No abstract

The aim of the investigation was to assess the functional state of the kidneys of preterm infants of various gestational ages with signs of acute kidney injury. Materials and Methods. The study included 30 preterm infants born at 29 to 36 weeks gestation with signs of acute kidney injury. Patients were divided into two groups: group I included children with low body weight, born at 3236 weeks of gestation; group II with very low birth weight, born at 2931 weeks of gestation. In the study of kidney function, the main markers were analyzed serum creatinine, urea, diuresis level, glomerular filtration rate (GFR) at the third week of life, as well as at discharge from the hospital when reaching the postconceptual gestational age of 36.0 [35.0; 39.0] weeks. Severity was assessed in both groups of patients. Results. In both groups of children, a slight degree of severity was recorded, the risk stage (Risk) according to the pRIFLE classification criteria (2007). The evaluation of the biochemical blood test did not show a statistically significant difference in creatinine, urea, GFR, and the rate of diuresis between groups of children with low body weight and very low birth weight. In both groups of patients, creatinine and urea levels in the third week of life exceeded the age standards. By the time the postconceptual gestational age was reached at 36.0 [35.0; 39.0] weeks, there was a statistically significant decrease in the level of these indicators in patients of both groups. In addition, it was found that premature children are at risk for the formation of hyperoxaluria (53% in the structure of crystalluria). Conclusion. Timely diagnosis of acute kidney injury in premature newborns will allow adequate therapy to prevent the progression and further formation of terminal renal failure. It is important to determine the level of excretion of oxalates in the urine to prevent the development of urolithiasis.

Цель работы состояла в представлении современных данных о способности про-и пребиотических препаратов предупреждать формирование вторичной гипероксалурии у детей. Для этого проведен анализ данных литературы с обобщением результатов оригинальных исследований, касающихся способности про-и пребиотиков предупреждать развитие и снижать выраженность лабораторных проявлений вторичной гипероксалурии путем улучшения состояния кишечной микрофлоры, участвующей в деградации оксалатов. Показана способность Oxalobacter formigenes, Lactobacillus spp. и Bifidobacterium spp. участвовать в метаболизме оксалатов, снижать экскрецию оксалатов с мочой, тем самым уменьшая выраженность лабораторных проявлений вторичной гипероксалурии. Представлена возможность терапевтической коррекции заболевания путем улучшения состояния кишечной микрофлоры как препаратами пробиотического действия, содержащими в своем составе штаммы Lactobacillus spp. и Bifidobacterium spp., так и пребиотическими средствами. Сделан вывод, что внедрение в терапию вторичной гипероксалурии препаратов, нормализующих состояние кишечной микрофлоры (про-и пребиотиков), поможет рационализировать тактику ведения пациентов и поспособствует уменьшению проявлений вторичной гипероксалурии.

No abstract

The aim of the study was to characterize the microbial landscape in the urine of children treated in multi-discipline hospitals based on the spectrum and drug-resistance of the urinary tract bacteria. Materials and Methods. The bacterial strains isolated from the urine of patients aged 1 month to 18 years with urinary tract infections treated in the pediatric wards of Nizhny Novgorod clinics from 2005 to 2017 were studied. The degree of bacteriuria and sensitivity to antibiotics/antibacterial agents were determined. Results. The results indicated a change in the spectrum of pathogens in urine samples of patients that underwent treatment in the Children's City Clinical Hospital No.1 (Nizhny Novgorod) during 2000-2016. A mixture of microbial species that prevailed earlier has been replaced with bacteria monocultures in recent years (2014-2016). Among those, gram-negative bacteria dominated (E. coli, Klebsiella, Proteus); the gram-positive flora was represented by the Streptococcus, Enterococcus, and Staphylococcus genera. Since 2014, the occurrence rate of Klebsiella has increased to 14.7%. In the surgery department of the Regional Children's Clinical Hospital of Nizhny Novgorod, gram-negative bacteria monocultures dominated throughout the entire study period (2005-2017). Among the gram-positive flora, bacteria of the Staphylococcus genus took the lead. In recent years, the occurrence of Klebsiella has also increased. Conclusion. Over the past 16 years, a change in the spectrum of the urinary tract pathogens occurred in both pediatric and surgery departments of multi-discipline children's hospitals. Continuous monitoring of urinary microflora and its sensitivity to antibiotics and other antimicrobial drugs is important for adjusting urinary tract infections therapy in pediatric patients.