Clinical and Economic Outcomes Associated with Complicated Urinary Tract Infections Caused by Carbapenem-resistant Enterobacterales in Patients Admitted to a Referral Center in Lima, Peru
Abstract
Background Urinary tract infections (UTIs) affect 150 million people annually, with increased incidence among individuals over 60 years of age. Complicated UTIs (cUTIs), frequently caused by multidrug-resistant pathogens such as Escherichia coli and Klebsiella pneumoniae, present therapeutic challenges due to host factors and anatomical abnormalities. Carbapenem-resistant Enterobacterales (CRE) infections are of particular concern as they are associated with higher mortality and healthcare costs. This study aimed to compare the clinical and economic outcomes of cUTIs caused by CRE and carbapenem-susceptible Enterobacterales (CSE) at a referral hospital in Lima, Peru. Materials and Methods This retrospective cohort study included 200 patients with cUTI admitted to the emergency department. Patients were categorized into two groups: those with CRE-cUTI and those with CSE-cUTI. Data were collected from electronic medical records, including demographics, comorbidities, antimicrobial treatments, and clinical outcomes, with a primary focus on the 30-day mortality. Kaplan-Meier survival curves, log-rank tests, and generalized linear models were used to assess mortality risk factors. Adjusted relative risks (aRRs) were reported with 95% confidence intervals (CI). The final multivariate model was adjusted for three variables selected based on epidemiological relevance: carbapenem resistance, septic shock on admission, and Charlson comorbidity index. Hospitalization costs were…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 200 participants or records.
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