Pattern of Infection among Children with Nephrotic Syndrome in a Tertiary Level Hospital

Abstract

Background: Patients with nephrotic syndrome are susceptible to numerous bacterial, viral, and fungal infections. To design preventive measures, it is vital to identify the various types of infections, their causative organisms, and sensitivity patterns in the local settings. Methods: From January 2012 to July 2014, this descriptive cross-sectional study was conducted in the Pediatric department of Sir Salimullah Medical College, Mitford Hospital, Dhaka. Children younger than 12 years admitted with nephrotic syndrome were screened for infection. Laboratory analysis with culture and sensitivity of urine, blood, CSF, and peritoneal fluids was performed to identify and analyze the causative organisms. Results: The most prevalent age range for the 90 admitted children with nephrotic syndrome was 2-5 years, and the male to female ratio was 0.95:1. 73% of the children had their initial attack of nephrotic syndrome, while 27% had recurrence. During admission, 38% of patients had various infections, and 57% of these infections occurred in children aged 2 to 5 years. Urinary tract infection (UTI), peritonitis, septicemia, and pneumonia were the most prevalent illnesses (incidence, 46%, 26%, 11%, and 9%, respectively). Escherichia coli, Proteus sp., and Streptococcus sp., commonly caused urinary tract infections, peritonitis, septicemia, and pneumonia. Organisms for UTI, peritonitis and pneumonia were sensitive to ciprofloxacin, azithromycin, and ceftriaxone, respectively. Conclusion: Infection should be ruled out carefully in every case of nephrotic syndrome during management in the hospital. Escherichia coli is the dominant causative agent for UTI. After sending relevant body fluids for culture sensitivity, ciprofloxacin for a suspected UTI, and azithromycin for peritonitis can be started immediately.

The Clinical Spectrum and Occurrence of Major Infections in Hospitalized Children With Nephrotic Syndrome

“…The mean age of children with major infections in NS patients was found to be 6.9 years, which was in concordance with the findings of Gulati et al [ 6 ], Kumar et al [ 14 ], and Lebel et al [ 15 ]. Infective complications were found more in females than in males (1.5:1), which is in concordance with the results of Rahman et al [ 16 ]. The preponderance of females having more infective complications is probably due to the fact that females are at high risk of developing UTI than males, since we observed that UTI was the commonest type of infective complication.…”

Sociodemographic, Clinical & Biochemical Features in Children with Nephrotic Syndrome: A Study in a Tertiary Care Hospital of Bangladesh

“…They showed that 67.0% of their study population resided in rural areas which was similar to our study. However, 63.0% of the children came from middle-income families and 27.0% came from low-income families [15]. Another study from Bangladesh showed that, among 50 children, most parents (48%) came from very poor socioeconomic conditions, which was relatable to this study [16].…”

Serum albumin level as predictor of infection in children with nephrotic syndrome age 2- 18years in northwest and East Amhara region, Ethiopia: a multi-center cross-sectional retrospective study

“…The top four common infections were intestinal parasitic infection, urinary tract infection, spontaneous bacterial peritonitis, and pneumonia. According to research done in Delhi, India, among hospitalized nephrotic syndrome children aged 1-12 years, the incidence of infection was 43.8%, and peritonitis (24%), pneumonia (18%), and UTI (15%) were the top three types of infection [15]. The other research done in India in hospitalized children aged 1-18 years indicated that the incidence of infection was 29.7%, and UTI and spontaneous bacterial peritonitis were the two common infection types [16].…”