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Published on: July 19, 2018
[Effect of urinary tract infections in children with chronic renal failure on peritoneal dialysis]
Maria Szczepańska1, Krystyna Szprynger, Piotr Adamczyk
1Katedra i Kliniki Nefrologii, Endokrynologii i Chorób Metabolicznych Wieku Dzleciecego Slaskiej Akademii Medycznej w Zabrzu. szczep57@poczta.onet.pl
Insights
Urinary tract infections (UTI) are common in children with kidney failure on peritoneal dialysis (PD). Escherichia coli and Streptococcus faecalis were the most frequent bacteria, with varying antibiotic sensitivities.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Renal Replacement Therapy
Background:
- Urinary tract infections (UTI) are a significant concern in children undergoing dialysis.
- UTIs can be an indirect contraindication for kidney transplantation.
- Management of UTIs in chronic renal failure (CRF) requires careful antibiotic selection and dosage adjustments.
Purpose of the Study:
- To evaluate UTI incidence in pediatric patients on peritoneal dialysis (PD).
- To identify common bacterial strains causing UTIs in this population.
- To assess the drug sensitivity patterns of isolated pathogens.
Main Methods:
- The study included 26 children and adolescents on PD for over 6 months.
- A total of 57 culture-positive UTI episodes were analyzed.
- Data on patient demographics, UTI frequency, and isolated bacteria were collected.
Main Results:
- UTI incidence was higher in children with urinary tract malformations and those on immunosuppression.
- Escherichia coli and Streptococcus faecalis were the most frequently isolated pathogens (22.8% each).
- E. coli showed sensitivity to ciprofloxacin and ceftazidime, while S. faecalis had limited sensitivity to common antibiotics.
Conclusions:
- UTIs are a notable complication in pediatric patients on PD.
- Understanding pathogen prevalence and antibiotic resistance is crucial for effective treatment.
- Tailored antibiotic strategies are necessary for managing UTIs in this vulnerable population.
Unlabelled:
Urinary tract infections (UTI) in children on dialysis treatment are regarded as indirect contraindication for kidney transplantation. In medication of UTI it is recommended to prescribe antibacterial agent in proper dosage (often in reduced amount) and to choose desired drug in selected period of chronic renal failure (CRF).
The Aim:
of the study was the evaluation of UTI incidence in children and adolescents with terminal renal failure on peritoneal dialysis treatment (PD), kind of isolated bacterial strains and their current drug-sensitivity.
Materials And Methods:
The study included 26 children and young adults (15 girls and 11 boys) on PD for the period longer than 6 months (mean 2.0+/-1.5 years). The mean age of examined children was 13.2+/-4.4 years. Total number of 57 culture-positive UTI episodes were recorded (30 in girls, 27 in boys)--1-episode/11.1 patient-month. In examined group UTI most frequently were present in children with uncorrected urinary tract malformation (1 episode/7.7 patient-month) and in children on immunosuppressive treatment (1 episode/5.7 patient-month). In children with cystic kidney disease infections had accidental character.
Conclusions:
The most frequent occurring pathogen was bacteria Escherichia coli--13 (22.8%) and Streptococcus faecalis--13 (22.8%) infections. E. coli strains shown sensitivity to second generation of quinolones: ciprofloxacin; third generation of cephalosporin: ceftazidime; partial sensitivity to amoxicillin with clavulanic acid, aminoglycosides. Streptococcus faecalis strains revealed only partial sensitivity to nitrofurantoin, vancomycin, teicoplanin.
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