8360def9fc9b86db139e586cba37e91f antibiotics-11-01511.pdf 9c580112e2eb90910f564d1bf8ef3a9a9a1a614b antibiotics-11-01511.pdf 42578b47a0770ed9dd1948dfe9b6cf3c6e475668a7b19bb27fef65134275f706 antibiotics-11-01511.pdf Title: Comparative Analysis of Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant Pseudomonas aeruginosa and Extended-Spectrum -Lactamase-Producing Klebsiella pneumoniae Subject: 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. Keywords: Pseudomonas aeruginosa; extensively drug-resistant; Klebsiella pneumoniae; extended-spectrum beta-lactamase-producing; multidrug resistance (MDR); urinary tract infections 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 and Silvia Gómez-Zorrilla Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Oct 31 11:22:23 2022 CET ModDate: Mon Oct 31 11:28:28 2022 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 21 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 371984 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- ZYYJXI+EURB10 Type 1 Builtin yes yes no 10 0 JUXSQN+VnURWPalladioL-Bold Type 1 Custom yes yes no 14 0 KNVYDE+VnURWPalladioL Type 1 Custom yes yes no 19 0 JCJUSF+URWPalladioL-Bold Type 1 Custom yes yes no 23 0 CFQQAA+URWPalladioL-Roma Type 1 Custom yes yes no 28 0 UNEMBG+URWPalladioL-Ital Type 1 Custom yes yes no 32 0 KUIIWR+URWPalladioL-BoldItal Type 1 Custom yes yes no 36 0 HHFREY+EURM7 Type 1 Builtin yes yes no 40 0 YYFPCJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 59 0 AHSHLD+CMSY10 Type 1 Builtin yes yes no 84 0 LWLIVD+EURM10 Type 1 Builtin yes yes no 140 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-09-30 04:07:33 CEST RepresentationInformation: antibiotics-11-01511.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-09-29 18:12:24 CEST Size: 371984 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 362 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Methods Destination: section.2 Children: Item: Title: Hospital Setting, Study Design, and Study Population Destination: subsection.2.1 Item: Title: Clinical Variables, Data Sources, and Definitions Destination: subsection.2.2 Item: Title: Outcomes and Follow-Up Destination: subsection.2.3 Item: Title: Microbiological Studies Destination: subsection.2.4 Item: Title: Statistical Analysis Destination: subsection.2.5 Item: Title: Cost Estimation Destination: subsection.2.6 Item: Title: Ethics Destination: subsection.2.7 Item: Title: Results Destination: section.3 Children: Item: Title: Primary Outcome: Clinical Failure Destination: subsection.3.1 Item: Title: Secondary Outcomes: Mortality, Microbiological Assessment, and Economic Analysis Destination: subsection.3.2 Item: Title: Adverse Events Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Comparative Analysis of Complicated Urinary Tract Infections Caused by Extensively Drug-Resistant Pseudomonas aeruginosa and Extended-Spectrum -Lactamase-Producing Klebsiella pneumoniae 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 and Silvia Gómez-Zorrilla Subject: 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. 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