Influence of vaccine therapy on clinical and laboratory parameters in patients with recurrent urinary tract infection.

Abstract

Recurrent urinary tract infection (UTI) remains a pressing issue in the era of large-scale antibiotic resistance (ABR). Modern discoveries testify to the paradigm's error regarding sterility of urine, pointing to the decisive role of the microbial symbiote in the persistence of infection. The purpose of the study was to study the clinical and laboratory efficacy of vaccine therapy in children with recurrent UTI. During the period 2018 - 2019, 21 children (girls) aged 7-18 years with recurrent UTI in the exacerbation phase were observed. By the nature of therapy, children were divided into groups: Ia - received vaccine therapy (VT) in the complex of therapy, Ib - a combination of VT and ABT, II – ABT. In addition to the generally accepted methods of assessing the clinical and laboratory status of a nephrologicals patient, modern non-routine diagnostic methods such as the identification of a microbial pathogen by MALDI TOF mass spectrometry and the determination of the susceptibility of microorganisms by the MIC 90 method were used. As vaccine therapy, the original multicomponent drug was used: Ecsherichia coli (CCM 7593), Enterococcus faecalis (CCM7591), Klebsiella pneumonia (CCM 7589), Proteus mirabilis (CCМ 7592), Pseudomonas aeruginosa (CCM 7590), Propionibacterium acnes (CCM 7083). The drug was prescribed according to the instructions, the duration of use was determined individually by clinical indicators,  from 3 to 12 months. According to the study, it was determined that VT leads to the restoration of the sensitivity of resistant strains of pathogens. The probability of recovery of sensitivity after the 3rd cycle of treatment was OR=1,87±1,13 [0,2; 17,3] at CI 95% (p<0,05), after the 6th cycle of therapy – OR=4,5±1.32 [0.33; 60.1], which is 2.4 times higher than the previous one. The effect of restoring the sensitivity of the strains was significantly confirmed in patients after the 9th cycle of therapy (p=0.008). A high association strength according to the Spearman criterion indicated the dependence of bacterial efficacy of VT on its term of application – p= -0.97, (p<0.05). It is shown that the probability of reinfection after 3 cycles of vaccine therapy is 20.5 times lower than after the course of ABT.