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Clinical and Economic Impact of Community-Onset Urinary Tract Infections Caused by ESBL-Producing Klebsiella pneumoniae Requiring Hospitalization: An Observational Cohort Study
Rozenkiewicz, D.; Esteve-Palau, E.; Arenas-Miras, M.; Grau, S.; Duran, X.; Sorlí, L.; Montero, M.M.; Horcajada, J.P. Clinical and Economic Impact of Community-Onset Urinary Tract Infections Caused by ESBL-Producing Klebsiella pneumoniae Requiring Hospitalization in Spain: An Observational Cohort Study. Antibiotics2021, 10, 585.
Rozenkiewicz, D.; Esteve-Palau, E.; Arenas-Miras, M.; Grau, S.; Duran, X.; Sorlí, L.; Montero, M.M.; Horcajada, J.P. Clinical and Economic Impact of Community-Onset Urinary Tract Infections Caused by ESBL-Producing Klebsiella pneumoniae Requiring Hospitalization in Spain: An Observational Cohort Study. Antibiotics 2021, 10, 585.
Rozenkiewicz, D.; Esteve-Palau, E.; Arenas-Miras, M.; Grau, S.; Duran, X.; Sorlí, L.; Montero, M.M.; Horcajada, J.P. Clinical and Economic Impact of Community-Onset Urinary Tract Infections Caused by ESBL-Producing Klebsiella pneumoniae Requiring Hospitalization in Spain: An Observational Cohort Study. Antibiotics2021, 10, 585.
Rozenkiewicz, D.; Esteve-Palau, E.; Arenas-Miras, M.; Grau, S.; Duran, X.; Sorlí, L.; Montero, M.M.; Horcajada, J.P. Clinical and Economic Impact of Community-Onset Urinary Tract Infections Caused by ESBL-Producing Klebsiella pneumoniae Requiring Hospitalization in Spain: An Observational Cohort Study. Antibiotics 2021, 10, 585.
Abstract
Objective: To analyze the clinical and economic impact of community-onset urinary tract infections (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae requiring hospitalization. Methods: A retrospective cohort study included all adults with UTI caused by K. pneumoniae 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 UTI caused by K. pneumoniae were studied; 112 were non-ESBL-producing and 61 ESBL-producing. Multivariate analysis identified ESBL production, acute confusional state associated with UTI, shock, and time to adequate treatment as risk factors for clinical failure during the first 7 days. Economic analysis showed differences between ESBL-producing and non-ESBL-producing K. pneumoniae for the total cost of hospitalization per episode (mean 6,718 € vs 3,688 € respectively). Multivariate analysis of the higher costs of UTI episodes found statistically significant differences for ESBL production and time to adequate treatment. Conclusion: UTI caused by ESBL-producing K. pneumoniae requiring hospitalization, and time to adequate antimicrobial therapy are associated with worse clinical and economic outcomes.
Copyright:
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