MICROBIOTA OF URINE OF CHILDREN WITH ANOMALIES OF DEVELOPMENT OF URINARY TRACT

Latsynska S. A., Voronkova Yu. S., Ostanina T. H., Voronkova O. S., Vinnikov A. I., Shevchenko T. M.

MICROBIOLOGY

Scentific article

Congenital malformations of the urinary system (CMUS), which include defects of the kidneys, collecting system, bladder and urethra, are considered one of the main causes of chronic renal failure in children and a significant risk factor for development urinary tract infections (UTIs). The problem of UTIs acquires additional complications due to the significant spread of antibiotic resistance among pathogens. Therefore, infectious conditions and malformations are often combined phenomena in clinical activities, and therefore the study of laboratory, namely bacteriological, features of pathogens, including the spectrum of their resistance to antibiotics, in such children is appropriate and relevant. The aim of the research was to investigate the etiological spectrum of UTIs in children with CMUS and the level of sensitivity of their pathogens to the most commonly used and common antibacterial drugs. 44 case histories of children (0-15 years) were studied. The selection criteria were the presence of CMUS (code Q60-Q64 according to ICD-10), from which the proportion of patients with urinary tract infection (code N10-N16 according to ICD-10) was further selected. Microbiological studies of urine samples obtained from children from the examined contingent were performed. The study of sensitivity to antibiotics was performed in accordance with recommendation of CLSI. The study of the frequency of detection of UTIs in children with CMUS showed that among the total number of examined in 31.8% (14) of children had an infectious process in the urinary tract. The study of the etiological structure of UTIs showed that among the 25 isolated strains from urine samples were 5 species: K. pneumoniae – 48.0%, E. coli – 24.0%, E. faecium – 16.0%, S. haemolyticus – 8.0%, E. faecalis – 4.0%. In 9 cases it was monoinfection, in 5 cases – two or more pathogens were isolated. The highest level of antibiotic susceptibility was observed to fosfomycin both among Gram-negative and Gram-positive bacteria. Significantly lower levels of sensitivity were observed to β-lactams, furazolidone, ciprofloxacin and gentamicin. Multidrug-resistant microbiota was found in 62.2% of UTIs episodes, of which 12.5% was a combination of antibiotic susceptible bacteria and multidrug-resistant forms. According to the received data, for effective starting therapy in children with CMUS with signs of UTIs, it is desirable to choose fosfomycin.

urinary tract infections, congenital malformations of the urinary system, microbiota, antibiotic resistance.

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«Bulletin of problems biology and medicine» Issue 2 Part 2 (165), 2022 year, 6-11 pages, index UDK 579.61: 616-06: 616-093/-098: 616.6

10.29254/2077-4214-2022-2-2-165-6-11