INFECTIONS IN INFANTS WITH CONGENITAL NEPHROSIS OF THE FINNISH TYPE

The incidence and type of infections were retrospectively analyzed in 21 infants with congenital nephrosis of the Finnish type (CNF). During the median follow-up time of 1.1 years the infants suffered from 63 v erified and 62 suspected episodes of sepsis. These accounted for half of all infections recorded. Forty percent of bacteremias were caused b y coagulase-negative staphylococci, 16% were caused by Staphylococcus aureus, 17% were streptococcal, and 24% were caused by Gram-negative b acteria. One infant died of pleural empyema, but otherwise the outcome of infections was good. The use of central venous lines tended to inc rease the rate of staphylococcal bacteremias but had no significant ef fect on the overall incidence of infections. Prophylactic use of antib iotics did not reduce the incidence of septic or other infections. Inf ants with CNF had low levels of serum IgG, but prophylactic immunoglob ulin infusions (0.5 - 1.0 g once or twice a week) did not reduce the f requency of infections, probably because the infused Ige was quickly l ost into the urine. The results indicate that infants with CNF often s uffer from septic infections associated with the invasive treatment mo dalities. Parenteral antibiotics covering the hospital strains of bact eria (especially staphylococci) should be started without delay when a nephrotic patient is not doing well.