Bibliographic Details
| Title: |
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. |
| Alternate Title: |
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. |
| Authors: |
Flores-Soto, Marleni E.1, Morales-Rocano, Anna K.1, Aguirre-Sosa, Ildauro1,2, Ayon-Dejo, Carmen Cecilia3, Llamo-Vilcherrez, Anita Paola4, Toro-Huamanchumo, Carlos J.5 toro2993@hotmail.com |
| Source: |
Revista Horizonte Médico. jul-sep2025, Vol. 25 Issue 3, p1-14. 14p. |
| Abstract (English): |
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 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 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 regression analysis 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. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): |
Objetivo: Identificar los factores que se asocian al tiempo de estancia hospitalaria en pacientes pediátricos con infecciones del tracto urinario (ITU) causadas por enterobacterias productoras de betalactamasas de espectro extendido (EP-BLEE) en dos hospitales peruanos. Materiales y métodos: Se realizó un estudio de cohorte retrospectivo basado en la revisión de historias clínicas de niños hospitalizados por ITU por EP-BLEE entre 2016 y 2022 en el Hospital Nacional Edgardo Rebagliati Martins - Seguro Social de Salud (EsSalud) y en el Hospital Nacional Docente Madre Niño “San Bartolomé†- Ministerio de Salud (Minsa). La variable de desenlace principal fue el tiempo de estancia hospitalaria, definido como el número de días entre el ingreso y el alta. Se aplicó regresión lineal con transformación logarítmica para identificar factores asociados con una mayor duración del internamiento. Además, se exploraron factores vinculados a hospitalizaciones prolongadas (>7 días) mediante modelos Poisson con varianzas robustas. Resultados: Se incluyeron 149 pacientes, con una mediana de estancia hospitalaria de cinco días (rango intercuartílico [RIQ]: 4-8 días). En el análisis de regresión lineal, se identificaron factores que contribuyeron a una mayor duración de la hospitalización: exposición previa a antibioticoterapia intravenosa (coeficiente [coef]: 1,48; intervalo de confianza (IC) del 95 % [IC 95 %]: 1,18 – 1,85; p = 0,001), resistencia al antibiótico iniciado (coef: 1,31; IC 95 %: 1,02 – 1,68; p = 0,036), peso bajo para la edad (coef: 1,41; IC 95 %: 1,10 – 1,82; p = 0,009) y demora en el resultado del urocultivo (coef: 1,28; IC 95 %: 1,02 – 1,61; p = 0,036). En contraste, haber presentado una enfermedad genitourinaria se asoció a un menor tiempo de hospitalización (coef: 0,80; IC 95 %: 0,64 – 0,99; p = 0,048). Además, en el análisis secundario, hospitalizarse en EsSalud se vinculó con mayor riesgo de estancia prolongada (RR: 2,27; IC 95 %: 1,41 – 3,64). Conclusiones: Se identificaron diferentes factores asociados con estancias hospitalarias prolongadas en niños con ITU por EP-BLEE. Estos hallazgos pueden ser útiles para optimizar las estrategias terapéuticas y de gestión hospitalaria, ya que permite reducir las complicaciones y costos asociados. [ABSTRACT FROM AUTHOR] |
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| Database: |
MedicLatina |
