title: Healthcare costs doubled when children had urinary tract infections caused by extended-spectrum β-lactamase-producing bacteria.
abstract: OBJECTIVE
  The impact of the emergence of antimicrobial resistant organisms has rarely been studied in children, including the healthcare costs of urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing bacteria. We evaluated the effect of ESBL on UTI healthcare costs and risk factors for paediatric UTIs.
  
  
  METHODS
  This retrospective case-control study covered 2005-2014 and focused on children below 16 years of age treated in a University hospital: 22 children with UTIs caused by ESBL-producing bacteria and 56 ESBL-negative UTI controls.
  
  
  RESULTS
  The median healthcare costs were 3929 Euros for the 22 ESBL patients and 1705 Euros for the 56 controls (p = 0.015). The mean and standard deviation length of hospital stay was 7.4 (5.9) days for the ESBL group and 3.6 (2.3) days for the controls (p = 0.007), and the figures for antibiotic treatment were 12.3 (5.5) days versus 5.8 (3.0) days (p < 0.001), respectively. The odd ratios for ESBL were underlying disease (6.63, p = 0.013), previous hospitalisation (6.07, p = 0.009) and antibiotic prophylaxis (5.20, p = 0.035).
  
  
  CONCLUSIONS
  Healthcare costs more than doubled when children had ESBL-related UTIs, mainly due to their increased length of stay. Effective oral antibiotics are urgently needed to treat paediatric infections caused by ESBL-producing bacteria.
authors.affiliation: Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors.forename: Oona
authors.initials: O
authors.lastname: Nieminen
authors.affiliation: Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Korppi
authors.affiliation: Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors.forename: Merja
authors.initials: M
authors.lastname: Helminen
mesh_terms: D002675:Child, Preschool; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000191:economics* / Q000382:microbiology*; D018440:beta-Lactam Resistance
keywords: Antimicrobial resistant organisms; Extended-spectrum beta-lactamase; Healthcare costs; Length of stay; Urinary tract infection