Sadova-Chuba Z. Children’s сatheter-associated urinary tract infections: diagnosis, prevention, treatment

Dissertation is sanctified to the problem of improvement of diagnostics of prophylaxis and treatment of catheter-associated infections of urinary ways for children that need intensive therapy, by clarification of their epidemiology, etiology, links of pathogeny, improvement of criteria of diagnostics, methods of prophylaxis and treatment. Research was entered by 193 patients by age 1-18, with surgical and somatic pathology, that were in the separation of intensive therapy. Research results showed that for patients the cannulation of urinary bladder was conducted that in the conditions of operating-room, the signs of infection of urinary ways develop with less frequency and speed, in comparing to the patients, the cannulation of urinary bladder was conducted that in the separation of intensive therapy. Specific composition of microorganisms that served as the causative agents of catheter-associated infections of urinary ways following: Escherichia coli, Klebsiella pneumoniae, Enterococcus spp., Pseudomonas aeruginosa, Candida albicans, Staphylococcus epidermidis. Gram-positive causative agents of catheter-associated infections of urinary ways were most sensible to imepenem, meronem, cefepime, vancomycin; gram-negative causative agents of catheter-associated infections of urinary ways - to imepenem and meronem. Formed diagnostically-curative algorithm of catheter-associated infections of urinary ways. The improved treatment is by confirmation of efficiency of addition of uroseptic to basic therapy of catheter-associated infections of urinary ways. Research showed that quality of life of children with the catheterized urinary bladder below substantially, especially after the parameter of the emotional functioning, in comparing to the children without an urinary catheter, and also, that quality of life is in a greater degree determined by volume of invasion interferences, but not by a presence or absence of infection of urinary ways.