Budnik T. Pathogenetic substantiation of the system of observation of children (diagnosis, prevention, treatment), patients with urinary tract infection in the conditions of antibiotic resistance

The dissertation is devoted to the optimization of diagnosis, prevention, and treatment of urinary tract infections (UTI) in children in antibiotic resistance (ABR) based on the study of recurrent morbidity, the dynamics of the prevalence of antibiotic-resistant strains of urological pathogens, comprehensive study of risk factors, treatment of differentiated alternative. The incidence of recurrent UTI among children, residents of the Kyiv region, and the city of Kyiv for the last decade (32.8%) and shows the dynamics of its growth (2009 - 29.8%, 2014 - 32.4%, 2019 - 42.0%). The main and secondary risk factors are specified and a multi-regression model of personal prognosis of recurrent UTI in a child is created. The prevalence of ABR (57.6%) in children with UTI was studied, the dynamics of E. Coli resistance was shown: 2009 - 51.2%; 2014 - 59%; 2019 - 70%, including to different classes of antibiotics, based on which the empirical choice of therapy is substantiated. The tactics of delayed antibiotic administration by stratification of the patient by the method of a dipstick urine test and the appointment of a standardized herbal remedy have been developed. The possibility of restoring the antibacterial sensitivity of uropathogens as a result of the use of polyvalent vaccine therapy from 3 to 12 cycles has been established. The effectiveness of combined phytocitrate in the treatment and prevention of UTI in children with mineral disorders has been studied. The algorithm of diagnostics, prevention, and treatment of UTI at children depending on the personal forecast of risk of reinfection is developed and scientifically substantiated, its efficiency is proved.