PYLONEPHRITIS IN GIRLS: FEATURES AT THE MODERN STAGE
Abstract
Girls performed the vast majority of patients with urinary system infections. The prevalence of acute disease and specific gravity of chronic kidney impartments have been increasing with the age and were often accompanied with concomitant urological, gynecological and sexual pathologies.
The purpose of the work was to determine the etiological and clinical preconditions of relapse and chronic pyelonephritis in girls.
Materials and methods. An analysis of the clinical course of187 cases ofpyelonephritis in girls of the age of1 - 18 years had been performing in period from 2008 to 2018 years. The 60 patients in observed group had acute process and 127 ones were with the chronic course of the disease.
Rresults. E. coli was the main etiological factor of the inflammatory process in kidneys. Thus, cases of acute and chronic pyelonephritis composed 63,5% and 44,2% in observed group appropriately. Furthermore, the proportion of grampositive flora increased in the cases of chronic pyelonephritis. In addition, almost 56,7% ofall girls with pyelonephritis had sexually transmitted infections, more likely the patients with chronic forms of the disease (69,3% and 30,0%, respectively (p <0,01). There was domination of the Chlamydia infection in the structure of these pathogens. The research revealed Chlamydia pathogen in the majority of cases — in 29,2% of the examined for urogenital infections girls with pyelonephritis. The presence of mycoplasma infection - 22.1%, trichomonas - 11.5%, candidiasis - 19.5% was less common. 24.8% of girls had clinical signs of vulvitis without identifying the etiological factor
Conclusions. E. coli prevails among the etiological factors of pyelonephritis in girls. Most of the girls with pyelonephritis with the recurrent and chronic course have urogenital infections. Moreover, association of bacterial microflora and sexually transmitted infections complicates the course of chronic pyelonephritis in girls; promotes the development and maintenance of urodynamic disorders, frequent relapses and progression of chronic inflammatory process in kidneys. In conclusion, urogenital infection examination should be mandatory for the girls with pyelonephritis.
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References
Вялкова А.А. О лечении и профилактике рецидивов инфекции мочевой системы у детей /А.А. Вялкова, В.А. Гриценко, И.В. Зорин, Л.М. Гордиенко// Рос. Вестн. Перинатол. и педиат.– 2010.–№6.–С.77–80
Коколина В.Ф. Урогенитальные инфекции у детей и подростков. Диагностика и лечение. Пособие для врачей.М.: ИД «Медпрактика–М», М.–2014.–92 с.
Лавренчук О. В. Оцінка мікробного профілю та антибактеріальної резистентності збудників інфекції сечової системи у дітей міста Києва і області / О. В. Лавренчук, І. В. Багдасарова // Український журнал нефрології та діалізу. – 2016. – № 3(51). – С.43–49.
Лавренчук О. В. Предиктори прогресування хронічного пієлонефриту у дітей / О. В. Лавренчук, I. В. Багдасарова, В. Э. Дріянська, Л. В. Король, Г.Д. Суслова // Український журнал нефрології та діалізу. – 2016. – № 4(52). – С. 59–66.
Майданник В.Г. Современные аспекты пиелонефрита у детей / В.Г. Майданник, И.В. Ковальчук // Міжнародний журнал педіатрії, акушерства та гінекології. – 2016. – № 3. – С. 17–40.
Плешков П.В. Инфекции мочевыводящих путей у девочек–подростков на фоне выделения потенциальных возбудителей инфекций, передающихся половым путем / П.В. Плешков // Научно– практический журнал: Клиническая микробиология и антимикробная терапия. – 2008. – Т. 10. –№ 4. – С. 31–39.
Романенко О.А. Особливості мікробного спектру сечостатевої системи жінок з рецидивуючим пієлонефритом / О.А. Романенко, Н.М. Степанова, А.В. Руденко, В.Т. Кругліков, Л.О. Лебідь, М.О. Колесник // Український журнал нефрології та діалізу. – 2013. – № 1(37). – С. 25–31.
Сафина А.И. Пиелонефрит у детей раннего возраста: современные подходы к диагностике и лечению. /А.И. Сафина //Практическая медицина. – 2012. – 7 (62). – С. 50–56.
Becknell B. The Diagnosis, Evaluation and Treatment of Acute and Recurrent Pediatric Urinary Tract Infections / B. Becknell, M. Schober, L. Korbel, J. D. Spencer // Expert Review of Anti–infective Therapy. – 2015. – V. – 13(1). – P. 81–90.
Cheung KK. Prevalence of Sexually Transmitted Infections Among Adolescents Entering Child Protective Services / K.K. Cheung, D. Montgomery, L.J. Benjamins // J Pediatr Adolesc Gynecol. – 2015. – V. 28 (5). – P. 324–326.
Eberly A. R. Biofilm Formation by Uropathogenic Escherichia coli Is Favored under Oxygen Conditions That Mimic the Bladder Environment /A.R. Eberly, K. A. Floyd, C. J. Beebout, S. J. Colling et all. // Int J Mol Sci. 2017. – V. 18(10). – P. 2077
Frej–Mqdrzak M. Diagnosing Chlamydia Trachomatis Urinary Tract Infections– Preliminary Report / M. Frej–Mdrzak, D. Teryks–Wolyniec, A. Jama–Kmiecik, J. Sarowska et all. // Adv Clin Exp Med. – 2015. – V. 24 (3). – P. 441–445.
Minardi D. Urinary tract infections in women: etiology and treatment options / D. Minardi, G. d’Anzeo, D. Cantoro et all. // Int. J. Gen. Med. – 2011. – V. 4. – P. 333–343.
Mishyna M. Etiology characteristics of pyelonephritis in young children and sensitivity to antibiotics of causative agents in form of biofilms./ M. Mishyna, Y. Mozgova, N. Makieieva, V. Golovachova et all. // Cambridge Journal of Education and Science. – 2016. – No.1. (15).– P.212– 219.
Paintsil E. Update on recent guidelines for the management of urinary tract infections in children: the shifting paradigm. / E. Paintsil // Curr Opin Pediatr. – 2013. – V. 25. – P. 88–94.
Stein R. Urinary tract infections in children: EAU/ESPU guidelines. R. Stein, H.S. Dogan, P. Hoebeke et all. // Eur Urol. – 2015. – V.67– 546.
Tewary K. Recurrent urinary tract infections in children: Preventive interventions other than prophylactic antibiotics / K.Tewary, H. Narchi // World J Methodol. – 2015. – V. 5 (2). – P. 13–19.
World Health Organization. Guidelines for the treatment of Chlamydia trachomatis. Epidemiology, burden and clinical considerations. Laboratory diagnosis // World Health Organization. – 2016. – P. 10–15.
