Status and influencing factors analysis of urinary tract infection in children with primary nephrotic syndrome
Objective To explore the status and influencing factors of urinary tract infection(UTI)in children with primary nephrotic syndrome(PNS).Methods A total of forty-nine children with PNS hospitalized in Beijing Children's Hospital,Capital Medical University from January 2016 to January 2023 were selected and were divided into infection group and control group according to whether they were complicated with UTI.The Clinical manifestations,laboratory results and treatment of the two groups were analyzed,and the multivariate logistic regression was used to analyze the influencing factors of UTI in children with PNS.Results Among the 49 childeren,there were 32 males and 17 females,aged from 10 months to 14 years old,and the mean age was(7.7±3.6)years.Twenty-three(46.94%)children with PNS developed UTI,of which 19(82.61%)cases had no symptoms such as fever,frequent micturition,urgency with urination or dysuria.A total of 42 strains of pathogenic bacteria were detected in the infected group,among which 18 cases were Gram-negative bacilli(42.86%),which were mainly Escherichia coli,Escherichia coli and Pseudomonas aeruginosa.Gram-positive cocci were found in 17 cases(40.48%),mainly Enterococcus faecalis and Enterococcus faecalis,and Fungi were found in seven cases(16.67%),including Candida albicans,Candida glabrata and Candida tropicalis.The resistance rate of Gram-negative bacilli to ampicillin,cefuroxime and ampicillin sulbactam was 100%,and the sensitivity rate of aminoglycosides and tetracyclines(amikacin,minocycline and polymyxin)was 100%.The resistance rate of gram-positive cocci to erythromycin was 100%,and the sensitivity rate to linezolid,vancomycin and nitrofurantoin was 100%.Multivariate logistic regression analysis results showed that UNS children with glucocorticoid resistance(OR=18.185,95%CI:1.830-180.735,P=0.013),combined immunosuppressive therapy(OR=13.686,95%CI:1.387-135.064,P=0.025),ALB<16.6 g/L(OR=10.650,95%CI:1.025-110.612,P=0.048)were more likely to have UTI,UNS children with older age(OR=0.738,95%CI:0.554-0.983,P=0.038)were more likely not to have UTI.Conclusions Children with PNS often have no typical symptoms of urinary tract infection when they have UTI,it is suggested to be alert to whether UTI occurs when the condicion is repeated.The proportion of drug-resistant bacteria in UTI is high,and fungal infection can not be ignored.For PNS children with young age,hormone resistance,treated with combined immunosuppressants and significant decrease in serum ALB,it is suggested to strengthen external genital care to avoid urinary tract infection.
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