ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 14 of 42
УЖМБС 2020, 5(2): 104–111

Biofilms Formation by Pyelonephritis Causative Agents in Infants as a Mechanism of Resistance to Antimicrobial Agents

Mishyna M. M. 1, Makieieva N. I. 1, Marchenko I. A. 1, Golovachova V. A. 1, Osolodchenko T. P. 2

In recent years, the number of children suffering from pyelonephritis on the background of disturbance of urodynamics has significantly increased, which is due to both organic and functional reasons. The purpose of this research is to study the ability of major uropathogens to form biofilms and the effect of the preparation of nitrofuran series "Furamag" on primary and secondary biofilms of isolated bacteria. Material and methods. We examined 37 children aged from 1 month to 3 years, including 26 children with acute pyelonephritis and 11 children with chronic pyelonephritis. The diagnosis was verified according to the protocol for diagnosis and treatment of children with urinary tract infections using standardized methods. Microbiological research methods were used. Results and discussion. The study revealed that all uropathogenic microorganisms had the ability to form daily biofilm. The optical density of the isolated bacteria in children with chronic pyelonephritis was significantly (p <0.05) higher than in children with acute pyelonephritis. We also found out that the densest daily biofilms were formed by Klebsiella pneumoniae, both in acute pyelonephritis and in chronic pyelonephritis. The strains of Klebsiella pneumonia, which were isolated in children under 3 years of age who were treated for pyelonephritis had the ability to form daily biofilms: isolates of acute pyelonephritis form biofilms with a density of 3.21 (2.89; 3.67) opt. un., K. pneumoniae isolates of chronic form – 4,56 (4,02; 4,87) opt. un. with the active production of planktonic cells (2.14 (1.86; 2.65) opt. un. and 3.06 (2.84; 3.31) opt. un., respectively, which formed denser secondary biofilms having high resistance to antimicrobials agents. The study highlighted that strains of P. mirabilis and S. aureus had the ability to form dense daily biofilm. However, it should be noted that causative agents of acute pyelonephritis formed lower density biofilms than causative agents of chronic pyelonephritis. At the same time causative agents of chronic pyelonephritis formed thicker primary biofilms. For nitrofuran derivative action on primary biofilm formed by P. mirabilis and S.aureus determined that created new planktonic cells do not form the dense secondary biofilm. Biofilms formed by acute pyelonephritis causative agents had gap with diameter ranged from 1.72 μm to 6.17 μm, and chronic pyelonephritis – from 4.47 μm to 20.98 μm. In the study nitrofuran derivative action on daily primary biofilm microbial pathogens of acute and chronic pyelonephritis in children found that the optical density of almost not decreased, but the data show microscopy formed "pores-gap" with a diameter from 5.98 μm to 21.66 μm and larger due to which the penetration of antibacterial drugs into the biofilm and the impact on planktonic forms of existence of microorganisms with their subsequent death or decrease in the active ability to form dense biofilms to prevent the development of relapses. Conclusion. The optical density of isolates in children with chronic pyelonephritis is significantly higher than in children with acute pyelonephritis. Nitrofuran derivatives in therapeutic dose effectively act on planktonic forms of uropathogens in the active phase of acute and exacerbation of chronic pyelonephritis, as well as prevent the formation of secondary biofilms. Under the influence of nitrofuran derivatives, "holes" are formed through which the penetration of antibacterial drugs into the biofilm is possible, which prevents the development of relapses. Nitrofuran derivatives are effectively prescribed for the prevention of pyelonephritis and for the treatment of chronic pyelonephritis in children.

Keywords: pyelonephritis, children, microorganisms, nitrofuran derivatives, biofilms

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