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العنوان
Screening of Asymptomatic Bacteriuria in Sickle Cell Pediatric Patients/
المؤلف
Mohammed, Nouran Osama Abdel Kader.
هيئة الاعداد
باحث / Nouran Osama Abdel Kader Mohammed
مشرف / Dalia Hosni Abdel Hamid
مشرف / Marwa Abdel Rasoul El-Ashry
مشرف / Sara Mostafa Makkeyah
تاريخ النشر
2021.
عدد الصفحات
113 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
أمراض الدم
تاريخ الإجازة
1/1/2021
مكان الإجازة
جامعة عين شمس - كلية الطب - باثولوجيا اكلينكية
الفهرس
Only 14 pages are availabe for public view

from 113

from 113

Abstract

S
ickle cell disease (SCD) is a multi-systemic disease of episodic acute illness and severe organ damage, it is one of the autosomal-recessive monogenic disorders worldwide.
Sickle cell disease is a genetic mutation in which GTG is substituted for GAG in the sixth codon of the β-globin gene, leads to replacement of a hydrophilic glutamic acid residue (Glu) with a hydrophobic valine residue (Val) at the sixth position in the β-globin chain, resulting in a mutated haemoglobin molecule in individuals Red blood cells.
Several studies indicated that SCD patients are more prone to develop bacteriuria when compared to their healthy counter parts.
SCD patients are of increased susceptibility to urinary tract infections as a result of alteration of the blood flow in the renal vasculature which causes papillary necrosis and loss of the concentrating and acidifying abilities of the nephrons leading to formation of abnormally diluted and alkaline urine which enhances bacterial proliferation.
Long term urinary infections in people with SCD may result in chronic kidney disease, in poor resource settings, early detection and management of ASB in SCD children may retard this progression.
However, the major determinants for ASB in children with SCD as well as ASB is a warning sign to more serious renal disease in children with SCD are unclear, so this study was taken to estimate the prevalence of ASB,its major determinants and its effect on kidney functions in SCD for early detection and treatment.
A fresh voided mid-stream urine samples were collected once from all patients and subjected to urinalysis and culture on chromogenic media.
Patients with positive culture results were asked to get another sample to confirm their culture results, while those with contaminated results were re-Instructed with precautions to get another fresh voided mid-stream urine samples, patients were divided into 2 groups according to their culture results.
Only 5 patients showed significant growth results of the same organisms on the two consecutive mid-stream urine samples collected, so the prevalence of confirmed ASB was 16.7%(5/30).
Staph.saprophyticus (60%) was the commonest organism isolated from the urine of these patients, followed by E.coli (20%) & Klebsiella pnuemoniae (20%).
Sulfamethoxazole +Trimethoprim (Sutrim) was the most sensitive antibiotic among all isolated micro-organisms, pyuria was the major determinant of ASB in this study, also serum creatinine was a non- sensitive marker to detect the effect of ASB on renal system in this study.