An important component of therapeutic measures for mucoviscidose is the determination of the functional state of the respiratory system, the fight against an opportunistic infection which accompanies the course of the chronic microbial-inflammatory process in the bronchopulmonary tract. Under conditions of reduced resistance to the child’s body, extra infecting of the digestive canal through the ingestion of sputum is extremely undesirable. The monitoring of the status of the microbiota of the oropharynx, the respiratory tract and the intestinal tract allows preventing the further development of the infectious process.
The aim of the present study was to determine the functional state of the respiratory and digestive systems in children with mucoviscidose against the background of quantitative changes and changes of species composition of the microbiota of the bronchopulmonary tract and intestines under the condition of the possible contamination of the gut with BPT microbiota. During the research the microbiological status of the bronchopulmonary tract was examined in 19 sick children. Faeces had been taken in 31 children, 12 of them were healthy (the control group).
In 11 patients (57,9 %) some developmental delays were observed, namely a decrease in the body weight and height. In each age group an increase in respiratory rate and a decrease in body mass index were registered. The decreased oxygen saturation was present in children from 3 to 11 years. The microflora of the bronchopulmonary tract by species was presented by isolates: S.aureus, P.aeruginosa, P.fluorescens, S.pyogenes, S.viridans, S.agalactiae, Еterterococcus spp., Neisseria spp., S.pseudodiphtheriae, S. freundii, E. coli, fungi of the Candida spp., Lactobacillus spp. Frequency of isolation of S. aureus, Pseudomonas spp. amounted to 53% and 47 % respectively.
The investigation of microbiocenosis of colon showed a moderate decrease in the number of Вifidobacteria and Lactobacilli. The reduced number of Enterococci was found in 1 patient (5,3 %), some increase in 8 patients (42,1 %). The growth in the number of Staphylococcus was observed in 3 patients (15,8 %). The quantitative level of Escherichia was reduced by 9 (47,4 %). In one patient some mold was found, in 9 patients (47,4 %) – fungi of the genus Candida. In 2 patients (10,5 %) Escherichia with atypical properties was found. Hemolytic E. coli were detected in one of the patients. The pathogenic enterobacteria and staphylococcus were not detected in the feces of any patient. 4 patients (21 %) were isolated because of S. coseri, C. freundii and K.pneumonia. In 2 patients (10,5 %) from the group “first diagnosed mucoviscidose” the state of the intestinal microflora was almost within the normal range. In 17 patient (89,5 %) postmedical dysbiosis was indicated. According to the results of microbiological studies, the endogenous colonization of the intestines of patients with mucoviscidose sputum has not been confirmed. One hundred percent of patients had steatorrhea; two patients had steatorrhea combined with creatorrhea.
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