Timely diagnosis, prognostic value of clinical signs and further treatment of patients of an early age with urinary tract infections (UTI) during outpatient stage are important constituents of an integrated management of patients in childhood. The article deals with new approaches concerning clinical algorithm in diagnosis of urinary tract infections in children. The algorithm of diagnostic and therapeutic measures for providing care to children under 5 years of age with urinary tract infections, in particular at the stage of primary care, includes: diagnosis of urinary tract infection in young children using The Diagnosis of Urinary Tract infection in Young children, patient’s examination by Gorelick Scale and UTIcalc, imaging methods with mandatory ultrasound of the kidneys and bladder, micturating cystogram after the first episode of infection in boys and the second — in girls, the prescription of antibiotic therapy based on data from regional monitoring of antibiotic resistance of the main groups of uropathogens, monitoring antibiotic resistance using electronic means and the implementation in microbiological laboratories of the guidelines of the European Committee on Antimicrobial Susceptibility Testing, as well as introduction of the prescription sale of antibiotics.

Les indicateurs de protéines métalliques (transferrine, céruloplasmine) chez les enfants avec surpoids et obésité Introduction. Dans tous les pays, on observe une augmentation progressive du nombre de patients obèses, tant chez les adultes que chez les enfants. Aujourd'hui, l'obésité est considérée comme une inflammation systémique chronique de faible activité. Actuellement, il existe une accumulation d'informations sur la signification biologique et clinique des protéines métalliques dans ce processus inflammatoire. But. Étudier les effets de la transferrine et de la céruloplasmine chez les enfants avec surpoids et obèses.

La giardiase chez les enfants: le génotype moléculaire, la croissance des enfants et la calprotectine fécaleIntroduction. La giardiase est la plus sévère infection parasitaire de l'intestin humain. L'objectif de l'étude a été d'investiguer la fréquence de la giardiase, trouver son génotype, estimer la croissance et déterminer le niveau de la calprotectine fécale chez les enfants. Matériel et méthodes. On a utilisé la méthode directe microscopique de 688 enfants, âgés de 6 à 18 ans pour G. duodenalis. Deux groupes se sont constitués: Groupe I -avec un test positif pour G. duodenalis (n = 90); groupe II -enfants avec un test négatif (n = 110). On a effectué pour ces enfants, le dosage génétique, l'anthropométrie et la calprotectine fécale. Résultats. Sur ces 688 enfants examinés pour G. duodenalis, 90 ont donné un résultat positif pour ABSTRACT Introduction. G iardiasis is the most frequently reported human intestinal parasitic infection. The objective of the study was to investigate the frequency of giardiasis, carry out the genotyping, estimate the growth and determine the level of fecal calprotectin in children. Material and methods. 688 children aged 6-18 years were examined for Giardia duodenalis by direct microscopy. Two groups were formed: group I -children with a positive test for Giardia duodenalis (n = 90); group II -children with a negative test (n = 110). Genetic examination, anthropometry and fecal calprotectin (FC) evaluation were carried out in these children.Results. Out of the 688 children examined, 90 had a positive result (G. duodenalis (+)). The leading clinical feature of G. duodenalis infection (+) was abdominal pain, followed by nausea and diarrhea. The FC content in the feces of the group I was significantly

Microbiological monitoring of the uropathogens is an effective "tool" for urinary tract infectious and inflammatory diseases treatment quality improvement. The aim of the article is to determine the range of the urinary tract infectious-inflammatory diseases etiological spectrum groups of pathogens in the child population in Chernivtsi region. Materials and methods. The etiologic spectrum of uropathogens identified in the urine samples of 657 patients who were provided with a specialized medical care in the Nephrology Department of the "Municipal Children's Clinical Hospital", Chernivtsi (2014-2015) was analyzed in order to dynamically control the possible changes of the "urinary tract infections" (UTI) regional etiological structure and antibiotic resistance of pathogens; identification of age and gender differences of urine microbial diversity in the child population in Chernivtsi region (2014-2015) compared with the monitoring data for the 2009-2013 period. Results. A significant difference has been found in the etiological structure of the urine microbial diversity in children with infectious and inflammatory diseases of the urinary tract (Gram-positive cocci-p < 0.05; Enterobacteria-p < 0.01; resident microflorap < 0.01) in comparison with uropathogens extracted in children with urinary tract noninfectious diseases. Administrative and territorial differences have been registered in etiological structure of the urine microbial diversity in children living in the urban areas (p < 0.01) from their peers living in the rural areas. Conclusions. The regional monitoring data showed changes of the urine resident microflora (p < 0.01) without significant changes of etiological spectrum of the UTI pathogens in examined children (0-18 years old) with urinary tract infectious and inflammatory diseases during 2009-2015 in Chernivtsi region. At the same time it as a matter of concern a significant increase in the proportion of "negative results" (no growth) in the urine bacteriological analysis (p < 0.01), which might indirectly indicate the "uncontrolled" use of antibiotics among children in the region.

In the scope of current medical practice the "viewpoint" regarding the growth of antibiotic resistance of microorganisms is a threat to national security. A reasonable use of antibiotics on the basis of uropathogen regional bacterial sensitivity gives the opportunity to "restrain" the growth of antibiotic resistance of microorganisms and increase the effectiveness of the UTI treatment.The aim of the article is to determine the range and dynamics of the antibiotic resistance of major groups of infectious-inflammatory diseases causative agents of the urinary tract in the child population of the Chernivtsi region. Materials and methods.The analysis of etiologic spectrum and antibiotic resistance of uropathogens was conducted and observed in the urine samples of 657 patients who were provided with a specialized medical care in the Nephrology department of the "Municipal Children 's Clinical Hospital", Chernivtsi (2014 with the purpose of the dynamic control of possible changes in the regional antibiotic resistance of pathogens of causative pathogens of the "urinary tract infections" (UTI); identify the age and gender differences of the child population of the Chernivtsi region (2014)(2015) compared to the monitoring data for the period of 2009-2013.Results. When UTI among of the child population of the Chernivtsi region leading etiologic organisms include strains of the family Enterobacteriaceae and uropathogen of the genus Proteus. A "wave-like" curve of the dynamics of antibiotic resistance of Enterobacteriaceae uropathogens with a decreasing tendency to the "drugs of choice" was observed among the child population of the region (2009)(2010)(2011)(2012)(2013)(2014)(2015): penicillin (P < 0.01), cephalosporin II-III generation (P < 0.01) and medicine of the fluoroquinolone series (P < 0.01). A "wave-like" curve of the dynamics of antibiotic resistance of Proteus uropathogens with a decreasing tendency to the "drugs of choice" was observed among the child population of the region (2009)(2010)(2011)(2012)(2013)(2014)(2015): semi-synthetic penicillin (P < 0.1), and medicine of the tetracycline series (P < 0.01). Conclusions.Regional microbiological monitoring of the uropathogens is an effective "tool" in higher quality treatment of infectious and inflammatory diseases of the urinary tract of the child population.Регіональний моніторинг антибіотикорезистентності збудників інфекцій сечової системи серед дитячого населення Чернівецької області Сучасний «погляд» у світовій медичній практиці щодо зростання антибіотикорезистентності мікроорганізмів -загроза національної безпеки. Раціональне використання антибіотиків, на підставі даних про регіональну бактеріальну чутливість уропатогенів, дає можливість «стримувати» зростання антибіотикорезистентності мікроорганізмів і підвищити ефективність лікування інфекційно-запальних захворювань сечової системи.Мета роботи -встановити динаміку антибіотикорезистентності основних груп збудників інфекційно-запальних захворювань сечової системи в дитячого населення Чернівецької області.Мате...