Clinical and economic impact of urinary tract infections caused by ESBL-producing Escherichia coli requiring hospitalization: A matched cohort study

E. Esteve-Palau, G. Solande, F. Sánchez, L. Sorlí, M. Montero, R. Güerri, J. Villar, S. Grau, J. P. Horcajada

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38 Citations (Scopus)

Abstract

© 2015 The British Infection Association. Objective: To analyze the clinical and economic impact of urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia 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: One hundred and twenty 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 €4980 vs. €2612). 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.
Original languageEnglish
Pages (from-to)667-674
JournalJournal of Infection
Volume71
Issue number6
DOIs
Publication statusPublished - 1 Dec 2015

Keywords

  • Economic impact
  • ESBL
  • OPAT
  • Urinary tract infection

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