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The purpose of the study was to estimate the incidence of urinary system congenital malformations and to analyze their clinical manifestations. The study comprised children hospitalized in the Department of Pediatric Nephrology, University Children's Hospital, Lublin, between 2000 and 2003. Urinary system congenital malformations were diagnosed in 16,2% of studied children. The most common urinary system congenital malformations was vesico-ureteral reflux (75,2%). The most common clinical manifestation was urinary tract infections, urinary incontinence and/or nocturnal enuresis, and abdominal pain. In 2% of patients, urinary system congenital anomalies were detected accidentally.
A retrospective study was conducted among 498 patients with urinary tract infections (UTI) referred to our department from January 2013 to December 2015. This study was performed to evaluate the etiology of UTI and the antibiotic susceptibility profile of Escherichia coli (E.coli) as the main etiological factor in different age groups. Urine samples were examined using standard microbiological methods. Three hundred sixty-three samples (72.9%) were identified as E.coli, of which 29 (8.0%) can produce extended-spectrum β-lactamases (ESBL). E.coli was highly sensitive to imipenem (100.0%), gentamicin (91.0%), nitrofurantoin (89.4%), amikacin (88.2%), piperacillin/tazobactam (87.0%) and cephalosporins (79.7–89.5%). Low sensitivity was found in relation to fluoroquinolones (60.3–70.4%). E.coli was least sensitive to ampicillin (30.2%) and amoxicillin/clavulanic acid (49.9%). We observed a significant fall in susceptibility level to piperacillin/tazobactam (68.4% vs. 88.8%; p=0.017), amikacin (61.1% vs. 90.7%; p=0.001), gentamicin (70.0% vs. 93.2%; p=0.002), cefalexin (41.2% vs. 83.3%; p<0.001), cefotaxime (63.6% vs. 89.4%; p=0.002), ceftazidime (61.9% vs. 85.6%; p=0.008), cefepime (73.7% vs. 91.1%; p=0.025), ciprofloxacin (54.1% vs. 72.2%; p=0.024) and norfloxacin (40.5% vs. 62.5%; p=0.011) among patients with catheter-associated UTI (CAUTI) compared to those with non-CAUTI. A similar susceptibility profile was observed between different age groups. In the longevity, E.coli showed a higher sensitivity to cephalosporins than in the young-old group. E.coli susceptibility to fluoroquinolones was low, which excludes them as a first-line drug in our department. Nitrofurantoin may be used as an alternative drug to carbapenems. Monitoring of susceptibility pattern is of great importance.
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