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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

Flores-Soto M.E.; Llamo-Vilcherrez A.P.; Aguirre-Sosa I.; Ayon-Dejo C.C.; Llamo-Vilcherrez A.P.; Toro-Huamanchumo C.J. · Horizonte Medico (2025) · DOI: 10.24265/horizmed.2025.v25n3.05

Resumen

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 and methods: 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 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 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 strategies, ultimately reducing complications and associated healthcare costs.

Instituciones: Universidad Peruana de Ciencias Aplicadas; Universidad San Ignacio de Loyola