ЗНАЧЕНИЕ ПРИСТЕНОЧНОЙ МИКРОБИОТЫ ТОЛСТОЙ КИШКИ В ПОДБОРЕ РАЦИОНАЛЬНОЙ АНТИБАКТЕРИАЛЬНОЙ ТЕРАПИИ У ПАЦИЕНТОВ С ЯЗВЕННЫМ КОЛИТОМ

Abstract

The purpose of the study: optimization of diagnosis and treatment of patients with ulcerative colitis by selecting rational antibacterial therapy based on the results of microbiological examination of the microflora of the wall of the colon. Materials and methods: 35 patients with ulcerative colitis aged from 28 to 61 years who were on outpatient and inpatient treatment at the departments of coloproctology and gastroenterology of the SamSMU Clinic were examined. Collection of biopsy material of ulcerative defects of the mucous membrane of the large intestine was performed during the fibrocolonoscopy, and a pure culture of microorganisms was isolated from biopsy material using classical methods. The isolated cultures were identified using MALDI-TOF mass spectrometry. All the isolated cultures were sensitive to antibiotics by a disco-diffusion method. Results: In assessing the quantitative composition of the isolated microflora in patients with mild disease, the microflora in the wall of the colon was absent, or low titers of the sown strains (10²-10³ CFU per biopsy) were determined. In patients with an average severity and severe course of the disease in 50.0% and 53.8% of cases, respectively, a pronounced microbial contamination of the submucosal layer (the number of microorganisms 105-106 CFU per biopsy), a wide variety of species. When analyzing sensitivity to antibiotics of isolated strains, it was found that 45% of them have resistance to 1-2 groups of drugs, 33% have resistance to 3 or more groups. Only 22% of the strains were sensitive to all tested drugs. Conclusion: The eradication of a resistant flora is complex and, from our point of view, pathogenetically substantiated and requires the appointment of a combination therapy after microbiological examination of the biopsy specimen.