Infection Patterns and Bacterial Profiles in Children with Nephrotic Syndrome at A Tertiary Care Centre In India

Abstract Background: Nephrotic syndrome (NS) is a common paediatric kidney disorder with increased susceptibility to infections due to immunosuppression and urinary loss of immunoglobulins. This study evaluates infection patterns and bacterial profiles in children with NS, comparing first episodes and relapses by age and gender. Methods: A two-year prospective observational study was conducted at a tertiary care centre in India. Children aged 6 months to 12 years diagnosed with NS using ISKDC criteria were enrolled. Demographic, clinical, and laboratory data were recorded. Infections were diagnosed clinically and confirmed microbiologically or radiologically. Data analysis was done using SPSS v21. Results: Seventy-one children were included (mean age 5.9 years; male: female ratio 1.6:1). First episodes accounted for 69%, predominantly in boys, while relapses were more common in girls. Urinary tract infection (UTI) was the most frequent infection (39.4%), followed by respiratory tract infections (38.0%), septicaemia (33.8%), and peritonitis (23.9%). UTIs were significantly more frequent during relapses (77.3%) than first episodes (22.4%), and in girls. Klebsiella spp. was the most common uropathogen (46.4%), followed by E. coli and Staphylococcus aureus. Children aged 1–5 years were most affected by UTIs. Conclusion: Infections, particularly UTIs, are a major complication in paediatric NS, especially during relapses and in girls. The predominance of Klebsiella spp. underscores the need for empirical antibiotic policies based on local patterns. Early detection and preventive strategies are vital to reduce infection-related morbidity.