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PubMed1993

Fleroxacin versus norfloxacin for oral treatment of serious urinary tract infections.

Fleroxacin, 400 mg once daily, and norfloxacin, 400 mg twice daily, both administered orally, were compared for the treatment of serious urinary tract infections (UTIs). In total, 301 patients from multiple centers who had serious UTIs were randomized to receive fleroxacin or norfloxacin in a double-blind study. The demographic parameters of the two groups were similar. A total of 190 patients were evaluable for efficacy, 94 in the fleroxacin group and 96 in the norfloxacin group. The reasons for exclusion from the efficacy analysis were not significantly different in the two groups, but more patients receiving fleroxacin were prematurely withdrawn from the study. The majority (134) of the diagnoses were complicated UTI, and the pathogens were primarily Enterobacteriaceae. The clinical responses were cure or improvement in 98% of the fleroxacin group and 92% of the norfloxacin group and failure in 2% of the fleroxacin group and 7% of the norfloxacin group. The bacteriologic results by infection were cure in 98% of the fleroxacin group and 89% of the norfloxacin group (including cure with superinfection in 4% of the fleroxacin group and 5% of the norfloxacin group) and failure in 2% of the fleroxacin group and 11% of the norfloxacin group. Adverse events were more common in the fleroxacin group and were mostly nausea, insomnia, and headache. Fleroxacin, 400 mg once daily, was as effective as norfloxacin, 400 mg twice daily, in eradicating UTIs but was associated with more adverse events.

Administration, Oral↗

PubMed1993

Comparison of intravenous fleroxacin with ceftazidime for treatment of complicated urinary tract infections.

Intravenous fleroxacin, 400 mg once daily, was compared with intravenous ceftazidime, 0.5-2 g three times a day or 1-2 g twice a day, administered for 4-21 days for treatment of complicated urinary tract infections (UTIs) due to susceptible organisms. Fleroxacin also was tested in an uncontrolled trial. The trial was a multicenter, randomized, open-label study of adults with pyelonephritis or signs and symptoms of UTI and complicating factors. In the controlled trial, 474 patients were randomly assigned in a 2:1 ratio to receive fleroxacin (n = 320) or ceftazidime (n = 154). The microbiologic criterion for diagnosis of UTI was the isolation of > or = 10(5) colony-forming units (CFU) of pathogenic bacteria/mL of urine. The efficacy analyses included 165 fleroxacin-treated and 82 ceftazidime-treated patients in the controlled trial and 97 patients in the uncontrolled trial. In the controlled trial, 317 fleroxacin-treated and 150 ceftazidime-treated patients were included in the safety analysis. In the controlled trial, the respective rates of bacteriologic cure (< or = 10(4) CFU/mL of urine 48-96 hours after first dose and 2-5 days posttherapy) were 94% (confidence interval [CI], 89-97%) and 95% (CI, 88-99%) in the fleroxacin and ceftazidime groups, and those of clinical cure were 86% (CI, 80-91%) and 89% (CI, 80-95%). Rates of clinical and bacteriologic cure in the uncontrolled study were 95%. In the controlled trial, 9% of the patients in each treatment group experienced one or more adverse events possibly or probably related to the study drug. The percentage of patients terminating therapy prematurely was higher in the fleroxacin than in the ceftazidime group. Once-daily dosing with 400 mg of intravenous fleroxacin was equivalent to a standard multidose regimen with respect to rates of bacteriologic and clinical cure in the treatment of complicated UTI.

Adult↗

PubMed1995

Treatment of urinary tract infections.

Urinary tract infections (UTIs) are common conditions in clinical practice. For uncomplicated UTIs, the causative organisms and their antimicrobial susceptibility profiles are generally predictable, and empiric short course (3 day) antibiotic therapy after an abbreviated laboratory workup is advocated. Acute pyelonephritis requires a 2 week antibiotic course, often with initial parenteral therapy. Women with frequent recurrences of UTIs may require intermittent self-treatment or continuous or postcoital antibiotic prophylaxis. Catheter-associated UTIs generally only require treatment if the patient shows signs of systemic infection. Treatment of asymptomatic bacteriuria is only recommended in certain circumstances. Careful consideration of the clinical circumstances, the patient's known or predicted urinary tract anatomy, and the antibiotic susceptibility of the bacterial pathogen(s) are critical factors in the choice of appropriate therapy for urinary tract infections.

Adult↗

PubMed1996

Urinary nitric oxide synthase activity and cyclic GMP levels are decreased with interstitial cystitis and increased with urinary tract infections.

PURPOSE: Since urinary nitric oxide synthase (NOS) activity correlates with certain disease process affecting the urinary tract and since nitric oxide increases cyclic GMP levels by activating guanylyl cyclase, urinary particulate NOS activity and cyclic GMP levels are evaluated in female patients with interstitial cystitis (IC) and compared with those from female controls and female patients with urinary tract infections (UTIs). MATERIALS AND METHODS: Urinary NOS activity is measured as the formation of [(14)C]-L-citrulline from [(14)C]-L-arginine, and urinary cyclic GMP levels are measured by an [(125)I]-radioimmunoassay. RESULTS: Female patients with IC have significantly less NOS activity in their urine pellet particulate fractions than female control females UTIs, 2.3 +/- 1.0, 14 +/- 3.0, and 120 +/- 10 pmol. citrulline formed/min./mg. protein. Urinary cyclic GMP levels are significantly lower in IC patients than in female controls or females with UTIs: 0.50 +/- 0.06, 0.82 +/- 0.14. and 3.72 +/- 0.81 micromol. cyclic GMP/g. creatinine. CONCLUSIONS: Regulation of urinary NOS activity with subsequent changes in nitric oxide and cyclic GMP may be an important determinant of symptoms and immunologic responses to UTIs and IC.

Adolescent↗

PubMed1996

Preeclampsia. A nested, case-control study of risk factors and their interactions.

OBJECTIVE: To study the risk factors for preeclampsia and their interactions. STUDY DESIGN: We used a nested, case-control study design to analyze data collected in the Delivery Interview Program, 1977-1980, Boston Hospital for Women (now known as the Brigham and Women's Hospital), Boston. Cases (n = 386) of obstetrician-diagnosed preeclampsia were compared with randomly selected controls (n = 2,355). Using multiple logistic regression, we derived maximum likelihood estimates of adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: The following risk factors were statistically significantly associated with preeclampsia: urinary tract infection (UTI) during pregnancy (OR 1.6, 95% CI 1.1-2.5), primiparity (OR 3.8, 95% CI 2.8-5.2), black race (OR 1.5, 95% CI 1.1-1.9), less than a high school education (OR 2.0, 95% CI 1.1-3.6), exposure to diethylstilbestrol in utero (OR 2.4, 95% CI 1.2-2.4), body mass index (kg/m2) > 30 (OR 2.7, 95% CI 1.6-4.4) and cigarette smoking (OR 0.6, 95% CI 0.5-0.8). When evaluating interactions between variables, we found that primiparas who had UTI during pregnancy were five times more likely (OR 5.3, 95% CI 2.9-9.7) to have preeclampsia than were primiparas who did not have UTI during pregnancy. CONCLUSION: It is possible that the preeclampsia associated with some of the risk factors we identified could be modified by the use of prophylactic drugs or other interventions. The primipara with a UTI would be a most likely beneficiary.

Adult↗

PubMed1996

[Urinary tract infection prevention in catheterized patients. Prevalence National Study: preliminary studies at the Pinerolo Hospital].

Urinary tract infection incidence can be a possible indicator of the quality of health care in hospital. It is now clear that some kind of health care, practice and particular organizational and structural orders change the risk of UTI during hospitalizations. One third of hospital infections can be prevented by carrying out specified rules and guidelines. About 80% of UTI are a consequence of bladder catheterism. According to Major Health Institute, our Hospital takes part in a Study Group on the incidence and prevention of UTI related to bladder catheterism. Preliminary results show how much surgery activity still weighs in the cases of necessity of catheterism. Differently, urinary retention and incontinence and diuresis monitoring have a minor incidence. However the incidence of UTI after bladder catheterism is very high in our study (until 85%) also and hence the subsequent necessary antimicrobical therapy.

Cross Infection↗

PubMed1996

[The clinical significance of glitter-cells in the urine during urinary tract infection].

To clarify the relationship between glitter-cells and urine osmotic pressure, neutrophils were isolated from venous blood of 4 normal volunteers and incubated in urine specimens with different osmotic pressures. Glitter-cells were detected in the urine with 100-400 mOsm/l. The rate of glitter-cells in neutrophils incubated for 4 hours were significantly less than those incubated for 0 minute (p < 0.05). We clinically investigated the relationship between the presence of glitter-cells in fresh urine and the site of urinary tract infection (UTI) or organisms isolated from urine. Fresh urine samples were obtained from 95 patients (55 male and 40 female). Urine samples were examined for bacteriuria by the quantitative culture method, and significant bacteriuria was defined as more than 10(5)/ml of bacilli for midstream urine or as more than 10(4)/ml for urine collected by catheterization. Leukocytes and glitter-cells in the unspun and unstained urine were counted on a disposable slide using a counting chamber. Patients with upper UTI showed a significantly higher incidence of glitter-cells than patients with lower UTI (p < 0.05). Patients with glitter-cells had a significantly higher incidence of polymicrobial infections than those without glitter-cell (p < 0.05). These findings suggest that patients with glitter-cells in the urine show upper UTI (pyelonephritis) and polymicrobial infections.

Adolescent↗

PubMedDate not supplied

Treatment of vancomycin-resistant Enterococcus faecium infections.

OBJECTIVE: To define the clinical characteristics of patients infected with vancomycin-resistant enterococci (VRE) and the outcome of the infections without the availability of effective antimicrobial therapy. METHODS: Charts of 28 patients with VRE infections were reviewed for demographics, clinical findings at the time of isolation of VRE, underlying medical problems, surgical procedures, invasive devices, treatment with antimicrobial agents, microbiological data, and patients' responses and outcomes. RESULTS: The infections included 6 cases of bacteremia, 9 surgical site infections (SSIs), 4 cases of peritonitis, 2 pelvic abscesses, 7 urinary tract infections (UTIs), and 2 soft tissue infections (STIs). Four of the 6 bacteremia cases were central-line related and resolved with line removal alone; 1 was treated with a combination product of quinupristin and dalfopristin (Synercid) and 1 had persistent bacteremia in the presence of a ventriculoperitoneal shunt. Seven of 9 SSIs resolved with surgical debridement and 2 of the 9 patients received antibiotics for organisms other than VRE. Similarly, 2 patients with STIs were treated with local debridement and antibiotics directed at organisms other than VRE and 2 patients with pelvic abscesses were treated with drainage and surgical debridement with antibiotics directed at other organisms; the infections resolved completely. Patients with peritonitis were treated with removal of their Tenckhoff catheters, drainage, and irrigation and 1 patient was treated with quinupristin-dalfopristin; 3 of 4 patients were cured. Two of 7 patients with UTIs were treated with nitrofurantoin and their urine cultures showed no growth after treatment; however, most patients with UTIs experienced resolution despite a lack of specific antimicrobial therapy. CONCLUSIONS: Although no antimicrobial agents are currently available for VRE infections, VRE line-related bacteremias could be treated by line removal alone. Surgical site infections, STIs, and abscesses could be managed by surgical debridement and drainage without specific antimicrobial agents against VRE and UTIs could be resolved with nitrofurantoin or removal of Foley catheters. Removal of foreign devices, debridement, and surgical drainage seemed to be important in the resolution of VRE infections.

Abdominal Abscess↗

PubMed1996

[Bacteriology and resistance in ambulatory urinary infections].

OBJECTIVES: To discover the bacteriological profile of urinary tract infections (UTI) in our out-clinic environment and their resistance to the most common antibiotics. DESIGN: A descriptive, retrospective study. SETTING: Ciudad Real Health Area (300,000 inhabitants). PARTICIPANTS: All the urine samples from the out-clinics referred to the microbiology lab for possible UTI in 1994 were included. MEASUREMENTS AND MAIN RESULTS: 3,522 cultures were studied, of which 241 were contaminated (7%), 2,870 negative (81%) and 409 positive (12%). Breakdown of bacteria: E. coli (248; 60%), enterococci (38; 9%), P. mirabilis (25; 6%), K. pneumoniae (20; 5%), S. epidermidis (11;3%), S. saprophyticus (8; 2%) and 61 others (15%). We found high sensitivity in the Gram-negatives to cephuroxim and amoxicillin-clavulanic. We observed widespread resistance, especially by E. coli, to quinolones, pipemidic acid and nitrofurantoin. CONCLUSIONS: E. coli is the micro-organism which most often causes UTI in our environment. We found enterococci were isolated more and S. saprophyticus less than in the series consulted. We found a considerable increase in resistance to some antibiotics often used in out-clinics for UTI treatment.

Community-Acquired Infections↗

PubMed1997

[Significance of postoperative elevation of urinary ulinastatin after open heart surgery under cardiopulmonary bypass].

To investigate the role of ulinastatin in perioperative stress, we measured the urinary levels of ulinastatin (UTI) in patients subjected to open heart surgery under cardiopulmonary bypass. The UTI levels began to increase on the first postoperative day and reached its maximum level on the third postoperative day. There is a good correlation between the maximum level of urinary UTI and cardiopulmonary bypass time. These results indicate that urinary UTI level can be an indicator of surgical stress.

Aged↗

PubMed1997

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1995). III. Differences in susceptibilities from previous years].

Susceptibilities to various antimicrobial agents were examined for Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa that were isolated from patients with urinary tract infections (UTIs) in 11 hospitals during June, 1995 through May, 1996, and the results were compared with those obtained during the same period in earlier years. 1. Macrolide resistant E. faecalis isolated from uncomplicated UTIs during the latest study period appeared to have increased compared to those in previous study periods. More than 50% of the isolated E. faecalis during the latest study period were resistant to macrolide antibiotics, for the first time in our history. 2. No obvious changes were observed through the years for susceptibilities of S. aureus to various antimicrobial agents. Vancomycin (VCM) showed the highest activity against S. aureus, with MICs below 2 micrograms/ml or below. 3. Among E. coli strains, those with low susceptibilities to quinolones appeared to have increased over the years with MIC90 changed from between 0.125 microgram/ml or below and 0.5 microgram/ml in the 1989-1990 period to between 8 micrograms/ml and 128 micrograms/ml in the latest study period. 4. Klebsiella spp. showed higher resistance to most antimicrobial agents during periods of 1993-1994 and 1994-1995, but somewhat lower resistance during period of 1995-1996. No resistant Klebsiella spp. were detected from uncomplicated UTIs during the latest study period. 5. Among P. aeruginosa isolates from complicated UTIs, resistance isolates to gentamicin appeared to be increasing over the years. Resistant strains to quinolones were isolated at lower frequencies during periods of 1991-1994, but higher frequency was observed in the latest period, and MIC50s were between 0.5 and 4 micrograms/ml during 1991-1994, but were 16-32 micrograms/ml during 1995-1996. These susceptibility changes should be utilized in determining clinical treatments.

Anti-Bacterial Agents↗

PubMed1997

Vesicoureteral reflux after kidney transplantation: clinical significance in the medium to long-term.

103 patients who received a cyclosporine-treated primary cadaver kidney transplant (TX) at our center between 1985 and 1989, whose graft survived for more than 1 year and who accepted to undergo voiding cystography after TX were analyzed and grouped according to the highest grade (regardless to whether active or passive) of vesicourteral reflux (VUR): group 0, absent (n = 14); group 1-2, grade I or II (n = 62); group 3, grade III (n = 27). Patient follow-up ranged from 5 to 10 (median 7) years. Patient and graft survivals and prevalence of hypertension (defined as the persistent need of antihypertensive therapy), did not differ significantly between groups (Mantel-Cox test p: n.s. in all cases). GFR (Cockroft and Gault) and proteinuria were evaluated with ANOVA for repeated measures at 1, 2, 3, 4 and 5 years in the 96 patients (group 0: 13, group 1-2: 56, group 3: 27) whose grafts lasted for 5 years or more. Neither GFR values (p: n.s.) nor GFR behaviour over time (p: n.s.) differed between groups, although a progressive decline of GFR was noted in all groups (p < 0.002). Proteinuria neither showed any significant differences between groups in values (p: n.s.) or behaviour over time (p: n.s.), nor any trend in behaviour over time in all groups as a whole (p: n.s.). Finally, in the first 5 years after TX the 3 groups did not differ for number of urinary tract infections (UTIs) (mean value for all patients: 2.5, range 0-22, episodes/pt/5 years) (p: n.s.), or for number of UTIs with leukocyturia (mean 0.6, range 0-6, episodes/pt/5 years) (p: n.s.), or for number of febrile UTIs (mean 0.3, range 0-5, episodes/pt/5 years) (p: n.s.), or for number of UTIs with sepsis (mean 0.1, range 0-2, episodes/pt/5 years) (p: n.s.). The same results were obtained when, instead of episodes/ pt/5 years, percentages of patients without or with 1 or more of such episodes in the same period were considered. In conclusion, VUR does not seem to be hazardous for the transplanted kidney in the medium to long-term.

Cadaver↗

PubMed1997

Some pathogenic fungi involved in serious cases of urinary tract infections in Nigeria.

Three hundred early morning midstream urine samples collected from 200 females and 100 males between the ages of 20 and 60 years, suffering from urinary tract infections (UTI) were studied to determine the etiologic agents. The caliberated loop-direct method used for culturing each sample on both bacterial and fungal media showed significant microbial growth in 117 of the 300 samples. Bacteria were the sole agents of infection in 30% of the cases while pathogenic yeasts were the sole agents of infection in 8% of the cases. Only 1% showed mixed infection. The bacterial pathogens identified from the culture were Escherichia coli (12.7%), Staphylococcus aureus (8.0%), Proteus mirabilis (4.3%), Klebsiella aerogenes (2.7%), Streptococcus faecalis (2.0%) and Pseudomonas aeruginosa (0.3%). The fungal pathogens isolated were Candida albicans (0.3%). While patients between the ages of 20 and 40 years were significantly more susceptible to UTI caused by bacteria (P = 0.05), patients between the ages of 41 and 60 years were more prone to UTI caused by fungi. Also females appeared to contact UTI more often than males.

Adult↗

PubMed1997

[Recurrent urinary tract infections. Biological suppositions and clinical treatment with thymopentin].

BACKGROUND: Urinary tract infections (UTI) are a common usual pathological event. They relapse often due to the periurethral colonization of microorganisms from the intestinal bacterial flora. They also constitute an important and considerable social and clinical problem. The absence of inducing organic conditions or an infective focus at the base of the pathogenetic mechanism suggests the existence of alterations of the immune response of the subject. MATERIALS AND METHODS: In this work we wanted to verify if, in those subjects with relapsing UTI (more than four events every year) cure with "biological" response modifiers, particularly "thymopentin", meaningfully reduced the number of events. RESULTS: The results obtained confirm that for those cases in which the chemo-antibiotic therapy did not have the expected results, it is rational to support it with an immune-modulating drug (thymopentin). In fact the post-therapy reduction of UTI observed during two years of follow-up is statistically significant when compared to the average of UTI before therapy. CONCLUSIONS: The "cost-benefits" analysis should prove to be a saving in favour of the use of thymopentin, taking into consideration the reduction of chemo-antibiotics consumption and the lower number of working hours lost every year.

Adjuvants, Immunologic↗

PubMed1998

[Urethrocystography in children. Practical considerations of irradiation doses].

OBJECTIVE: Rational use of voiding cystourethrography (VCUG) is imperative, as it is an invasive procedure exposing the child to ionizing radiation and other well documented risks. The objective of this study was to contribute to the achievement of a reduction in the irradiation dose in VCUG. PATIENTS AND METHODS: We reviewed the medical records of a consecutive sample of 125 children that underwent VCUG in our hospital between January 1995 and June 1996. RESULTS: Of the 125 VCUGs, 100 were normal, 13 showed vesicoureteric reflux grade II or higher, and 12 of them presented with other anomalies. The indication for VCUG was febrile UTI in 54 children, hydronephrosis detected prenatally in 12 and other causes in 60 children. It is important to note that children with vesicoureteric reflux presented as febrile UTI or fetal hydronephrosis. The age was significantly lower in the reflux group (p < 0.01). Eleven of the 13 children with vesicoureteric reflux were less than one year of age. Ultrasound anomalies and renal scarring in Tc99 DMSA were seen in a larger proportion in the reflux group. Preliminary X-rays showed anomalies in only 3 of 125 cases. CONCLUSIONS: 1) Vesicoureteric reflux is related to febrile UTI and fetal hydronephrosis. The other indications are questionable. 2) VCGU is not recommended following the first UTI in the evaluation of children 6 years of age or older who have a normal ultrasound and Tc99 DMSA. 3) VCUG could be substituted by a nuclear cystogram in girls who do not have a history of voiding dysfunction. 4) A preliminary X-ray is not justified.

Child, Preschool↗

PubMedDate not supplied

Circulating interleukin (IL)-1 beta, IL-6 and tumor necrosis factor-alpha in children with febrile infection--a comparison with C-reactive protein.

Circulating interleukin (IL)-1 beta, IL-6, and tumor necrosis factor (TNF)-alpha were examined in 42 febrile children with fever lasting more than 4 days. Their diagnosis were probable viral syndrome in 22, urinary tract infection (UTI) in 10, and probable bacterial pneumonia in 10. None of our study patients had detectable serum IL-1 beta. TNF-alpha levels were significantly higher in children with pneumonia than in those with viral syndrome (p < 0.01). Children with UTI and pneumonia had significantly higher IL-6 and CRP, compared to those with probable viral syndrome (p < 0.01 for both IL-6 and CRP). When appropriate cutoff values are chosen, IL-6 had greatly improved specificity (86.4%, > 20 pg/ml) to demonstrate UTI and pneumonia, as compared to that using CRP (48%, > 40 mg/l). After three days' antibiotic treatment, IL-6 fell to control levels in children with UTI and pneumonia, while CRP remained elevated. There was no difference in TNF-alpha values before and after treatment. Thus, IL-6, rather than IL-1 beta and TNF-alpha, may be a helpful diagnostic tool for evaluation of pediatric febrile infection. Sequential studies involving more patients are needed to determine whether IL-6 is better than CRP in this clinical setting.

Adolescent↗

PubMed2024

Mendelian randomization analysis reveals higher whole body water mass may increase risk of bacterial infections.

BACKGROUND AND PURPOSE: The association of water loading with several infections remains unclear. Observational studies are hard to investigate definitively due to potential confounders. In this study, we employed Mendelian randomization (MR) analysis to assess the association between genetically predicted whole body water mass (BWM) and several infections. METHODS: BWM levels were predicted among 331,315 Europeans in UK Biobank using 418 SNPs associated with BWM. For outcomes, we used genome-wide association data from the UK Biobank and FinnGen consortium, including sepsis, pneumonia, intestinal infections, urinary tract infections (UTIs) and skin and soft tissue infections (SSTIs). Inverse-variance weighted MR analyses as well as a series of sensitivity analyses were conducted. RESULTS: Genetic prediction of BWM is associated with an increased risk of sepsis (OR 1.34; 95% CI 1.19 to 1.51; P = 1.57 × 10- 6), pneumonia (OR: 1.17; 95% CI 1.08 to 1.29; P = 3.53 × 10- 4), UTIs (OR: 1.26; 95% CI 1.16 to 1.37; P = 6.29 × 10- 8), and SSTIs (OR: 1.57; 95% CI 1.25 to 1.96; P = 7.35 × 10- 5). In the sepsis and pneumonia subgroup analyses, the relationship between BWM and infection was observed in bacterial but not in viral infections. Suggestive evidence suggests that BWM has an effect on viral intestinal infections (OR: 0.86; 95% CI 0.75 to 0.99; P = 0.03). There is limited evidence of an association between BWM levels and bacteria intestinal infections, and genitourinary tract infection (GUI) in pregnancy. In addition, MR analyses supported the risk of BWM for several edematous diseases. However, multivariable MR analysis shows that the associations of BWM with sepsis, pneumonia, UTIs and SSTIs remains unaffected when accounting for these traits. CONCLUSIONS: In this study, the causal relationship between BWM and infectious diseases was systematically investigated. Further prospective studies are necessary to validate these findings.

Humans↗

PubMed2003

Infections in children with nephrotic syndrome.

OBJECTIVE: To determine the different types of infections in nephrotic children and their association with the activity of disease. DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: It was carried out at National Institute of Child Health (NICH), Karachi from August 1995-July 1996. PATIENTS AND METHODS: All children with nephrotic syndrome who had various infections during the study period were evaluated for the activity of disease and type of infections. RESULTS: Out of 62 children with nephrotic syndrome having infections, 45 (72.58%) were boys and 17 (27.42%) girls in a ratio of 2.5:1. Out of them 53 (85.45%) were known nephrotics and 36 (58%) of them were on steroid therapy. Nine were new cases and had not received steroids. A total of 74 episodes of infections were observed in 62 children. Acute respiratory infections (ARI) and skin infections were the most common (29.27% and 27.02% respectively) followed by diarrhoea (13.51%), UTI (12.5%) and peritonitis (10.81%). Two patients had pulmonary tuberculosis and 3 patients had more than one infection (cellulitis, peritonitis and pneumonia). All children with cellulitis and peritonitis were in active disease, whereas more than 80% of patients with ARI, diarrhoea and UTI were having either relapse or had recent onset of disease. CONCLUSION: The study showed that ARI, cellulitis and diarrhoea were most common infections followed by UTI and peritonitis. Majority of the infections (>78%) were associated with active disease

Child↗