[Symptomatology and diagnosis of congenital abnormalities of the lower urinary tract in children].
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Biomedical subjects
Publications and source records attributed to I Krzeska.
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An infection with E. coli is the most frequent cause of the urinary infections in childhood. Virulence depends on several factors out of which a principal role is played by the adhesion of bacteria to the urinary tract epithelium. Such a property have E. coli strains with adherence mannose-positive fimbriae of type P with antigens recognizing and binding glycolipid receptors on epithelial cells in the urinary tract. Children with such infections owe their "sensitivity+" (10% of the population) to genetically determined large number o receptors binding E. coli strains. Incidence and clinical course of the urinary tract infections have been analysed in the group of 184 children. Moreover, sequelae of the urinary tract infections with E. coli have been analysed in dependence on E. coli strain characteristics, i.e. presence or absence of adherent fimbriae from cases of cystitis and significant asymptomatic bacteriuria. Considering pathogenesis of the urinary tract infections as the result of interactions between bacteria and host, antigenic properties of adherent fimbriae might be used for preparation of a vaccine preventing such infections.
The authors evaluated clinically cefoperazone (Cefobid-Pfizer)--an antibiotic of the III generation of cephalosporins--administering it in the form of monotherapy to 32 infected neonates and premature babies. A complete recovery was achieved im 25 neonates, i.e. 78.1%, out of which 76.5% were generalized infections. The result of therapy was doubtful in the remaining 7 babies (21.9%). The drug was changed or the second antibiotic added. No decidedly unfavourable results (deaths) or adverse reactions necessitating withdrawal of the drug were observed. The authors compare this favourable results with the mortality rate of neonates prior to the introduction of the II and III generation cephalosporins. It was about 14%, then. Therefore, both +antibiotic monotherapy and cefoperazone enabling its use are worth wide popularization in neonates and small babies.
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