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Comparative analysis of complicated urinary tract infections caused by extensively drug-resistant pseudomonas aeruginosa and extended-spectrum β-lactamase-producing klebsiella pneumoniae

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dc.contributor.author Sendra, Elena
dc.contributor.author López Montesinos, Inmaculada
dc.contributor.author Rodríguez-Alarcón, Alicia
dc.contributor.author Du, Juan
dc.contributor.author Siverio-Parès, Ana
dc.contributor.author Arenas-Miras, María Del Mar
dc.contributor.author Cañas-Ruano, Esperanza
dc.contributor.author Prim, Núria
dc.contributor.author Duran Jordà, Xavier, 1974-
dc.contributor.author Blasco-Hernando, Fabiola
dc.contributor.author García-Alzórriz, Enric
dc.contributor.author Cots Reguant, Francesc
dc.contributor.author Ferrández, Olivia
dc.contributor.author Gómez-Zorrilla, Silvia
dc.date.accessioned 2023-02-21T07:23:43Z
dc.date.available 2023-02-21T07:23:43Z
dc.date.issued 2022
dc.identifier.citation Sendra E, López Montesinos I, Rodriguez-Alarcón A, Du J, Siverio-Parés A, Arenas-Miras M, et al. Comparative analysis of complicated urinary tract infections caused by extensively drug-resistant pseudomonas aeruginosa and extended-spectrum β-lactamase-producing klebsiella pneumoniae. Antibiotics (Basel). 2022 Oct 29; 11(11): 1511. DOI: 10.3390/antibiotics11111511
dc.identifier.issn 2079-6382
dc.identifier.uri http://hdl.handle.net/10230/55831
dc.description.abstract The objective was to compare clinical characteristics, outcomes, and economic differences in complicated urinary tract infections (cUTI) caused by extensively drug-resistant Pseudomonas aeruginosa (XDR P. aeruginosa) and extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-K. pneumoniae). A retrospective study was conducted at a tertiary care hospital. Patients with XDR P. aeruginosa and ESBL-K. pneumoniae cUTIs were compared. The primary outcome was clinical failure at day 7 and at the end of treatment (EOT). Secondary outcomes: 30- and 90-day mortality, microbiological eradication, and economic cost. Two-hundred and one episodes were included, of which 24.8% were bloodstream infections. Patients with XDR P. aeruginosa cUTI more frequently received inappropriate empirical therapy (p < 0.001). Nephrotoxicity due to antibiotics was only observed in the XDR P. aeruginosa group (26.7%). ESBL-K. pneumoniae cUTI was associated with worse eradication rates, higher recurrence, and higher infection-related readmission. In multivariate analysis, XDR P. aeruginosa was independently associated with clinical failure on day 7 of treatment (OR 4.34, 95% CI 1.71-11.04) but not at EOT, or with mortality. Regarding hospital resource consumption, no significant differences were observed between groups. XDR P. aeruginosa cUTI was associated with worse early clinical cures and more antibiotic side effects than ESBL-K. pneumoniae infections. However, no differences in mortality or in hospitalization costs were observed.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher MDPI
dc.rights Copyright © 2022 by Sendra E, López Montesinos I, Rodriguez-Alarcón A, Du J, Siverio-Parés A, Arenas-Miras M, et al. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.title Comparative analysis of complicated urinary tract infections caused by extensively drug-resistant pseudomonas aeruginosa and extended-spectrum β-lactamase-producing klebsiella pneumoniae
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.3390/antibiotics11111511
dc.subject.keyword Klebsiella pneumoniae
dc.subject.keyword Pseudomonas aeruginosa
dc.subject.keyword Extended-spectrum beta-lactamase-producing
dc.subject.keyword Extensively drug-resistant
dc.subject.keyword Multidrug resistance (MDR)
dc.subject.keyword Urinary tract infections
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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