In vitro Antimicrobial Susceptibility of Urinary Tract Infection Pathogens in Children

Aim:Urinary tract infection (UTI) is one of the most common bacterial infections in children. Empirical treatment is commenced according to the patient’s characteristics and the antimicrobial susceptibility patterns in the region. Therefore, a determination of antimicrobial resistance patterns has a great importance in effective treatment. The aim of this study was to determine the pathogens which cause UTIs in patients admitted to a university hospital in Izmir and to determine their antimicrobial susceptibility pattern.Materials and Methods:The files of patients aged between 0-18 years, followed up with a diagnosis of UTI, vesicoureteral reflux and neurogenic bladder in Ege University Faculty of Medicine Paediatric Nephrology Unit between February, 2013 and November, 2018 were retrospectively reviewed.Results:A total of 1,126 positive urine cultures from 729 patients (65% female) were included in this study. Gram-negative pathogens constituted 88.2% of the cultures. Escherichia coli (E. coli) was the most commonly isolated bacteria with a prevalence of 59.1%, followed by Klebsiella pneumonia with 17.9%, and Enterococcus faecalis with 8.3% (n=93). Ampicillin, cefuroxime and trimethoprim-sulfamethoxazole with susceptibility rates of 18.6%, 39.6%, 49.0% respectively, constituted the highest resistant antimicrobials to Enterobacteriaceae. Enterococcus spp. showed the highest resistance to gentamycin with 50% resistance in tested cases. Pseudomonas spp. with 64.3% susceptibility showed the highest resistance to piperacillin-tazobactam.Conclusion:This study revealed that bacterial resistance to commonly used antimicrobials in UTI is an important and challenging problem which requires planning

Evaluation of Vascular Involvement in Children with Celiac Disease

Aim:Celiac disease is associated with an increased risk of cardiovascular disease due to inflammation and autoimmunity involved in its pathophysiology. We aimed to evaluate vascular involvement in children with celiac disease based on their augmentation index, carotid pulse wave velocity, carotid intima-media thickness, echocardiographic findings, and blood pressure.Materials and Methods:This cross-sectional and controlled study was performed at a single center between 2018 and 2019. The study population consisted of 44 patients with celiac disease who had been on a gluten-free diet for at least one year.Results:We compared celiac patients with a healthy group. While the celiac patients had significantly higher carotid intima media thickness and carotid pulse wave velocity values, there was no difference in the augmentation index values. There was no significant difference in carotid artery intimal medial thickness, augmentation index and carotid pulse wave velocity values between the diet-compliant and non-compliant groups.Conclusion:Although hypertension was not detected, arterial stiffness and carotid intima media thickness measurements were higher in the celiac disease patients compared to the healthy controls. This showed that these parameters can be used in early vascular damage assessment. These measurements, which are non-invasive and repeatable, can be a guide for the monitoring of the development of preclinical atherosclerosis in the follow-up of the pediatric patients diagnosed with celiac disease

COVID-19 in pediatric nephrology centers in Turkey

Background/aim: There is limited data on COVID-19 disease in children with kidney disease. We aimed to investigate the characteristics and prognosis of COVID-19 in pediatric nephrology patients in Turkey. Materials and methods: This was a national, multicenter, retrospective cohort study based on an online survey evaluating the data between 11th March 2020 and 11th March 2021 as an initial step of a detailed pediatric nephrology COVID-19 registry. Results: Two hundred and three patients (89 girls and 114 boys) were diagnosed with COVID-19. One-third of these patients (36.9%) were between 10–15 years old. Half of the patients were on kidney replacement therapy: kidney transplant (KTx) recipients (n = 56, 27.5%), patients receiving chronic hemodialysis (n = 33, 16.3%) and those on peritoneal dialysis (PD) (n = 18, 8.9%). Fifty-four (26.6%) children were asymptomatic. Eighty-two (40.3%) patients were hospitalized and 23 (28%) needed intensive care unit admission. Fifty-five percent of the patients were not treated, while the remaining was given favipiravir (20.7%), steroid (16.3%), and hydroxychloroquine (11.3%). Acute kidney injury developed in 19.5% of hospitalized patients. Five (2.4%) had MIS-C. Eighty-three percent of the patients were discharged without any apparent sequelae, while 7 (3.4%) died. One hundred and eight health care staff were infected during the study period. Conclusion: COVID-19 was most commonly seen in patients who underwent KTx and received HD. The combined immunosuppressive therapy and frequent exposure to the hospital setting may increase these patients’ susceptibility. Staff infections before vaccination era were alarming, various precautions should be taken for infection control, particularly optimal vaccination coverage

TWO ATYPICAL HUS CASES WITH POSITIVE COMPLEMENT FACTOR B MUTATION

WOS: 00044399840023

A pediatric case of cystinuria diagnosed after nephrectomy

WOS: 000582489100029Cystinuria is a disease characterized by impaired reabsorption of cystine and other dibasic amino acids. in this paper, we report a case diagnosed with cystinuria after multiple surgical interventions. A 16-year-old girl with a history of recurrent kidney stones admitted to Pediatric Nephrology Clinic. Her medical history revealed kidney stones detected at the age of one year, after that she had multiple surgical interventions, including nephrectomy. Direct microscopic examination of the urine revealed cystine crystals. Cystinuria was considered due to positive urinary cystine and dibasic amino acid excretion. She was recommended dietary sodium restriction and hydration. the patient was followed up without the formation of new kidney stones after the 12th month of her treatment. the etiology of the stone should be investigated in patients with recurrent urinary stones. Chronic kidney disease and associated morbidity and mortality can be prevented in patients with regular follow-up and treatment that will prevent stone formation

PEDIATRIC RENAL TRANSPLANT SCINTIGRAPHY IN EVALUATION OF DELAYED GRAFT FUNCTION

WOS: 00044399840049

The Pediatric Case of a Recently Defined Syndrome: Shrunken Pore Syndrome

INTRODUCTION: Creatinine was started to be used as a marker of glomerular filtration rate (GFR) in 1920’s. Later in the 1990s, cystatin C was shown to be superior to creatinine in assessing GFR. In some patients, glomerular filtration of cystatin C was found to be low compared to creatinine, and it was hypothesized that glomerular pores may have been shrunken in these patients. For the group of patients having a cystatin C based estimation of GFR (eGFR cystatin C) to creatinine-based estimation of GFR (eGFR creatinine) ratio of ≤60%, the pathophysiological classification is defined as Shrunken Pore Syndrome. CASE: A 16-month-old female patient was admitted to Ege University Pediatric nephrology clinic with the diagnosis of neurogenic bladder secondary to meningomyelocele. She had a history of antenatal meningomyelocele, and hydrocephalus diagnosed as Arnold Chiari type 2. On postnatal day 1, she had undergone meningomyelocele sac excision and ventriculoperitoneal shunt operation. There was no history of pyelonephritis. Systemic examination revealed a dysmorphic facial appearance, operation scar on her back and syndactyly of the toes, and paraplegia on neurological examination. In laboratory examination; urea: 24 mg/dL, creatinine: 0.3 mg/dL, parathormone: 47 ng/mL, cystatin C: 1.4 mg/L (RR: 0.53-0.95), blood β2 microglobulin: 2716 ng/mL. Patient’s eGFRcystatin C: 107 ml/min/1.73m2 and eGFRcreatinine: 188 ml/min/1.73m2. Shrunken Pore Syndrome was considered due to the difference between the patient's eGFRcystatin C value and eGFRcreatinine value. CONCLUSION: Shrunken Pore Syndrome has no known treatment; however, it is important to diagnose these patients because of accompanying risks such as increased cardiac mortality. With the usage of cystatin C as a marker of GFR, possible mortality risks can be predictable and preventive measures can be taken early on

Pediatric Kidney Transplantation in Patients With Urologic Anomalies

1st International Transplant Network Congress -- OCT 17-21, 2018 -- Antalya, TURKEYWOS: 000487349900028PubMed ID: 31400969Introduction. and Aim. End-stage renal disease owing to structural urologic anomalies is frequent in the pediatric population. Impaired bladder function is thought to have a negative effect on graft function and survival. The aim of this study was to present our single-center experience and long-term follow-up results in pediatric patients who underwent renal transplantation for urologic reasons and to compare graft survival among patients who underwent transplantation for nonurologic reasons. Method. The paper records of renal transplanted children (<18 years of age) held by Ege University Medical Faculty between 1998 and 2018 were evaluated retrospectively. Patients with normal bladder function who underwent transplantation for urologic reasons were defined as group A, whereas patients who had impaired bladder function and underwent transplantation for urologic reasons were defined as group B; a control group was defined as group C. Results. Eighty-three patients were included in the study. The creatinine values of the patients at their last visit were no different between groups (P =.930). One-, 5-, and 10-year graft survival rates were 97%, 89%, and 74%, respectively, in group A; 100% for all years in group B; and 97%, 94%, and 80%, respectively, in group C. There was no statistically significant difference in terms of graft survival between groups (P = .351). Conclusion. Children with end-stage renal disease owing to urologic abnormalities may be good candidates for kidney transplantation with a favorable prognosis for graft function and survival