Epidemiology and outcomes of pneumococcal sepsis in children with nephrotic syndrome in a developing country

• Published in: Pediatric nephrology (Berlin, West) West), 2023-01, Vol.38 (1), p.131-137
• Main Authors: Mathew, Georgie, George, Anish Sam, Deepthi, R. V., Rose, Winsley, Verghese, Valsan Philip, Varghese, Rosemol, Veeraraghavan, Balaji, Agarwal, Indira
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacteremia; Child; Children; Complications and side effects; Developing Countries; Dosage and administration; Electronic medical records; Epidemiology; Erythromycin; Humans; Infant; Infections; Kidney diseases; Medicine; Medicine & Public Health; Meningitis; Morbidity; Mortality; Nephrology; Nephrotic syndrome; Nephrotic Syndrome - complications; Nephrotic Syndrome - drug therapy; Nephrotic Syndrome - epidemiology; Original; Original Article; Patient outcomes; Pediatric research; Pediatrics; Pneumococcal infections; Pneumococcal Infections - drug therapy; Pneumococcal Infections - epidemiology; Pneumococcal Infections - prevention & control; Pneumococcal vaccine; Pneumococcal Vaccines - therapeutic use; Prevention; Risk factors; Sepsis; Serotypes; Streptococcus infections; Streptococcus pneumoniae; Urology
• ISSN: 0931-041X; 1432-198X; 1432-198X
• DOI: 10.1007/s00467-022-05550-0

Background Pneumococcal infections are common in children with nephrotic syndrome. Knowledge of the commonly available serotypes and antibiotic susceptibility will help in prevention and appropriate management of pneumococcal sepsis, especially in resource-limited countries. Methods Demographic, clinical, and laboratory data on children with nephrotic syndrome and pneumococcal infections were extracted from the electronic medical records. Results Sixty - three isolates of pneumococci obtained from 60 children with nephrotic syndrome, over a period of 14 years, were included in the study. This represented 18% of all pneumococcal infections occurring in children during the same period. Commonly available vaccines covered up to 58% of all the serotypes causing infection. Severe disease, with shock, intensive care admission and/or meningitis, was observed in 38% children and mortality was observed in 10%. Resistance to commonly used antibiotics was not observed, except for erythromycin. Conclusions Pneumococcal sepsis was observed to be common in children with nephrotic syndrome and results in significant morbidity and mortality. Commonly used antibiotics were observed to be effective in management of the infections.