RELATIONSHIP BETWEEN THE REPRESENTATION OF VARIOUS HISTOCOMPATIBILITY ANTIGENS AND THE IDENTIFICATION OF PATHOGENIC AND SAPROPHYTIC STAPHYLOCOCCUS STRAINS AS AN ETIOLOGICAL SUBSTRATE OF SECONDARY PYELONEPHRITIS IN CHILDREN WITH CONGENITAL OBSTRUCTIVE UROPATHIES

The study involved 73 patients aged 5-15 years of Russian nationality admitted to a surgical hospital for surgical treatment of congenital obstructive uropathies (hydronephrosis, vesicoureteral reflux, megaureter). All patients underwent a full range of standard urological examinations, including urine cultures for microflora with an antibiogram and determination of the microbial count. Microbiological analysis of the spectrum of uropathogens revealed that Staph. aureus (45.0%) and Staph. epidermidis (22.5%) were most often cultured from the urine of patients. Patients with secondary pyelonephritis underwent immunogenotyping for the HLA - A and HLA - B loci. Statistical methods: canonical correspondence analysis, calculation of relative risk and odds ratio.

The aim of the study was to identify the relationship between the first class antigens of the major histocompatibility complex (loci A and B of the HLA system) with the isolation of Staph. aureus and Staph. epidermidis in children with obstructive pyelonephritis.

Results: Using the Past program (version 3.26, 2019) (using Staph. aureus and Staph. epidermidis as independent variables as the cause of pyelonephritis in children, and histocompatibility antigens of loci A and B as dependent variables), combinations of relationships between histocompatibility antigens of loci A and B associated with the detection of Staph. aureus and Staph. epidermidis in children were identified with secondary pyelonephritis. For Staph. aureus (odds ratio) were: A28 (42.8), A27 (10.4), A11 (10.4), A26 (5.0), B28 (12.7), B15 (5.0), B1 (4.33). For Staph. epidermidis: A4 (6.7), A25 (4.9), B 41 (6.7), B16 (4.9). With statistical significance, the highest relative risk of detecting Staph. aureus was revealed for child patients with pyelonephritis who have the HLA - A28 antigen; relative risk 24.5 (P=0.028) with an odds ratio of 42.78 (P= 0.019).

Conclusions: The obtained data can be used to predict the risk and nature of the course of pyelonephritis, as well as guide the direction of etiotropic treatment of obstructive pyelonephritis in children.

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