Comparative Analysis of Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant
Klebsiella pneumoniae
Pseudomonas aeruginosa
extended-spectrum beta-lactamase-producing
extensively drug-resistant
multidrug resistance (MDR)
urinary tract infections
Journal
Antibiotics (Basel, Switzerland)
ISSN: 2079-6382
Titre abrégé: Antibiotics (Basel)
Pays: Switzerland
ID NLM: 101637404
Informations de publication
Date de publication:
29 Oct 2022
29 Oct 2022
Historique:
received:
03
10
2022
revised:
24
10
2022
accepted:
26
10
2022
entrez:
11
11
2022
pubmed:
12
11
2022
medline:
12
11
2022
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 36358167
pii: antibiotics11111511
doi: 10.3390/antibiotics11111511
pmc: PMC9686592
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Instituto de Salud Carlos III
ID : FIS PI21/00509
Organisme : Spanish Society of Infectious Diseases and Clinical Microbiology
ID : research grant from SEIMC
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