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.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.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.doi http://dx.doi.org/10.3390/antibiotics11111511
  • dc.identifier.issn 2079-6382
  • dc.identifier.uri http://hdl.handle.net/10230/55831
  • 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.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • 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.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.type.version info:eu-repo/semantics/publishedVersion

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Articles (Hospital del Mar Research Institute)
Articles (Departament de Medicina i Ciències de la Vida)