To study the frequency, etiology and predisposing factors of urinary tract infection in children with nephrotic syndrome in Eastern Odisha Region: a hospital based study

Abstract

Background: The increased prevalence of infection in nephrotic syndrome is due to immunoglobulin loss, defective T cell function, and presence of ascites, relative malnutrition, and immunosuppressive therapy and associated with other factors. The objective of this study was to study the incidence, aetiology and the antibiotic sensitivity pattern of urinary tract infections (UTI) in children at presentation of nephrotic syndrome (NS).Methods: A retrospective hospital-based study carried out in IMS and SUM Hospital, Bhubaneswar, India. Seventy six children aged between two to twelve years with a diagnosis of NS at the time of were studied from April 2014 to March 2016.Results: The mean age of males was 5.9±0.5years and females are 6.2±0.8years. Pyuria was noted in 44 (57.89%) of the patients. Boys were more commonly affected with urinary tract infection than girls with a ratio of 1.9:1. UTI is the most common encountered infection and was predominantly caused by E. Coli in 18 (39%), Klebsiella species 7 (15.21%) and culture negative in 8 (17.28%) cases. There was high in vitro resistance of these organisms to cefixime and ampicillin but sensitive to cefotaxime, amikacin, ceftriazone , piperacillin- tazobactum and vancomycin.Conclusions: It is recommended that UTI should be sought for in patients with nephrotic syndrome and treatment should be prompt and appropriate taking into account of etiology and predisposing factors. UTI is one of the most common infections accompanying NS due to many factors. A high index of suspicion and early institution of appropriate antibiotics will help in reducing morbidity and mortality.