Prevalence of Urinary Tract Infection in Nephrotic Syndrome at Zagazig University Children Hospital

Abstract

Background: Nephrotic syndrome (NS) is the most common chronic glomerular diseases in children. Nephrotic syndrome increases a child's susceptibility to infection. Urinary tract infection (UTI) is the second most common bacterial disease in children after upper respiratory tract infection. Aim of this work: To find out the prevalence of UTI (either community acquired or hospital acquired) in NS children and to uncover the bacterial spectrum and their sensitivity pattern for selecting the empirical antibiotic therapy till the results of culture are awaited. Subjects and methods: This study was descriptive cross sectional. 33 nephrotic syndrome cases were included in study. All patients were subjected to full history taking, complete clinical examination and investigations as urine analysis and urine culture. Results: The percentage of community acquired urinary tract infection (CA-UTI) was 57.6 % and hospital acquired urinary tract infection (HA-UTI) was 42.4 %. E. coli is the commonest organism causing UTI followed by klebsiella and proteus mirabilis. The isolated organisms showed resistance to many oral and parenteral antibiotics. Amikacin gentamycin may be the first option of empiric therapy while waiting for culture reports. Conclusion: Children with nephrotic syndrome are frequently predisposed to UTI and in most cases it is asymptomatic often undiagnosed. Identifying bacterial causes and their susceptibility pattern of UTI will help in selecting the empirical antibiotic therapy till the results of culture are awaited. Although dipstick and microscopic urinalysis can support the diagnosis of UTI, growth of a single type of bacteria on urine culture is the gold standard.