The Prevalence of Urinary Tract Infection in Childhood Nephrotic Syndrome

A retrospective analysis of hospital records of 89.2 percent of 65 paediatric patients with nephrotic syndrome (NS) admitted into the University of Benin Teaching Hospital (UBTH), between January 1992 and December 1996 was under- taken for the prevalence of urinary tract infection (UTI), causative organisms, pattern of in-vitro antibiotic sensitivity and the effect on patients' management. Urinary tract infection prevalence of 44.8 percent in this small series was high compared with that of 0.04 percent for the general population. Similarly, the 42.1 percent of males in the present study was in contrast to 0.04 percent, as seen in the general population. Presence of UTI did not influence the response to steroid therapy (p>0.05), duration of hospitalization (p>0.05) and the incidence of relapse (p>0.05). UTI was caused predominantly by Staphylococcus aureus in 54.3 percent and untyped coliform organisms in 31.4 percent of the cases. There was high in-vitro resistance of these organisms to nalidixic acid, ampicillin and nitrofurantoin, but sensitivity to gentamicin, streptomycin, ceftazidime and cefuroxime. In view of the long term morbidity associated with UTI, it is recommended that UTI be sought for, in patients with NS and treated promptly and appropriately. In communities with inadequate or lack of laboratory facilities for bacteriological studies and sensitivity patterns, empirical use of any of gentamicin, streptomycin, ceftazidime and cefuroxime may be justified.