DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20163674

Prevalence and bacterial spectrum of urinary tract infection in nephrotic syndrome: a cross sectional study from a tertiary care centre

Sawai S. Lora, Vishnu K. Goyal, Suresh Kumar, Pramod Sharma, Harish K. Mourya, Monika Chaudhary

Abstract


Background: Nephrotic syndrome is a common renal disorder in paediatric population, which predisposes to various systemic infections. Out of these UTI remains most important as it can be easily missed, if active search is not made. The present study was conducted to find out the prevalence of UTI in these children and to uncover the bacterial spectrum and their sensitivity pattern.

Methods: It was a cross sectional descriptive study which included all children less than 18 years of age admitted with nephrotic syndrome. All the relevant data pertaining to history, examination and investigations were recorded in a pre-designed performa. A clean-catch midstream urine specimen was obtained in all at admission for bacterial culture besides routine investigations.

Results: Among all the seventy six children of nephrotic syndrome studied, boys were affected more than the girls with a male to female ratio of 3.47:1. Their mean age at presentation was 6.4±3.74 years. Urinary tract infection was detected in twenty children (26.32%). The commonest micro-organism isolated was Escherichia coli (45%), followed by Klebsiella (20%), Proteus (20%), Staphylococcus aureus (10%) and Enterococcus (05%). Most of the micro-organisms were sensitive to fluoroquinolones and cefepime.

Conclusions: About one fourth of nephrotic syndrome children have UTI at admission and relapse episode serves as an additional risk factor for it.  Gram negative enteric bacilli remain the most common agent. For empirical coverage fluoroquinolones and cefepime show the best sensitivity pattern.  


Keywords


Antibiotic, Micro-organisms, Nephrotic syndrome, Urinary tract infection

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References


Bagga A. Management of steroid sensitive nephritic syndrome: Revised guidelines. Indian Pediatr. 2008;45:203-14.

Rahman MH, Jsemin T, Muinuddin G. An update of management of idiopathic nephrotic syndrome: A review article. Bangladesh J Child Health. 2013;37(2):102-21.

Soeiro EMS, Koch VH, Fujimura MD, Okay Y. Influence of nephrotic state on the infectious profile in childhood idiopathic nephrotic syndrome. Rev. Hosp Clin Fac Med. 2004;59(5):273-8.

Uwaezuoke SN. Steroid sensitive nephrotic syndrome in children: triggers of relapse and evolving hypotheses on pathogenesis. Italian J Pedia. 2015;41(19):2-6.

Moorani KN, Mukesh R. Spectrum of infections in children with newly diagnosed primary nephrotic syndrome. Pak J Med Res. 2012;51(1):10-4.

Akl KF, Allawama M, Khatib FA, Sleiman MJ, Bulos NK. The clinical profile of infections in childhood primary nephrotic syndrome. Jordan Med J. 2011;45(4):303-7.

Paul SK, Islam QR, Uddin GM, Hossain MM. Infections in children with newly diagnosed idiopathic nephrotic syndrome. Chattagram Maa Shishu Hospital Med College J. 2013;12(3):1-4.

Kumar R, Manjunath, Rudrappa S, Kiran S, Yadav SV. Urinary tract infection in children with nephrotic syndrome: a prospective open labeled study. J Evolution Med Dental Sci. 2014;3(41):10336-43.

Senguttuvan P, Ravanan K, Prabhu N, Tamilarasi V. Infections encountered in childhood nephrotics in a pediatric renal unit. Indian J Nephrol. 2004;14:85-8.

Gulati S, Kher V, Gupta A, Arora P, Rai PK, Sharman RK. Spectrum of infections in Indian children with nephrotic syndrome. Pediatr Nephrol. 1995;9(4):431-4.

Adeleke SI, Asani MO. Urinary tract infection in children with nephrotic syndrome in Kano, Nigeria. Annals African Med. 2009;8(1):38-41.

Adedoyin OT, Ojuawo IA, Odimayo MS, Anigalaje EA. Urinary tract infections in children in primary nephrotic syndrome and acute glomerulonephritis. West Afr J Med. 2010;29(4):235-8.