Urinary tract infection in children with nephrotic syndrome in Kano, Nigeria

Abstract

Background: Nephrotic syndrome is a common childhood renal disorder; the prevalence of Urinary tract infection (UTI) in these patients is high. The increased prevalence of UTI are due to immunoglobulin loss, defective T cell function, presence of ascites and relative malnutrition. Objective: The study is to evaluate the prevalence of UTI , its etiological agents, antibiotics, sensitivity pattern and the outcome in children with nephrotic syndrome. Methods: A prospective study of all patients with diagnosis of nephrotic syndrome from January 2003 to December 2006. Urine specimen were routinely obtained by clean catch method following careful preparation urethral orifices. The specimens were processed immediately. Five millimeters (5mml) loopful of the sample were inoculated on a blood agar and CLED agar plates. Identification of the organism to species level was by using stokes disc diffusion technique. Results: Forty two patients were studied. The mean age and SEM for males was 8.2 + 0.5years and females with 7.9 + 0.8years. The age range was two to fifteen years UTI was caused predominantly by Staphylococcus aureus in 67.9%, Klebsiella species (17.9%) and Pseudomonas (14.2%). There was high invitro resistance of these organisms to nalidixic acid and ampicillin but sensitive to cefotaxime, ceftriazone and ciprofloxacin. Conclusion: It is recommend that UTI should be sought for in patients with nephrotic syndrome and treatment should be prompt and appropriate. Key words: Childhood, nephrotic syndrome, UTI, prevalenceRésumé Arrière-plan : Syndrome néphrotique est un trouble rénale enfance courant ; la prévalence des voies urinaires infections (UTI) chez ces patients est élevée. La prévalence accrue de UTI sont dues à perte immunoglobuline, fonction de la cellule T défectueux, présence de l'ascite et la malnutrition relative. Objectif: L'étude est d'évaluer la prévalence de la UTI, ses agents étiologique, les antibiotiques, motif de la sensibilité et le résultat chez les enfants avec néphrotique Syndrome. Méthodes: Une étude éventuelle de tous les patients présentant le diagnostic du syndrome nephrotique entre le janvier 2003 à décembre 2006. Le spécimen d'urine ont été par habitude obtenus par la méthode propre de crochet suivant les orifices uréthraux de préparation soigneuse. Les spécimens ont été traités immédiatement. Cinq millimètres (5mml) de loopful de l'échantillon ont été inoculés des plats de sang agar et d'agar de CLED. L'identification de l'organization aux espèces de niveau était en employant charge la technique de diffusion de disque Résultats: Quarante deux patients ont été étudiés. L'âge moyen et le SEM pour des mâles étaient 8.2 + 0.5years et femelles avec 7.9 + 0.8years. La tranche d'âge était de deux à quinze ans où UTI a été causé principalement près Staphylocoque doré dans 67.9%, espèces de klebsiella (17.9%) et pseudomonas (14.2%). Il y avait hauts résistance d'invitro de ces organizations à l'acide et à l'ampicilline nalidixic mais sensible au cefotaxime, au ceftriazone et au ciprofl...

The risk of urinary tract infection in children with nephrotic syndrome

“…besides the loss of immunoglobulin via urine, UTI may result from T cell dysfunction, ascites, and relative malnutrition in NS patients. 5 In addition to UTI, other infections commonly found in NS are peritonitis, pneumonia, cellulitis, and fungal infection. 3 In this study, UTI occurred in 34 of 74 NS patients (46%).…”

“…3 In this study, UTI occurred in 34 of 74 NS patients (46%). Arcana et al 8 and Adeleke et al 5 reported UTIs in 42% and 66.7%, of NS patients, respectively. However, Moorani et al 6 and ritonga 7 found only 25%.…”

“…3,4 The prevalence of UTI in NS patients is high, due to immunoglobulin loss, defective T-cell function, the presence of ascites, and relative malnutrition. 5 A study in Pakistan reported that UTI was the second most common infection in NS patients (25.2%), after bronchopneumonia (46.6%). 6 Another previous study found the prevalence of UTI in NS patients in Yogyakarta to be 25%.…”

Infections in Children with Newly Diagnosed Idiopathic Nephrotic Syndrome

“…Two studies from India & Nigeria found it as the most common infection and two studies from Pakistan & Taiwan found it as the 2 nd most common infection 1,8,[10][11] . Organisms causing UTI were almost similar to other studies though one study found staphylococcus aureus as the commonest organism 1,[9][10][11] . We found only one case of Tuberculosis.…”

Occurrence of Urinary Tract Infection in Children With Nephrotic Syndrome in a Tertiary Care Hospital

“…1 Other infections which occur in children with NS include spontaneous bacterial peritonitis, bacteraemia, sepsis, cellulitis and pneumonia. [5][6][7][8] Relapses in nephrotic syndrome are often temporally associated with increased occurrence of infection. 3 Although there have been several studies in the past pertaining to infections in nephrotic syndrome, most have been from the developed countries and in hospitalized patients.…”