Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Clinical and Economic Impact of Community-Onset Urinary Tract Infections Caused by ESBL-Producing Klebsiella pneumoniae Requiring Hospitalization: An Observational Cohort Study

Version 1 : Received: 20 March 2021 / Approved: 22 March 2021 / Online: 22 March 2021 (12:08:23 CET)

A peer-reviewed article of this Preprint also exists.

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. Antibiotics 2021, 10, 585.

Journal reference: Antibiotics 2021, 10, 585
DOI: 10.3390/antibiotics10050585

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.

Keywords

Community onset ESBL -producing Klebsiella pneumoniae; Urinary tract infection; Clinical impact; Economic impact

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