Recurrent urinary tract infections--uropathogen incidence and drug sensitivity.

The aim of the study was the retrospective analysis of the results of the drug sensitivity studies of bacterial species cultured from 681 urinary specimens collected from 79 children (12 boys and 67 girls) aged 0-18 years with recurrent urinary tract infection in a period from 1997 to 2001. Factors predisposing to recurrent urinary tract infections and the incidences of particular uropathogens were also analyzed. Escherichia coli (57.3%), Proteus spp. (15.6%) and Pseudomonas aeruginosa (9.1%) were the most frequent isolated pathogens. Reinfections and relapses of urinary tract infections were observed in 74.7% and 25.3% of the children, respectively. In some children etiologic variability of particular infection episodes were observed. In the majority of the children infection episodes were caused by one or two bacterial species and new infections differed from previous ones only in drug sensitivity. In 30 children vesicoureteral reflux was detected. Other anatomical abnormalities of urinary tract were revealed in 17 children. In 18 children, neurogenic bladder dysfunction was diagnosed. Urodynamics disclosed functional abnormalities in 48/55 children.

Urinary excretion of N-acetyl-beta-D-glucosaminidase and alpha1-microglobulin in children with proliferative blood diseases.

The purpose of the study was to estimate the urinary excretion of NAG and alpha-1M among children who suffer from proliferative blood diseases. The group of the examined children included those who went through a viral hepatitis (VH) and who are or were treated by means of cytostatic drugs. The study comprised 73 children aged from 4 to 18 (average 11.7+/-3.5. There were 70 children with the diagnosis of leukemia and 3 with the diagnosis of non-Hodgkin lymphoma. The examined group was divided according to the stage of treatment of a basic disease. Group I--22 children who are treated currently or whose treatment has been completed recently. Group II--51 children whose treatment was completed over two years ago. In group II there were 4 subgroups distinguished depending on positive antigenemia HBs and the presence of HCV antibodies. There were no clinical or biochemical features of damage of renal function observed among any of the children. The testing group consisted of 70 healthy children who were selected regarding age and sex. The urinary excretion of NAG and alpha-1M was estimated in the second morning portion of urine and it was presented as NAG/creatinine and alpha-1M/creatinine ratio. The results of the research underwent the statistical analysis by means of a t-Student test. It was stated that the urinary excretion of NAG and alpha-1M was higher among children who currently are or were treated by means of cytostatics drugs. It was also stated that the urinary excretion of NAG was higher among the children who went through viral hepatitis C in comparison with HBs antigen carriers. Similarly, the urinary excretion of alpha-1M was higher among children with positive markers of viral hepatitis B and C markers in comparison with a group of HBs antigen carriers.

Efficacy of vaccination against viral hepatitis type B in children with the nephrotic syndrome.

The purpose of the study was to estimate the efficacy of vaccination against viral hepatitis type B in children with the nephrotic syndrome and to estimate the probable cause-effect relationship between the occurrence of the nephrotic syndrome and infectious diseases and vaccination in children. The retrospective study comprised 235 nephrotic children aged 1-14 years hospitalized in the Department of Pediatric Nephrology at University Children Hospital, Lublin, between 1982 and 1997. 56 nephrotic children aged 2-13 years received vaccination against viral hepatitis type B. In 49 children the vaccine was administered during the treatment of the nephrotic syndrome and in the remaining 7 children--after completion of the therapy. Retrospective analysis revealed the presence of infection with hepatitis B virus in 30 (12.8%) nephrotic children. In 20 of those children the presence of infection with hepatitis B virus was detected during the second and succeeding relapses of the syndrome. In 15 (5.1%) children the nephrotic syndrome was probably induced by other infectious diseases and in 7 children the nephrotic syndrome developed as a result of active immunization. Among 56 children who received vaccination against viral hepatitis type B in 6 (10.7%) the increase of urinary protein excretion was observed and 5 developed a succeeding relapse of the syndrome. In 41 of 56 children who received vaccination against viral hepatitis type B the titers of anti-HBs antigen antibodies were measured. The protective titer of anti-HBs antigen antibodies was detected in 39 (95.1%) nephrotic children. It is well known that both active immunization and infectious diseases may induce the nephrotic syndrome. Despite this, vaccination against viral hepatitis type B in nephrotic children is highly recommended, since it influences favorably the further clinical course of the syndrome by the protection of the disease. In our study, none of the nephrotic children who received vaccination developed viral hepatitis type B.