• Etiological diagnosis of pyelonephritis in children and the problem of antibiotic resistance of microorganisms

Etiological diagnosis of pyelonephritis in children and the problem of antibiotic resistance of microorganisms

PERINATOLOGY AND PEDIATRIC. UKRAINE. 2018.2(74):73-78; doi 10.15574/PP.2018.74.73

Tsymbalista O. L., Melnychuk  L. V.
SHEI «IvanoFrankivsk National Medical University», Ukraine
IvanoFrankivsk National Medical University, Ukraine

Objective: to study the etiology of acute pyelonephritis and exacerbation of chronic pyelonephritis in children according to the results of bacteriological examination of urine.
Material and methods. A comparative analysis of the results of bacteriological examination of urine in children with acute pyelonephritis and exacerbation of chronic pyelonephritis at the age of 3–15 years over the 2009–2011 (n=282) and 2012–2017 (n=2273) periods has been conducted.
Results. There was found a decrease in the frequency of detecting positive cultures — from 45% of cases during 2009–2011 up to 29.0% of cases during 2012–2017. Gram-negative and gram-positive pathogens were inoculated with almost the same frequency during the both observation periods. Among gram-negative pathogens, the role of Еscherichia coli in the etiology of pyelonephritis increased — from 32.5% up to 43.1% of cases; Klebsiella pneumonia was found to be detected more often — from 5.4% up to 18.3% of cases; bacteria Pseudomonadaceae were causative agents of pyelonephritis in 17.7% of cases.
Among gram_positive pathogens, the frequency of detecting Staphylococcus aureus increased (from 17.7% to 40.5%). The detecting rate of Candida species
in urine samples increased as well — from 2.0% of cases during 2009–2011 up to 11.1% of cases during 2012–2017.
Conclusions. The analysis of antibiotic susceptibility pattern to a large range of antibiotics of different classes has revealed a relatively high resistance to reserve drugs.
Key words: children, pyelonephritis, diagnostics, antibiotics.

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