MICROBIAL ASSOCIATIONS DEFECTING IN CHILDREN WITH CHRONIC PYELONEPHRITIS

Aim . To study rate of detection of bacteria and viruses from dif ferent ta xonomic groups and their associations in children with pyelonephritis. Materials and methods . Two hundred seventy-four patients aged 5 — 10 years divided on two groups were studied: 1 st group — 240 children with chronic secondary pyelonephritis, 2 n d group — children with nephrectomy due to terminal stage of renal obstructive process. Qualitative and quantitative composition of bacterial flora in urine and renal biopsy samples was studied by bacteriological methods as well as presence of viruses (HSVI, HSVII, CMV, EBV, HPV) by means of PCR. Results . In group 1, 72.2% of children had bacterial mixed infection with associations of coagulase-negative staphylococci, Escherichia , peptococci, and Mycoplasma . Herpesviruses and human papillomaviruses were detected in 50.0% of cases. In group 2, bacterial flora was isolated from preoperative urine in diagnostically-significant titer in 91.2% of cases, whereas in urine obtained from the same patients during operation the microorganisms were detected in 38.2% of cases with predominance of Mycoplasma and Ureaplasma . Bacteriological tests of renal biopsy samples yielded bacteria in 29.5% of cases. Studied viruses were detected in preoperative and intraoperative urine as well as in renal biopsy samples in 52.9%, 44.1%, and 58.8% of cases, respectively. In 32.4% of patients viruses were detected in biopsy samples but not in intraoperative renal pelvis’ urine. There was no difference in HPV and CMV detection rate in the nephrectomy group. Conclusion . Bacterial-viral mixed infection is encountered in children with obstructive pyelonephritis and this should be taken into account during diagnostics and treatment of this condition.

bacterial-viral infection, detection rate, obstructive pyelonephritis