Rozenkiewicz, DawidEsteve Palau, ErikaArenas-Miras, María Del MarGrau Cerrato, SantiagoDuran Jordà, Xavier, 1974-Sorlí, LuisaMontero, Maria MilagroHorcajada Gallego, Juan Pablo2021-08-302021-08-302021Rozenkiewicz D, Esteve-Palau E, Arenas-Miras M, Grau S, Duran X, Sorlí L, Montero MM, Horcajada JP. 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 (Basel). 2021;10(5):585. DOI: 10.3390/antibiotics100505852079-6382http://hdl.handle.net/10230/48344Objective: 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.application/pdfeng© 2021 by the authors. 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 (http://creativecommons.org/licenses/by/4.0/).info:eu-repo/semantics/articlehttp://dx.doi.org/10.3390/antibiotics10050585ESBL-producing Klebsiella pneumoniaeClinical impactEconomic impactUrinary tract infectioninfo:eu-repo/semantics/openAccess