Background: A predisposition to infections is one of the most significant complications of childhood nephrotic syndrome (NS). A number of studies, from different populations, have described the frequency and type of infections in children with NS, with varied results, reporting 12-72% of infections as bacterial. This is the first description of the frequency and type of infections in children with NS from Israel.
Methods: The charts of children with NS who were admitted with fever in a large tertiary hospital in Israel, between 1995 and 2016 were reviewed. Data collected included demographic, clinical and microbiological parameters. Statistical analysis was done to compare those with bacterial versus viral infections in terms of baseline disease and therapeutic factors in order to determine whether there were any factors associated with an increased risk of bacterial infection.
Results: There were 239 admissions of 107 children with NS between 1995 and 2016. Bacterial infections were diagnosed in 70 admissions (29.3%), out of which 13 invasive infections (5.4%) had microbiological confirmation: No difference was found when comparing bacterial infection and viral infections in the type of disease, immunosuppressive therapy and dose, remission or relapse status, degree of proteinuria, albumin level, vaccinations or antibiotic prophylaxis.
Conclusions: Overall, the number of bacterial infections, especially invasive and microbiologically proven infections was smaller in comparison to most other published series. Patients which were more immunosuppressed (heavy proteinuria, high steroid dose) did not have more bacterial infections than less immunosuppressed patients. Antibiotic prophylaxis did not protect against bacterial infections.
