African Journal of Paediatric Nephrology

Infections urinaires et antibiorésistance chez l'enfant : étude transversale au centre Hospitalier National d'enfants Albert Royer de Dakar sur 207 patients

2026-04-22T11:33:43+00:00

Résumé:

Introduction: Les infections urinaire (IU) sont fréquentes chez l'enfant. L'objectif de cette étude était de décrire les aspects cliniques et microbiologiques des infections urinaires chez l'enfant au Centre Hospitalier National d'Enfants Albert Royer (CHNEAR).

Patients et méthodes: Il s'agissait d'une étude transversale descriptive et analytique er sur une période, allant du 1 Mars au 31 Mai 2024. Étaient inclus, tous les enfants âgés de 0 à 15 ans, chez lesquels une étude cytobactériologique des urines (ECBU) était réalisée au laboratoire du CHNEAR.

Résultats: Au total sur 207 patients ayant effectué une ECBU pour suspicion d'infection urinaire, 15,9 % avaient une infection confirmée (n/N = 33/207). L'âge médian était de 3 ans avec des extrêmes de 10 jours et 15 ans. Le sex ratio était de 2,7. Les uropathies sous-jacentes étaient retrouvées dans 27,3% des cas (n/N=9/33) avec une association statistiquement significative aux IU (p=0,001). Escherichia coli était le germe le plus fréquemment isolé 39,4 % des cas suivi du staphylocoque (18,2 %), de Klebsiella pneumoniae (15,15 %) et d'Enterobactersp (12,12 %). Escherichia coli était résistant à l'amoxicilline dans 74% des cas , à l'amoxicilline acide clavulanique dans 53% des cas et à la ceftriaxone dans 32% des cas. Dans 39,9% des cas (n/N= 13/33) les bactéries isolées étaient des bactéries multirésistantes (BMR). Les germes retrouvés étaient plus sensibles à l'amikacine, à l'imipénème et au céfixime. Conclusion: Les infections urinaires sont courantes chez l'enfant notamment chez ceux porteurs d'une uropathie sous-jacente. L'augmentation de la résistance aux antibiotiques rend leur prise en charge plus difficile.

Abstract:

Background: Urinary tract infections (UTI) are common bacterial infections in children. The aim of this study was to describe clinical and microbiological aspects of UTI in children at Centre Hospitalier National d'Enfants Albert Royer (CHNEAR). Patients and methods: This was a crosssectional study covering the period from March 1 to May 31, 2024. Children aged 0 to 15 in whom a urine culture was performed at the CHNEAR laboratory were included.

Results: Of a total of 207 patients who underwent urine culture, 15.9% had a confirmed infection (n/N = 33/207). The median age was 3 years, with extremes of 10 days and 15 years. The sex ratio was 2.7. Uropathy was found in 27.3% of cases (n/N=9/33), and were associated with UTIs (p=0.001). Escherichia coli was most frequently isolated (39.4%), followed by staphylococcus (18.2%), Klebsiella pneumoniae (15.15%) and Enterobacter sp (12.12%). Escherichia coli was resistant to amoxicillin in 74% of cases, to amoxicillin clavulanic acid in 53% and to ceftriaxone in 32%. In 39.9% of cases (n/N= 13/33), pathogens isolated were multidrug-resistant (MDR). Pathogens were more sensitive to amikacin, imipenem and cefixime.

Conclusion: Urinary tract infections are common in children, especially those with uropathy. Increasing antibiotic resistance makes their management more difficult.

Health-related quality of life of children with chronic kidney disease at the University of Port Harcourt Teaching Hospital, Port Harcourt

2026-04-22T11:50:27+00:00

Background: Chronic kidney disease (CKD) has implications on different aspects of the lives of children, which can impact their quality of life. Recently, quality of life has been receiving attention as a measure of treatment outcome and a more reliable indicator of the impact of disease than clinical opinion. This study aims to assess the health-related quality of life of children with CKD and associated factors.

Methods: The study was a cross-sectional study of children with CKD at the University of Port Harcourt Teaching Hospital. The sociodemographic and clinical details were obtained from the participants and their medical records. The health-related quality of life (HRQoL) was assessed using the PedsQL™ version 4.0 Generic Core Scales questionnaire.

Results: A total of 64 children aged 5–18 years were recruited. The median (IQR) age of children with CKD was 12.00 (9.00–14.00) years, with 46.9% of them aged between 13 and 18 years. There were 35 (54.7%) males and 29 (45.3%) females. Twenty (31.3%) of the CKD patients were classified as stage 1 with normal or elevated eGFR; 52 (81.3%) were on conservative treatment, while 12 (18.7%) were receiving haemodialysis. There was a statistically significant difference in the median (IQR) HRQoL scores reported by children and their parents/caregivers. The children's reports were 70.65 (52.72–83.42), whereas parent/caregiver reports were 65.76 (46.74-80.43). Health-related quality of life was significantly associated with parental/caregiver education, disease aetiology, CKD stage, and treatment modality (p<0.05). CKD patients on haemodialysis had significantly lower health-related quality of life compared to those on conservative treatment, with the differences being statistically significant (p<0.001).

Conclusion: Children with terminal stages of CKD and those receiving haemodialysis had lower HRQoL. Therefore, clinicians should identify and monitor high-risk groups for early psychosocial intervention and comprehensive multidisciplinary care.

Chronic kidney disease with severe renal osteodystophy and refractory urinary tract infection secondary to a neglected posterior urethral valve: A case report

2026-04-22T11:41:36+00:00

Background: Posterior urethral valve (PUV) is a congenital anomaly of the urinary tract in male children. It is the leading cause of urinary tract obstruction in children. Early diagnosis is the key to the reduction of morbidity and mortality.

Case Report: A 7-year-old Nigerian child presented with an 8-months history of generalized body pain and abnormal posturing of the lower limbs. There was a history of valve ablation and bilateral cutaneous ureterostomy done 3 years before presentation due to poorly managed posterior urethral valve (PUV). A diagnosis of recurrent urinary tract infection, chronic kidney disease, and renal osteodystrophy was made, and he is on conservative management.

Conclusion: The report highlights the complications of neglected PUV in our environment and the need for early diagnosis and surgical valve ablation to delay progression to chronic kidney disease (CKD).

A rare case of acute pancreatitis with kidney disease in a Gambian child

2026-04-22T11:53:28+00:00

Background: Acute pancreatitis (AP) with severe acute kidney injury (AKI) is rare in children and is associated with high morbidity and mortality rates. Pancreatitis and kidney disease are complex combinations. Severe acute pancreatitis associated with multiorgan failure (respiratory, cardiovascular, and kidney) may occur in about 20% of patients with acute pancreatitis.

Case Report: We report the rare case of a 12-year-old boy who presented with acute pancreatitis and acute kidney injury at the Department of Paediatrics, Edward Francis Small Teaching Hospital (EFSTH). He presented with a week's history of loss of appetite, four days of abdominal pain, vomiting, fever and nonpassage of urine of 2 days duration. He was seen in a private clinic before presenting to EFSTH, where he came with AKI and had a pancreatic cyst on ultrasound. He was given intravenous fluids, antibiotics (IV Ciprofloxacin, Meropenem) and had haemodialysis (HD) for 23 sessions until renal function improved. He was discharged on outpatient follow-up with regular monitoring of pancreatic enzymes (serum amylase, lipase) and kidney function. He currently has a reduction in his estimated glomerular filtration rate at 34.0ml / min / 2 1.73m, with occasional relapse of pancreatitis, and is being managed for chronic kidney disease, stage 3.

Conclusion: This case highlights the poor outcome of the rare case of acute pancreatitis complicated by acute kidney disease, which progressed to chronic kidney disease despite prompt treatment and initiation of kidney replacement therapy.