Regional monitoring of the urinary tract infections etiological spectrum pathogens in the child population in Chernivtsi region: dynamic changes, age, gender, administrative and territorial characteristics

Безрук, В. В.; Безрук, Т. O.; Babiy, O. R.; Sokolnyk, S. O.; Шеремет, М. І.; Maksymyuk, V. V.; Godovanets, О. S.; Kovtun, A. I.

doi:10.14739/2310-1210.2017.5.110222

Cited by 4 publications

(3 citation statements)

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“…Аналіз результатів етапів моніторингу і їх порівняння свідчать, що домінуючими уропатогенами серед дитячого населення в регіоні є представники родини Enterobacteriaceae. Серед штамів родини Enterobacteriaceae (за винятком протея) найбільш суттєвою виявилась різниця в чутливості до напівсинтетичних пеніцилінів (ампіцилін, амоксиклав -29,8 % чутливості штамів у хлопчиків проти 31,6 % чутливості у дівчат, р < 0,01) і цефалоспоринів (цефазолін -64,4 % проти 40,1 % відповідно, р < 0,001) [3][4][5].…”

Section: результати та обговоренняunclassified

“…Антибіотикочутливість бактерій роду протей, що є збудниками ІСШ, має певні особливості: у сечі дівчат визначено вірогідно нижчий відсоток резистентних штамів протею порівняно з іншими ентеробактеріями до карбеніциліну (k = 259, р < 0,05); амоксиклаву (k = 131, р < 0,05); офлоксацину (k = 378, р < 0,01); ципрофлоксацину (k = 390, р < 0,01); у хлопців встановлено статистично значущу різницю чутливості між бактеріями роду протей та іншими ентеробактеріями для карбеніциліну (k = 105, р < 0,001); цефоперазону (k = 100, р < 0,001); цефтріаксону (k = 145, р < 0,001); офлоксацину (k = 134, р < 0,05); ципрофлоксацину (k = 145, р < 0,05); пефлоксацину (k = 103, р < 0,05); канаміцину (k = 102, р < 0,01) [3][4][5].…”

Section: результати та обговоренняunclassified

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Monitoring and features of antibiotic resistance during the COVID-19 pandemic

Безрук

Ivanov

Shkrobanets

2023

KIDNEYS

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Background. Urinary tract infection (UTI) is an urgent problem in nephrology. The current state of antibiotic resistance to antimicrobial drugs complicates the empirical choice of antibacterial therapy, and indications for the use of antimicrobial drugs are not always clinically justified. The purpose of the study: to compare the antibiotic resistance of the main groups of UTI pathogens during coronavirus 2019 (COVID-19) pandemic in 2020–2022 with the results of 2014–2016 monitoring among children of the Chernivtsi region. Materials and methods. Urine samples were collected from 657 children (0–17 years old) who received specialized medical care in health care institutions of the Chernivtsi region (2014–2016). During 2020–2022, a clinical and laboratory examination of 180 children (0–17 years old) was conducted. Results. The results of the monitoring proved the wave-like nature of changes in antibiotic resistance to semi-synthetic penicillins and cephalosporins with the maintenance of a sufficient level of sensitivity to these antimicrobial drugs among the main groups of UTI pathogens; the data obtained give reason to suggest a negative trend to increasing resistance to fluoroquinolones, tetracyclines over time (2020–2022 — the period of the COVID-19 pandemic); a multidirectional and time-dependent differences were revealed in sensitivity to aminoglycosides: gentamicin, amikacin and kanamycin in children of Chernivtsi region, as well as a negative trend to increasing the share of carbapenem-resistant strains of uropathogens — 55.8 ± 5.1 % (imipenem — χ2 = 5.432; p = 0.020). Conclusions. The monitoring results indicate the need to comply with standards in the provision of medical care (prescribing antibacterial therapy taking into account the data of regional monitoring on antibiotic resistance to antimicrobial drugs), administration of antimicrobial drugs in health care institutions that provide medical care in outpatient and inpatient settings. High level of antibiotic resistance of UTI uropathogens to carbapenems (2020–2022), used for the treatment of severe bacterial infections, requires their exclusively targeted prescription in everyday pediatric practice.

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Section: результати та обговоренняunclassified

Monitoring and features of antibiotic resistance during the COVID-19 pandemic

Безрук

Ivanov

Shkrobanets

2023

KIDNEYS

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“…According to the data of the Ministry of Health of Ukraine, namely the Center of Medical Statistics of the Ministry of Health of Ukraine, the negative dynamics of the primary morbidity of the population is noted, particularly due to genitourinary diseases [1]. Among children aged 0-18 years, the most common microbial and inflammatory diseases of the genitourinary system are urinary tract infections (UTIs) [2]. More than 1 million children with a diagnosis of UTI visit the hospital annually, 500,000 visit the emergency department, and more than 50,000 children are…”

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confidence: 99%

Prediction of the chronicity of inflammatory diseases of the urinary system in children

Lezhenko

Zakharchenko

2023

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Background. The purpose was stratification of factors that lead to the chronicity of inflammatory diseases of the urinary system in children, as well as creation of a mathematical model for predicting their course. Materials and methods. The research group consisted of 97 children (average age — 10.0 ± 1.3 years). The main group was divided into subgroups: the first one — 43 children with acute urinary tract infections (UTIs), the second one — 34 patients with chronic UTIs. The control group consisted of 20 conditionally healthy children. The content of 1,25(OH)2D3, vitamin D-binding protein, inducible nitric oxide synthase (NOS2), cystatin C, cathelicidin, hepcidin, lactoferrin, interleukins 6, 15 was investigated by immunoenzymatic analysis. The impact of factor characteristics on the process of UTI chronicity was evaluated using factor and cluster analyses. A logistic regression equation was used to predict the probability of developing chronic UTIs. The quality of the constructed model was assessed by its sensitivity and specificity, and receiver operator characteristic (ROC) analysis was also used. Results. It was found that 6 factors had the greatest significance: the factor of functional disorders of the urinary tract, the factor of comorbid conditions, the protective factor, the immune factor, chronic foci of the disease, and the NOS2 factor. According to the results of logistic regression, the model for predicting the probability of developing chronic UTI in children had the form of an equation that included 6 variables (early manifestation of the disease, vitamin D level, vesicoureteral reflux, dysmetabolic nephropathy, neurogenic bladder, UTI in the mother in childhood). The classification ability of the model was determined based on the data of the training sample and was 75.0 %. The sensitivity of the model was 78.3 %, and the specificity was 76.5 %. The area under the ROC curve that corresponded to our mathematical model was equal to 0.776. The Gini index was 55.2 %, which corresponds to the good quality of the model. Conclusions. The process of chronicity of the inflammatory process in the urinary system in children occurs under the conditions of the interaction of some pathological factors. The leading risk factors for the chronicity of the inflammatory process are the presence of functional disorders of the urinary tract, early manifestation of the disease, the level of vitamin D, intestinal dysfunction, and the presence of UTI in the mother in childhood.

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Medical management: a model for giving medical aid to children with infectious-inflammatory diseases of the urinary system

et al. 2021

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Increasing requirements of medical aid given to children with infectious-inflammatory diseases of the urinary system stipulate the necessity to improve its quality using evidence-based therapeutic-diagnostic and organization technologies. The aim of the work – to substantiate, develop the improved model of the specialized nephrology care for children with infectious inflammatory diseases of the urinary system at the regional level. The official statistical data have been studied (2006 to 2017); information-analytical and statistical methods have been used. A bacteriological study (2009–2016) of urine samples was carried out for 3089 children (0–17 years old) in the Chernivtsi region. They formed the foundation for substantiation and development of an improved functional-organizational model of the system. In addition to the existing and functionally changed elements contains new elements: regional/inter-regional center of specialized medical aid to children with infectious-inflammatory diseases of the urinary system. Implementation of the elements of the suggested improved model in a part of a rational approach in distribution of functions concerning medical observation of patients at the stages of giving medical aid enabled to make the period of hospitalization of nephrological patients 11,40% shorter and an average period of treatment of patients with infectious-inflammatory diseases of the urinary system 2,93% shorter.

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Regional monitoring of the urinary tract infections etiological spectrum pathogens in the child population in Chernivtsi region: dynamic changes, age, gender, administrative and territorial characteristics

Cited by 4 publications

References 1 publication

Monitoring and features of antibiotic resistance during the COVID-19 pandemic

Monitoring and features of antibiotic resistance during the COVID-19 pandemic

Prediction of the chronicity of inflammatory diseases of the urinary system in children

Medical management: a model for giving medical aid to children with infectious-inflammatory diseases of the urinary system

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