ЕКОЛОГІЧНИЙ АНАЛІЗ УМОВНО-ПАТОГЕННОЇ МІКРОФЛОРИ ПРИ ПНЕВМОНІЯХ

Abstract

Actuality: Purulent-inflammatory diseases of the respiratory tract are more often induced (under the influence of different triggers) by endogenous microflora. One of the factors that determine the appropriateness of the choice of antibiotics and, therefore, the beneficial outcome of the disease is the microbial spectrum of causative agents of infection. At the present time, there is increasing information on changes in the composition of human microbiota at various diseases and its role in the pathogenesis of various disorders, including respiratory diseases. Objective: Studying the species composition of the microflora in non-hospital pneumonia and the determination of the participation of different species in the structure of microbiocenosis. Materials and methods: Bacteriological research of various clinical materials from 336 patients with pneumonia is conducted. Microbiological examination included an isolation of pathogens, identification by morphological, cultural and biochemical properties. An ecological analysis of the microflora of clinical material was carried out by studying its structure and functional characteristics using indicators such as the index of constancy, the Berger-Parker domination index. Results and discussion: During the study of micro-ecological indicators of microflora of patients with pneumonia, the distribution of endogenous microorganisms of nasopharynx in the biocenosis of lungs was revealed, which was confirmed by the indices of constancy and the dominance of Berger-Parker. In the etiological spectrum of infectious factors, fungi of the genus Candida and streptococci of viridans group, which had a high colonization level, were prevailed. Microorganisms were isolated in both a monocultural and associative form, which contained two to five species. Combinations of bacteria and fungi of the genus Candida were the most common, which were registered at 80.7 % (152/187). The associations included not only autochthonous bacteria but also non-specific habitats such as K. pneumoniae, P. aeruginosa, E. coli, E. cloacae, E. aerogenes, E. faecalis, E. faecium, P. vulgaris, P. mirabilis, C. xerosis and A. baumonii. Conclusion: The obtained data have shown that the lungs of patients with pneumonia are actively colonized by the representatives of the microflora of the nasopharynx with certain qualitative and quantitative changes of microbiocenosis. This is manifested in the emergence of transient and random opportunistic microorganisms against the background of reduced domination of the autochthonous microflora of the nasopharynx. Fungi of the genus Candida and streptococci of the viridans group were predominant among the other isolated opportunistic microorganisms and characterized by high colonization levels.