TY - JOUR
T1 - Unraveling the Length of Hospital Stay for Patients with Urinary Tract Infections
T2 - Contributing Factors and Microbial Susceptibility
AU - Rahme, Deema
AU - Nakkash Chmaisse, Hania
AU - Salameh, Pascale
N1 - Publisher Copyright:
© 2025 by the authors.
PY - 2025/4
Y1 - 2025/4
N2 - Background/Objectives: Length of hospital stay (LOS) is a critical measure of healthcare efficiency. This study investigated factors contributing to prolonged LOS in adult patients with urinary tract infections (UTIs) in Lebanon and assessed microbial susceptibility patterns of causative pathogens. Methods: A retrospective cohort study was conducted across five Lebanese university hospitals (March 2022–December 2023), analyzing 401 patients. Data on microbiological findings and the LOS were extracted from medical records. Statistical analyses, including descriptive statistics, bivariate tests (t-tests, ANOVA, and Pearson’s correlation), and multiple linear regression (significance: p ≤ 0.05), were performed using IBM SPSS® 27. Results: The mean LOS was 5.85 ± 2.41 days. Prolonged hospitalization was associated with patient-related factors (age, comorbidities, UTI type, specific symptoms, and multidrug-resistant infections) and treatment-related factors. Empirical use of carbapenems (β = 0.783, p = 0.004) and fluoroquinolones (β = 1.360, p = 0.014), along with inappropriate antibiotic prescriptions (β = 0.609, p = 0.022), significantly extended the LOS. Conversely, antibiotic de-escalation based on culture results reduced the LOS (β = −0.567, p = 0.029). Escherichia coli (61.8%) was the predominant pathogen, followed by Klebsiella pneumoniae (11.9%), Proteus mirabilis (7.8%), and Pseudomonas aeruginosa (7.5%). Notably, susceptibility to antibiotics showed a concerning decline. Conclusions: Inappropriate antibiotic prescriptions were linked to a prolonged LOS, emphasizing the need for judicious antimicrobial use. The positive impact of de-escalation supports culture-guided therapy. Declining antibiotic susceptibility highlights the urgency for robust antimicrobial stewardship programs (ASPs) and a national microbial resistance database to combat antimicrobial resistance (AMR) in Lebanon.
AB - Background/Objectives: Length of hospital stay (LOS) is a critical measure of healthcare efficiency. This study investigated factors contributing to prolonged LOS in adult patients with urinary tract infections (UTIs) in Lebanon and assessed microbial susceptibility patterns of causative pathogens. Methods: A retrospective cohort study was conducted across five Lebanese university hospitals (March 2022–December 2023), analyzing 401 patients. Data on microbiological findings and the LOS were extracted from medical records. Statistical analyses, including descriptive statistics, bivariate tests (t-tests, ANOVA, and Pearson’s correlation), and multiple linear regression (significance: p ≤ 0.05), were performed using IBM SPSS® 27. Results: The mean LOS was 5.85 ± 2.41 days. Prolonged hospitalization was associated with patient-related factors (age, comorbidities, UTI type, specific symptoms, and multidrug-resistant infections) and treatment-related factors. Empirical use of carbapenems (β = 0.783, p = 0.004) and fluoroquinolones (β = 1.360, p = 0.014), along with inappropriate antibiotic prescriptions (β = 0.609, p = 0.022), significantly extended the LOS. Conversely, antibiotic de-escalation based on culture results reduced the LOS (β = −0.567, p = 0.029). Escherichia coli (61.8%) was the predominant pathogen, followed by Klebsiella pneumoniae (11.9%), Proteus mirabilis (7.8%), and Pseudomonas aeruginosa (7.5%). Notably, susceptibility to antibiotics showed a concerning decline. Conclusions: Inappropriate antibiotic prescriptions were linked to a prolonged LOS, emphasizing the need for judicious antimicrobial use. The positive impact of de-escalation supports culture-guided therapy. Declining antibiotic susceptibility highlights the urgency for robust antimicrobial stewardship programs (ASPs) and a national microbial resistance database to combat antimicrobial resistance (AMR) in Lebanon.
KW - antimicrobial stewardship
KW - drug resistance
KW - inappropriate prescribing
KW - Lebanon
KW - length of stay
UR - https://www.scopus.com/pages/publications/105003375129
U2 - 10.3390/antibiotics14040421
DO - 10.3390/antibiotics14040421
M3 - Article
AN - SCOPUS:105003375129
SN - 2079-6382
VL - 14
JO - Antibiotics
JF - Antibiotics
IS - 4
M1 - 421
ER -
