Clinical and Economic Impact of Community-Onset Urinary Tract Infections Caused by ESBL-Producing Klebsiella pneumoniae Requiring Hospitalization in Spain : An Observational Cohort Study
Rozenkiewicz, Dawid (Institut Hospital del Mar d'Investigacions Mèdiques)
Esteve-Palau, Erika (Institut Hospital del Mar d'Investigacions Mèdiques)
Arenas-Miras, Maria del Mar (Instituto de Salud Carlos III)
Grau, Santiago (Hospital del Mar (Barcelona, Catalunya))
Duran-Jordà, Xavier (Institut Hospital del Mar d'Investigacions Mèdiques)
Sorlí, Luisa (Instituto de Salud Carlos III)
Montero, María Milagro (Instituto de Salud Carlos III)
Horcajada, Juan Pablo (Instituto de Salud Carlos III)
Universitat Autònoma de Barcelona

Fecha:	2021
Resumen:	Objective : To analyze the clinical and economic impact of community-onset urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae requiring hospitalization. Methods : A retrospective cohort study that included all adults with a UTI caused by K. pneumoniae that were admitted to a tertiary care hospital in Barcelona, Spain, between 2011 and 2015. Demographic, clinical, and economic data were analyzed. Results : One hundred and seventy-three episodes of UTIs caused by K. pneumoniae were studied; 112 were non-ESBL-producing and 61 were ESBL-producing. Multivariate analysis identified ESBL production, acute confusional state associated with UTI, shock, and the time taken to obtain adequate treatment as risk factors for clinical failure during the first seven days. An economic analysis showed differences between ESBL-producing and non-ESBL-producing K. pneumoniae for the total cost of hospitalization per episode (mean EUR 6718 vs EUR 3688, respectively). Multivariate analysis of the higher costs of UTI episodes found statistically significant differences for ESBL production and the time taken to obtain adequate treatment. Conclusion : UTIs caused by ESBL-producing K. pneumoniae requiring hospitalization and the time taken to obtain adequate antimicrobial therapy are associated with worse clinical and economic outcomes.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	ESBL-producing Klebsiella pneumoniae ; Urinary tract infection ; Clinical impact ; Economic impact
Publicado en:	Antibiotics, Vol. 10 (may 2021) , ISSN 2079-6382

DOI: 10.3390/antibiotics10050585
PMID: 34063338

10 p, 237.9 KB

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