

102

100%

 

 

 

 

 

 


Table 3

Infection Sites / Antibiotics Prescribed

 

Site of Infection

(n)

Antibiotic

Used

Prescrib

Times

(n)

Culture

Or

Empiric*

Route

Symptom Response

Yes/No

Urinary Tract (17)

First Line

 

 

 

Second Line

Trimethoprim

Cephalexin

Augmentin Forte

Dicloxacillin

Cotrimoxazole

Gentamicin

9

4

2

1

1

1

 

C(7)E(2)

C(3)E(1)

C(2)

C(1)

C(1)

C(1)

PO

PO

PO

PO

PO

PO

Yes(4)

Yes(2)

Yes(2)

No(1)

No(1)

Yes(1)

Respiratory Tract (9)

First Line

 

 

 

 

Second Line

Augmentin Forte

Ciprofloxacin

Trimethoprim

Cotrimoxazole

Isoniazid

Augmentin Forte

2

2

3

1

1

1

C(1)E(1)

C(1)E(1)

C(2)E(1)

C(1)

E(1)

C(1)

PO

PO

PO

PO

PO

PO

Yes(1)No(1)

No(2)

Yes(2)No(1)

No(1)

No(1)

No(1)

Blood/Bacteremia (5)

First Line

 

 

 

 

 

Second Line

 

Ampicillin

Gentamicin

Augmentin Forte

Ciprofloxacin

Penicillin V

Switched to

Ampicillin

Amoxycillin

Ceftriaxone

1

1

1

1

1

 

1

1

1

 

C(1)

C(1)

C(1)

C(1)

C(1)

 

C(1)

C(1)

C(1)

 

IV

IV

PO

PO

PO

 

IV

PO

IV

 

Yes(1)

No(1)

No(1)

No(1)

No(1)

 

No(1)

Yes(1)

No(1)

 

Skin/Subcutaneous (5)

 

 

Amoxycillin

Cephalexin

Cotrimoxazole

Metronidazole

Trimethoprim

 

1

1

1

1

1

C(1)

C(1)

C(1)

C(1)

C(1)

PO

PO

PO

PO

PO

Yes(1)

No(1)

No(1)

No(1)

No(1)

Eyes (4)

 

 

Chloramphenicol

Ointment 0.5%

4

E(4)

Tp

Yes(4)

 


 

 

Table 4

Frequency of Bacterial Species and Antibiotic Sensitivities

 

Organism / Site

n

Antibiotic Sensitivities % (n)

Amox Amp AugF Cep Cef Cip Gen Cot/Tri Van Pen Ery Tic Met Clox

Escherichia coli

- urinary tract(5)*

- blood (2)

7

66.7 100 100 100 100 - 100 100 100 100 - - - -

(4/6) (1/1) (1/1) (5/5)(1/1) (7/7) (7/7) (2/2)(2/2)

Enterobacter fecalis

- urinary tract (3)

3

66.7 - 50 75 100 - 100 100 - 0.0 - 100 - -

(2/3) (1/2) (3/4)(1/1) (4/4) (5/5) (0/2) (1/1)

Staphylococcus aureus

- urinary tract (1)

- skin (1)

2

- - 100 100 100 - 100 - - 0.0 100 100 100 -

(1/1) (2/2)(1/1) (1/1) (0/2)(2/2)(1/1)(1/1)

 

Pseudomonas aeruginosa

- urinary tract

2

100 - - - 100 - 100 100 - 0.0 100100 - 100

(1/1) (1/1) (2/2) (1/1) (0/1)(1/1)(2/2) (1/1)

Strepcoccus bovis

- blood

1

- - - - - - - - 100 100 - - - -

Enterobacter aerogenes

- urinary tract (1)*

- skin (1)

2

0.0 - 0.0 0.0 - - 100 100 - - - - - -

(0/2) (0/2) (0/2) (2/2) (4/4)

Enterococcus species

- skin

1

- - - - - - - - 0.0 - - - - -

(0/1)

Streptococcus pyogenes group A

- blood

1

100 - - - - - 100 - 100 100 - - - -

Proteus mirabilis

- urinary tract*

1

- 100 100 100 - 100 100 100 - - - 100 - -

Total:

20

 

* urinary catheter involved in 5 cases

Amox = amoxycillin Amp = ampicillin AugF = augmentin forte Cep = cephalexin

Cef = ceftriaxone Cip = Ciprofloxacin Gen = Gentamicin

Cot/Tri = (trimethoprim/sulfamethoxazole) / trimethoprim

Van = vancomycin Pen = penicillin Ery = erythromycin Tic = ticarcillin

Met = methicillin Clox = cloxacillin


 

Table 5

Palliative care outcomes for

patients with and without infections

 

 

 

Variable

Patients with infection

Yes (n) No (n)

Mann-Whitney

U test25

Total Patients in groups

Median Survival (days)

35 67

22 10

 

P = .013

Mean(SD) Char Score

Mean(SD) Ajd Char Score

6.9 (3) 6.5 (3.4)

5.0 (2.9) 4.6 (3.3)

ns

ns

Prominent Symptoms

- severe pain

- dyspnea

- immobility

- depression/anxiety

- confusion

- weakness

- loss appetite

- nausea/vomiting

 

6 (17.1%) 13 (19.4%)

5 (14.3%) 19 (28.4%)

28 (80.0%) 55 (82.1%)

8 (22.9%) 14 (40.0%)

10 (28.6%) 32 (47.8%)

24 (68.6%) 38 (56.7%)

19 (54.3%) 24 (35.8%)

13 (37.1%) 14 (21.0%)

 

ns

ns

ns

ns

ns

ns

ns

ns

Primary Carer

23 (65.7%) 43 (64.2%)

ns

Family Support

24 (68.6%) 33 (49.3%)

ns

Comfortable Death

30 (85.7%) 35 (52.2%)

ns

Family Conflict

6 (17.1%) 4 (6.00%)

ns

Major Psychological distress post admission

20 (57.1%) 6 (8.90%)

 

P = .001

Major Depression

post admission

6 (17.1%) 5 (7.50%)

ns

 

 

 

 





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