Urinary Tract Infection in Children with Nephrotic Syndrome in Kano, Nigeria

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.Arri\ue8re-plan : Syndrome n\ue9phrotique est un trouble r\ue9nale enfance courant ; la pr\ue9valence des voies urinaires infections (UTI) chez ces patients est \ue9lev\ue9e. La pr\ue9valence accrue de UTI sont dues \ue0 perte immunoglobuline, fonction de la cellule T d\ue9fectueux, pr\ue9sence de l'ascite et la malnutrition relative. Objectif: L'\ue9tude est d'\ue9valuer la pr\ue9valence de la UTI, ses agents \ue9tiologique, les antibiotiques, motif de la sensibilit\ue9 et le r\ue9sultat chez les enfants avec n\ue9phrotique Syndrome. M\ue9thodes: Une \ue9tude \ue9ventuelle de tous les patients pr\ue9sentant le diagnostic du syndrome nephrotique entre le janvier 2003 \ue0 d\ue9cembre 2006. Le sp\ue9cimen d'urine ont \ue9t\ue9 par habitude obtenus par la m\ue9thode propre de crochet suivant les orifices ur\ue9thraux de pr\ue9paration soigneuse. Les sp\ue9cimens ont \ue9t\ue9 trait\ue9s imm\ue9diatement. Cinq millim\ue8tres (5mml) de loopful de l'\ue9chantillon ont \ue9t\ue9 inocul\ue9s des plats de sang agar et d'agar de CLED. L'identification de l'organization aux esp\ue8ces de niveau \ue9tait en employant charge la technique de diffusion de disque R\ue9sultats: Quarante deux patients ont \ue9t\ue9 \ue9tudi\ue9s. L'\ue2ge moyen et le SEM pour des m\ue2les \ue9taient 8.2 + 0.5years et femelles avec 7.9 + 0.8years. La tranche d'\ue2ge \ue9tait de deux \ue0 quinze ans o\uf9 UTI a \ue9t\ue9 caus\ue9 principalement pr\ue8s Staphylocoque dor\ue9 dans 67.9%, esp\ue8ces de klebsiella (17.9%) et pseudomonas (14.2%). Il y avait hauts r\ue9sistance d'invitro de ces organizations \ue0 l'acide et \ue0 l'ampicilline nalidixic mais sensible au cefotaxime, au ceftriazone et au ciprofloxacin. Conclusion: Il est recommandent qu'UTI devrait \ueatre cherch\ue9 pour dans des patients pr\ue9sentant le syndrome nephrotique et le traitement devrait \ueatre prompt et appropri\ue9