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Clinical and economic impact of urinary tract Infections caused by ESBL-producing Escherichia coli requiring hospitalization: a matched cohort study.
J Infect. 2015 Sep 14;
Authors: Esteve-Palau E, Solande G, Sánchez F, Sorlí L, Montero M, Güerri R, Villar J, Grau S, Horcajada JP
Abstract
OBJECTIVE: To analyze the clinical and economic impact of urinary tract infections (UTIs) caused by Extended-Spectrum Beta-Lactamase (ESBL)-producing E. coli requiring hospitalization.
METHODS: Matched cohort study including adults with UTI caused by ESBL-producing E. coli admitted to a tertiary care hospital in Barcelona, Spain, between August 2010 and July 2013. Demographic, clinical and economic data were analyzed.
RESULTS: 120 episodes of UTI were studied: 60 due to ESBL-producing E.coli and 60 due to non-ESBL-producing E.coli. Bivariate analysis showed that prior antimicrobial treatment (p = 0.007) and ESBL production (p< 0.001) were related to clinical failure during the first 7 days. Multivariate analysis selected ESBL as the sole risk factor for clinical failure (p = 0.002). Regarding the economic impact of infections caused by ESBL-producing E. coli, an ESBL-producing infection cost more than a non-ESBL-producing E. coli infection (mean €4,980 vs. €2,612). Looking at hospital expenses separately, the total pharmacy costs and antibiotic costs of ESBL infections were considerably higher than for non-ESBL infections (p<0.001), as was the need for outpatient parenteral antibiotic therapy (OPAT) and its related costs. Multivariate analysis performed for the higher costs of UTI episodes found statistically significant differences for males (p = 0.004), chronic renal failure (p = 0.025), ESBL production (p = 0.008) and OPAT (p = 0.009).
CONCLUSION: UTIs caused by EBSL-producing E.coli requiring hospital admission are associated with worse clinical and economic outcomes.
PMID: 26380898 [PubMed - as supplied by publisher]