Open AccessActual dynamics of the species structure of etiological pathogens of urinary tract infections in children and antibacterial sensitivity of this pathogenes
Author(s) -
T.V. Budnik,
L.V. Kvashninа,
M.L. Chernyavskaya
Publication year - 2022
Publication title -
sučasna pedìatrìâ. ukraïna
Language(s) - English
Resource type - Journals
eISSN - 2706-6134
pISSN - 2663-7553
DOI - 10.15574/sp.2022.121.25
Subject(s) - escherichia coli , urinary system , etiology , antibiotics , medicine , antibiotic resistance , biology , microbiology and biotechnology , biochemistry , gene
Understanding the structure of etiopathogenes of urinary tract infections (UTIs) in children, the state of antibacterial resistance (ABR) is an important component of the empirical choice of antibiotics in treatment. Purpose - to study the species structure of UTIs pathogens in children, the prevalence of ABR the rate of its formation at the present stage. Materials and methods. The study involved 2754 hospital and outpatient children aged 0 to 18 years with UTIs in the active phase of the disease for the period 2009-2019. The contingent of subjects was divided into 3 groups: patients for 2009, 2014 and 2019 years of follow-up. Results. Escherichia coli was recognized as the leading uropathogen in all observation groups: in the 1st group (2009) its share was 47% (158/337), in the 2nd (2014) - 64% (210/328), in 3rd (2019) - 66.5% (252/379). The high dynamics of ABR prevalence of Escherichia coli was recognized: an increase of 11% in 2019 compared to 2014; by 18.8% compared to 2009. Thus, in 2019, every second child had resistance (57.6%±1.6 (1586/2754)) and every third - polyresistance (27.4%±3), 04 (755/2754)). We found an increase in the relative risk of ABR in 2019 1.6 times compared to 2014 and 3 times compared to 2009. The mathematical forecast of the prevalence of resistant strains of Escherichia coli for 15 years approached 100% (y=9.5x6+41=98%) at R² = 0.9918. For 10 years the indicator corresponded to 88.5%, for 5 years - 79%. The prognostic increase in ABR relative risk of 2.9-3.7 times in the next 5-10 years has been established. Conclusions. The obtained data are of great practical importance for general practitioners and specialists, as they indicate a high rate of formation of resistant strains of Escherichia coli and other pathogens among children with UTIs, which complicates the empirical choice of antibacterial therapy. The study was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of all the institutions mentioned in the work. Informed consent of the children's parents was obtained for the research. The authors declare no conflict of interest. Key words: urinary tract infection, children, etiological pathogens, antibacterial resistance.