Factores asociados al tiempo de estancia hospitalaria en pacientes pediátricos con infecciones del tracto urinario por enterobacterias productoras de betalactamasas de espectro extendido en dos hospitales peruanos

Abstract

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.