Respiratory microbiota disorders in children with neurological disabilities at repeated respiratory diseases

Olena Koreniuk

doi:10.15587/2519-4798.2021.224333

Abstract

 The relevance of the problem of recurrent respiratory diseases in children with severe neurological pathology is due to the high frequency, severity of clinical symptoms and the protracted nature of their exacerbations, as well as the tendency to chronicity of the pathological process. The aim of the research was to study the respiratory microbiota to optimize antibacterial therapy of recurrent respiratory diseases. Materials and methods: the 16 children with severe neurological pathology at repeated respiratory diseases were examined. We used a microbiological examination of the upper respiratory tract using a deep smear from the oropharynx to identify a possible causative agent of the disease. Research results: the pronounced imbalance of the respiratory microbiota, corresponding to II and III degrees of dysbiotic disorders, was revealed in the examined children. The feature of the microflora of the upper respiratory tract was the dominance of Pseudomonas aeroginosa, intestinal opportunistic microflora (Klebsiella pneumoniae, Proteus vulgaris) and their frequent combination with Streptococcus pyogenus, Staphylococcus aureus and yeast-like mushrooms of the Сandida genus. The maximum degree of respiratory microbiota disorders was noted in the group of children with congenital malformations of the brain and correlated with the severity of bronchopulmonary diseases. The analysis of the pathogenic microflora sensitivity to antibiotics showed high resistance of the identified microorganisms to most medicines. Conclusions: respiratory pathology in children with neurological disabilities is characterized by a recurrent and chronic bronchitis with a tendency of a protracted course which determines the duration of antibiotic therapy. The use of a non-invasive technique for the respiratory microbiota studying makes it possible to identify suspected pathogens of bronchopulmonary diseases and optimize their treatment

Highlights

The problem of recurrent respiratory diseases in children with severe neurological pathology is still relevant
The aim of the study is to investigate the respiratory microbiota in children with severe neurological pathology in order to optimize an antibacterial therapy of recurrent respiratory diseases
The microbiological research of the upper respiratory tract using a deep smear from the oropharynx was done

Summary

Introduction

The problem of recurrent respiratory diseases in children with severe neurological pathology is still relevant. A feature of respiratory pathology in children with disabilities is a tendency to protracted course, which requires long-term, multi-stage antibiotic therapy. The empirical method of choosing an antibiotic for the treatment of a respiratory disease is most often used in practice, which leads to the ineffectiveness of the therapy and its prolongation. In this regard, the most important issue is the use of techniques that allow to optimize treatment as a result of the correct selection of a medicine. The anatomical features of the airway structure allow rapid microbial immigration to the lower airways [2]

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