Factors associated with the length of hospital stay among pediatric patients with urinary tract infections caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in two Peruvian hospitals

• Autores: Flores-Soto, Marleni E., Morales-Rocano, Anna K., Aguirre-Sosa, Ildauro, Ayon-Dejo, Carmen Cecilia, Llamo-Vilcherrez, Anita Paola, Toro-Huamanchumo, Carlos Jesús
• Formato: artículo
• Fecha de Publicación: 2025
• Institución: Universidad de San Martín de Porres
• Repositorio: Horizonte médico
• Lenguaje: español
• OAI Identifier: oai:horizontemedico.usmp.edu.pe:article/3745
• Enlace del recurso: https://www.horizontemedico.usmp.edu.pe/index.php/horizontemed/article/view/3745
• Nivel de acceso: acceso abierto
• Materia: Tiempo de Internación; Infecciones Urinarias; Enterobacteriaceae; Betalactamasas; Pediatría; Length of Stay; Urinary Tract Infections; beta-Lactamases; Pediatrics

Objective: To identify factors associated with the length of hospital stay among pediatric patients with urinary tract infections (UTIs) caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) in two Peruvian hospitals. Materials andmethods: A retrospective cohort study was conducted through a review of medical records of children with UTIs caused by ESBL-E hospitalized between 2016 and 2022 at Hospital Nacional Edgardo Rebagliati Martins (Seguro Social de Salud [EsSalud] – Peru’s Social Health Insurance) and Hospital Nacional Docente Madre Niño San Bartolomé (Ministerio de Salud [MINSA] – Ministry of Health). The primary outcome variable was the length of hospital stay, defined as the number of days between admission and discharge. Linear regression with logarithmic transformation was used to identify factors associated with longer hospital stays. Additionally, factors related to prolonged hospital stays (> 7 days) were analyzed using Poisson regression models with robust variance. Results: A total of 149 patients were included, with a median hospital stay of five days (interquartile range [IQR: 4–8 days]). Linear regressionanalysis identified the factors contributing to longer hospital stays: prior exposure to intravenous antibiotic therapy (coefficient [coef]: 1.48; 95 % confidence interval [95 % CI]: 1.18–1.85; p = 0.001); resistance to the initially prescribed antibiotic (coef: 1.31; 95 % CI: 1.02–1.68; p = 0.036); low weight-for-age (coef: 1.41; 95 % CI: 1.10–1.82; p = 0.009); and delayed urine culture results (coef: 1.28; 95 % CI: 1.02–1.61; p = 0.036). In contrast, a history of genitourinary disorder was associated with a shorter hospital stay (coef: 0.80; 95 % CI: 0.64-0.99; p = 0.048). In the secondary analysis, hospitalization at EsSalud was associated with an increased risk of prolonged stay (risk ratio [RR]: 2.27; 95 % CI: 1.41–3.64). Conclusions: Several factors were associated with prolonged hospital stay among children with UTIs caused by ESBL-E. These findings may help optimize therapeutic and hospital management strategies, ultimately reducing complications and associated healthcare costs.