Comparative Analysis of Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant <i>Pseudomonas aeruginosa</i> and Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i>
The objective was to compare clinical characteristics, outcomes, and economic differences in complicated urinary tract infections (cUTI) caused by extensively drug-resistant <i>Pseudomonas aeruginosa</i> (XDR <i>P. aeruginosa</i>) and extended-spectrum beta-lactamase-producin...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-10-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/11/11/1511 |
| _version_ | 1797469318560088064 |
|---|---|
| author | Elena Sendra Inmaculada López Montesinos Alicia Rodriguez-Alarcón Juan Du Ana Siverio-Parés Mar Arenas-Miras Esperanza Cañas-Ruano Nuria Prim Xavier Durán-Jordà Fabiola Blasco-Hernando Enric García-Alzorriz Francesc Cots Olivia Ferrández Silvia Gómez-Zorrilla |
| author_facet | Elena Sendra Inmaculada López Montesinos Alicia Rodriguez-Alarcón Juan Du Ana Siverio-Parés Mar Arenas-Miras Esperanza Cañas-Ruano Nuria Prim Xavier Durán-Jordà Fabiola Blasco-Hernando Enric García-Alzorriz Francesc Cots Olivia Ferrández Silvia Gómez-Zorrilla |
| author_sort | Elena Sendra |
| collection | DOAJ |
| description | The objective was to compare clinical characteristics, outcomes, and economic differences in complicated urinary tract infections (cUTI) caused by extensively drug-resistant <i>Pseudomonas aeruginosa</i> (XDR <i>P. aeruginosa</i>) and extended-spectrum beta-lactamase-producing <i>Klebsiella pneumoniae</i> (ESBL-K. <i>pneumoniae</i>). A retrospective study was conducted at a tertiary care hospital. Patients with XDR <i>P. aeruginosa</i> and ESBL-<i>K. pneumoniae</i> 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 <i>P. aeruginosa</i> cUTI more frequently received inappropriate empirical therapy (<i>p</i> < 0.001). Nephrotoxicity due to antibiotics was only observed in the XDR <i>P. aeruginosa</i> group (26.7%). ESBL-<i>K. pneumoniae</i> cUTI was associated with worse eradication rates, higher recurrence, and higher infection-related readmission. In multivariate analysis, XDR <i>P. aeruginosa</i> 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 <i>P. aeruginosa</i> cUTI was associated with worse early clinical cures and more antibiotic side effects than ESBL-<i>K. pneumoniae</i> infections. However, no differences in mortality or in hospitalization costs were observed. |
| first_indexed | 2024-03-09T19:19:42Z |
| format | Article |
| id | doaj.art-0d5a65f6366e439ebb9bb0d62a4b502e |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T19:19:42Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-0d5a65f6366e439ebb9bb0d62a4b502e2023-11-24T03:27:36ZengMDPI AGAntibiotics2079-63822022-10-011111151110.3390/antibiotics11111511Comparative Analysis of Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant <i>Pseudomonas aeruginosa</i> and Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i>Elena Sendra0Inmaculada López Montesinos1Alicia Rodriguez-Alarcón2Juan Du3Ana Siverio-Parés4Mar Arenas-Miras5Esperanza Cañas-Ruano6Nuria Prim7Xavier Durán-Jordà8Fabiola Blasco-Hernando9Enric García-Alzorriz10Francesc Cots11Olivia Ferrández12Silvia Gómez-Zorrilla13Infectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Universitat Pompeu Fabra (UPF), 08003 Barcelona, SpainInfectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Universitat Pompeu Fabra (UPF), 08003 Barcelona, SpainPharmacy Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Universitat Pompeu Fabra (UPF), 08003 Barcelona, SpainInfectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Universitat Pompeu Fabra (UPF), 08003 Barcelona, SpainMicrobology Service, Laboratori de Referència de Catalunya, Hospital del Mar, 08003 Barcelona, SpainInfectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Universitat Pompeu Fabra (UPF), 08003 Barcelona, SpainInfectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Universitat Pompeu Fabra (UPF), 08003 Barcelona, SpainMicrobology Service, Laboratori de Referència de Catalunya, Hospital del Mar, 08003 Barcelona, SpainMethodology and Biostatistics Support Unit, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, SpainInfectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Universitat Pompeu Fabra (UPF), 08003 Barcelona, SpainManagement Control Department, Hospital del Mar-Parc de Salut Mar, 08003 Barcelona, SpainManagement Control Department, Hospital del Mar-Parc de Salut Mar, 08003 Barcelona, SpainPharmacy Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Universitat Pompeu Fabra (UPF), 08003 Barcelona, SpainInfectious Diseases Service, Hospital del Mar, Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Universitat Autònoma de Barcelona (UAB), Universitat Pompeu Fabra (UPF), 08003 Barcelona, SpainThe objective was to compare clinical characteristics, outcomes, and economic differences in complicated urinary tract infections (cUTI) caused by extensively drug-resistant <i>Pseudomonas aeruginosa</i> (XDR <i>P. aeruginosa</i>) and extended-spectrum beta-lactamase-producing <i>Klebsiella pneumoniae</i> (ESBL-K. <i>pneumoniae</i>). A retrospective study was conducted at a tertiary care hospital. Patients with XDR <i>P. aeruginosa</i> and ESBL-<i>K. pneumoniae</i> 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 <i>P. aeruginosa</i> cUTI more frequently received inappropriate empirical therapy (<i>p</i> < 0.001). Nephrotoxicity due to antibiotics was only observed in the XDR <i>P. aeruginosa</i> group (26.7%). ESBL-<i>K. pneumoniae</i> cUTI was associated with worse eradication rates, higher recurrence, and higher infection-related readmission. In multivariate analysis, XDR <i>P. aeruginosa</i> 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 <i>P. aeruginosa</i> cUTI was associated with worse early clinical cures and more antibiotic side effects than ESBL-<i>K. pneumoniae</i> infections. However, no differences in mortality or in hospitalization costs were observed.https://www.mdpi.com/2079-6382/11/11/1511<i>Pseudomonas aeruginosa</i>extensively drug-resistant<i>Klebsiella pneumoniae</i>extended-spectrum beta-lactamase-producingmultidrug resistance (MDR)urinary tract infections |
| spellingShingle | Elena Sendra Inmaculada López Montesinos Alicia Rodriguez-Alarcón Juan Du Ana Siverio-Parés Mar Arenas-Miras Esperanza Cañas-Ruano Nuria Prim Xavier Durán-Jordà Fabiola Blasco-Hernando Enric García-Alzorriz Francesc Cots Olivia Ferrández Silvia Gómez-Zorrilla Comparative Analysis of Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant <i>Pseudomonas aeruginosa</i> and Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i> Antibiotics <i>Pseudomonas aeruginosa</i> extensively drug-resistant <i>Klebsiella pneumoniae</i> extended-spectrum beta-lactamase-producing multidrug resistance (MDR) urinary tract infections |
| title | Comparative Analysis of Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant <i>Pseudomonas aeruginosa</i> and Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i> |
| title_full | Comparative Analysis of Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant <i>Pseudomonas aeruginosa</i> and Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i> |
| title_fullStr | Comparative Analysis of Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant <i>Pseudomonas aeruginosa</i> and Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i> |
| title_full_unstemmed | Comparative Analysis of Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant <i>Pseudomonas aeruginosa</i> and Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i> |
| title_short | Comparative Analysis of Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant <i>Pseudomonas aeruginosa</i> and Extended-Spectrum β-Lactamase-Producing <i>Klebsiella pneumoniae</i> |
| title_sort | comparative analysis of complicated urinary tract infections caused by extensively drug resistant i pseudomonas aeruginosa i and extended spectrum β lactamase producing i klebsiella pneumoniae i |
| topic | <i>Pseudomonas aeruginosa</i> extensively drug-resistant <i>Klebsiella pneumoniae</i> extended-spectrum beta-lactamase-producing multidrug resistance (MDR) urinary tract infections |
| url | https://www.mdpi.com/2079-6382/11/11/1511 |
| work_keys_str_mv | AT elenasendra comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT inmaculadalopezmontesinos comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT aliciarodriguezalarcon comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT juandu comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT anasiveriopares comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT mararenasmiras comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT esperanzacanasruano comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT nuriaprim comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT xavierduranjorda comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT fabiolablascohernando comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT enricgarciaalzorriz comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT francesccots comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT oliviaferrandez comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei AT silviagomezzorrilla comparativeanalysisofcomplicatedurinarytractinfectionscausedbyextensivelydrugresistantipseudomonasaeruginosaiandextendedspectrumblactamaseproducingiklebsiellapneumoniaei |