Pattern of infection in children presented with obstructive uropathy - a hospital based study. Md. Habibur Rahmanr, Kamrul Laila2, Golam Muinuddin3 lProfessor, 2Residmt, 3Professor, Departmeot ofPediahic Nsphrclogy, Begabmdhu Sheikh Mujib Medical UniveNity, Shahbag, Dhak4 Bmgladesh. Abstract: Background: Obstructive uropathy refers to the structural impedance to the flow of urine anywhere along the urinary tract which may result from congenital (anatomic) lesions or can be caused by trauma, neoplasia, calculi, inflammatory process or surgical procedure. It is responsible for about 40lo ofend-stage renal disease. Obstructive uropathy is invariably associated with some co-morbid conditions specially infection. Objecctive: This study was conducted in the deparhnent of pediatric nephrology, Bangabandhu Sheil*r Mujib Medical University (BSMM[I), Shahbag, Dhaka, Bangladesh with an objective to identiff different pattern of infections in children with obstructive uropathy. Methods: A total of 55 patients of obstructive uropathy were enrolled. Thorough clinical and laboratory evaluation including hematological , biochemical, radiological and radio nucleotide imaging were done along with blood and urine culture. Result: Out of 55 cases, 42.27o/o of obstructive uropathy was detected between I to 5 years and 89.27%o was infected. Among obstructive uropathy cases, majority had posterior urethral valve @UV) (42.27%). Urinary tact infection was the commonest (60%) type of infections followed by septicemia and respiratory tract infection. Conclusion: Age between 1 to 5 years was the commonest age of children for hospital admission due to obstructive uropathy. Among various manifestations of obstruc- tive uropathy, infections, mostly urinary tract infection was the commonest one. Key Words: obstructive uropathy, infection, micro-organism. IBSMMUJ 2014;7 (1) : aa-s2J Introduction: Obstructive uropathy is an important cause of chronic renal failure in children.l Obstruction is defined as arr impediment to the urinary outflow which if not treated promptly, can cause progressive renal damage.'Urinary tract obstruction can result from congenital (anatomic) lesions or can be caused by trauma) neoplasia, calculi, inflammatory process or surgical procedure.2 Each year about 211000 people in the United States of Ameica ( USA) are hospita hzed for obstructive uropathy.3 The condition has a bimodal distribution. In childhood, it is mainly due to congenital anomalies of the urinary tract.3 Overall, obstructive uropathy is responsible for abo ut 4o/o of end-stage renal disease.3 Children generally present Address for Correspondence: Habibur Rahman, Professor, Department of Pediatric Nephrology, BSMMU, E mail: adiba@dhaka.net with dribbling of urine, pain during micturition, fever, urinary tract infection , poor stream and palpable bladder and kidney.l Infection compli cating obstruction may cause dysuria, pprua, urinary urgency and frequency, referred kidney and ureteral pain, costovertebral angle tenderness, fever, and, occasionally, septicemia.3 Most obstruction can be corrected, but a delay in therapy can lead to irreversible renal damage. How long it takes for nephropathy to develop is variable depending on the underlying pathology, the presence or absence of Urinary Tract Infection (UTI), and the degree and duration of the obstruction. Prognosis is worse if UTI remains untreated.3 From March 1993 to December 1994, a study was conducted among a totalof 304 children less than 5 years of age with their first documented symptomatic urinary 44