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.