TANUKA BARUA1, SUKHENDU SHEKHAR SEN2, JHULAN DAS SHARMA3, MAHMOOD AHMED CHOWDHURY ARZU4, LUTFANESSA5, PRADIP KUMAR DUTTA6
Abstract
Background: Urinary tract infection (UTI) is a common infection in nephrotic syndrome
children having a propensity for long term renal damage. Organisms causing UTI in
nephrotic syndrome are becoming resistant to common antimicrobial agents and
increase the morbidity and mortality. Surveillance of local antibiotic sensitivity pattern
is necessary for proper management of UTI in nephrotic children.
Objective: To see the pattern of antimicrobials sensitivity of organisms causing UTI
in Nephrotic syndrome children.
Methods: This was a hospital based cross-sectional study conducted in the department
of Paediatrics, Chittagong Medical College Hospital, Chittagong from January 2009
to December 2009. 52 nephrotic children aged 2-6 years with typical clinical features
were included. A clean catch midstream urine sample were collected in aseptic
procedure and sent for inoculation in culture media. In case of collection failure, urine
was collected by sterile catheterization. Bacterial isolates were tested for microbial
sensitivity. Data regarding etiological organisms and antibiogram were analyzed using
appropriate statistical method.
Results: UTI was found in 30.8% nephrotic children. E-coli was the commonest
organism isolated in urine culture followed by klebsiella. All organisms isolated on
culture were more or less resistant to commonly used antibiotics except to amikacin.
E coli were resistant to most of antibiotics and resistance to cotrimoxazol is quite
high for all isolates. Ciprofloxacin as oral and amikacin as parenteral are good for first
line treatment of UTI in nephrotic syndrome.
Conclusion: Resistance among organisms causing UTI in nephrotic syndrome is an
emergent problem now a day. Routine urine culture should be advised since treatment
failure is likely to occur with commonly used antibiotics. Risk factor for emergence of
antibiotic resistance of these pathogens should be evaluated.
Key words: Antibiotic sensitivity, Nephrotic syndrome, UTI.