Bacterial infections such as peritonitis, pneumonia, cellulitis or meningitis are well known complications in children with steroid sensitive (SSNS) and steroid resistant nephrotic syndrome. The risk of developing aninfection with encapsulated bacteria, is partially due to reduced serum concentrations of immunoglobulins, decreased cellular immunity, and the administration of immunosuppressive therapy. The most common pathogenic agent is Streptococcus Pneumonia andantipneumococcal vaccination is recommended in order to prevent life threatening events . In an era of universal childhood anti-pneumococcal vaccination and frequent antibiotic treatment, the incidence of bacterial infections in children with SSNS may have changed.
Objectives
To characterize the incidence of infections in children with SSNS on relapse, admitted to our hospital.
Patients and Methods
We reviewed all electronic charts of children with SSNS complicated with infection from 1975-2018. The diagnosis of nephrotic syndrome was based according to the criteria of the International study of Kidney Diseases in Children.
Results
Sixty-six children (66/205, 32%) were admitted since 2009 with SSNS relapse, when anti pneumococcal vaccination was initiated routinely in our national childhood vaccination program. Fourty-two episodes of severe bacterial infections were identified.
Peritonitis, pneumonia, and sepsis were the mostcommon infections.
Ten children (10/29, 34%) developed infection afterintroduction of Pneumococcal vaccine. Twenty five episodes of bacteremia were identified, the most common pathogen was S. pneumonia.
Conclusions
Pneumococcus is the most common cause for infection in SSNS, although there is decrease in the incidence of pneumococcal bacteremia.
