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[Urinary microflora and the status of local immunity in children with cystitis]
Insights
Escherichia coli (E. coli) strains with specific properties are linked to pediatric cystitis and pyelonephritis. Treatment with tomicide instilled into the urinary bladder proved effective in children with cystitis.
Area of Science:
- Pediatric Urology
- Microbiology
- Immunology
Background:
- Urinary tract infections (UTIs) are common in children.
- Escherichia coli (E. coli) is a primary causative agent of UTIs.
- Understanding E. coli virulence factors and host immune responses is crucial for effective treatment.
Purpose of the Study:
- To investigate the enzymatic and adhesive properties of E. coli in children with cystitis.
- To assess local urinary immune responses in pediatric cystitis.
- To evaluate the efficacy of tomicide treatment for cystitis.
Main Methods:
- Isolation and characterization of E. coli from urine samples.
- Analysis of bacterial enzymatic (DNAase, phosphatase) and adhesive (P-fimbriae) properties.
- Assessment of urinary immunoglobulin (SIgG, SIgA1, SIgA2, IgA, IgG, IgM) levels.
- Clinical evaluation of tomicide instillation therapy.
Main Results:
- E. coli strains positive for P-fimbriae, DNAase, and phosphatase with high hemolytic and metabolic activity were prevalent in children with cystitis and chronic obstructive pyelonephritis.
- Children with cystitis showed decreased urinary secretory Immunoglobulin G (SIgG) and absent SIgA1 and SIgA2.
- In younger children (up to 3 years), IgA synthesis was dominant in the bladder mucosa, with less intensive IgG and IgM output.
- Tomicide instillation was effective in treating pediatric cystitis.
Conclusions:
- Specific E. coli virulence factors are associated with more severe pediatric urinary tract infections.
- Local immune dysregulation, particularly involving secretory immunoglobulins, is observed in pediatric cystitis.
- Tomicide demonstrates efficacy as a treatment for childhood cystitis.
Abstract:
Study of the enzymatic and adhesive properties of E. coli isolated from the urine of children with cystitis has demonstrated that P-fimbriae, DNAase- and phosphatase-positive strains with pronounced hemolyzing and metabolic properties mostly occurred in children with associated cystitis and chronic obstructive pyelonephritis. In children suffering from cystitis, the changes on the part of local immunity manifested by the decrease of the content of SIgG in the urine and by the lack of SIgA1 and SIgA2. In children with a disease standing up to 3 years, the synthesis of IgA turned out dominant in the mucous membrane of the neck of the urinary bladder and in the trigone of the bladder, with IgG and IgM output being less intensive. The authors have proved the efficacy of the treatment with tomicide instilled into the urinary bladder of children suffering from cystitis.