RISK FACTORS AND CHARACTERISTICS OF URINARY TRACT INFECTIONS IN ADOLESCENT GIRLS WITH COMORBID PATHOLOGIES

Abstract

Relevance. Urinary tract infections (UTIs) in adolescent girls are among the most common childhood diseases, second only to respiratory tract infections. Special attention is required for cases with comorbid pathologies, where UTIs develop against the background of various somatic or functional disorders. This combination leads to an increased frequency of relapses, chronic inflammation, and reduced quality of life. The present study analyzes the risk factors of comorbid pathologies in urinary tract infections among adolescent girls, which is crucial for early detection and prevention of complications. Objective. To study the risk factors and clinical characteristics of urinary tract infections in adolescent girls with comorbid conditions. Materials and Methods. The study included 50 female patients aged 10–17 years who received inpatient treatment in the Department of Urology and Pediatric Gynecology, Clinic No. 2, Tashkent State Medical University. All patients underwent a comprehensive examination following a standardized protocol, which included a detailed medical history (including perinatal and gynecological data), clinical assessment, laboratory tests (urinalysis, urine culture with pathogen titer determination), coprological and microbiological stool analysis, and ultrasound scanning of the abdominal and pelvic organs. Results and Discussion. Patients were divided into two groups according to age and nature of the identified pathology. Group I included girls aged 10–13 years (n = 30; 60.0%). Among them, 18 (60%) had isolated urinary tract diseases, while 12 (40%) had comorbid urinary and genital tract pathologies. Group II consisted of girls aged 14–17 years (n = 20; 40.0%). In this group, isolated urinary tract diseases were found in 8 (40%) patients, and combined urinary and genital tract diseases were observed in 12 (60%). The mean age of patients with comorbid urinary and genital infections was 13.1 ± 1.2 years, which was significantly higher than that of patients with isolated urinary diseases (10.6 ± 1.1 years; p < 0.05). Comorbid urinary tract infections with somatic and gynecological disorders in adolescent girls were characterized by more severe clinical manifestations, higher recurrence rates, structural renal changes (ultrasound findings: chronic pyelonephritis – 32.5%, reflux nephropathy – 27.5%), and metabolic disturbances (anemia – 86.3%). The data indicate that the risk and severity of UTIs directly depend on comorbid somatic, hormonal, and microbiological disturbances, as well as early perinatal factors. This underscores the need for a comprehensive multidisciplinary approach to patient management. Conclusions. In girls with combined somatic and gynecological diseases, urinary tract infections are more severe and recurrent (3.4 ± 0.6 vs. 1.9 ± 0.3, p < 0.001) and are accompanied by more pronounced clinical symptoms. Antenatal and perinatal risk factors significantly contribute to susceptibility to urinary infections (57.1% vs. 20.0%, p < 0.05). The predominant clinical manifestations include lumbar pain, dysuria, subfebrile temperature, and signs of urogenital inflammation (vulvovaginitis – 34.9%, adnexitis – 2.4%). Microbiological analysis revealed a high frequency of bacteriuria and vaginal dysbiosis, with matching pathogens in 38% of cases, confirming an ascending infection route. Menstrual dysfunction and endocrine–metabolic disorders (oligomenorrhea, algomenorrhea, PCOS, obesity) play an important role in maintaining chronic inflammation.