Lactic acid bacteria (LAB) are often used for prevention and treatment of dysbiosis. However, the action of various strains of LAB on metabolism and digestion under these conditions are poorly understood. The purpose of this study was to investigate the influence of probiotic LAB on metabolism, digestion and microbiota in animals with dysbiosis. After administration of ampicillin and metronidazole male Wistar rats, were fed products containing Enterococcus faecium L3 (E.f.), Lactobacillus fermentum Z (L.f.) or milk (control 1). Animals in control group 2 were fed milk, after water instead of antibiotics. Dyspeptic symptoms disappeared after administration of probiotic compared with control 1. At the end of the experiment, an increase in the content of enterococci and lactobacilli in the proximal part of the small intestine was found in the animals treated with E.f. and L.f., respectively. After the introduction of probiotic enterococci, the quantity of lactobacilli and bifidobacteria in the intestines of rats increased, and the content of Klebsiella spp. and Escherichia coli decreased in comparison with the control group 1 and the group fed lactobacilli. The activity of alkaline phosphatase and aspartate transaminase was greater in blood serum of rats with dysbiosis receiving milk and lactobacilli. Intestinal alkaline phosphatase activity increased in the epithelium and chyme in the jejunum of the animals treated with L. f. and in the chyme only in the animals treated with E. f. Thus, the specific effects of different strains of probiotic LAB on the microbiota, and on metabolism and digestion of various nutrients were demonstrated.

Campylobacteriosis is one of the most common bacterial intestinal infections with high risks of severe and prolonged infection in childhood. The growing incidence of campylobacteriosis, the variety of clinical forms of the disease, the difficulties of timely diagnosis of the infection against the background of a high level of resistance of the microorganism to a number of antibacterial drugs determine the need to optimize the rational tactics of treating this infectious disease. One of the possible ways to overcome these difficulties is to further expand the use of probiotics and autoprobiotics. Aim: to reveal the features of the influence of autoprobiotic and probiotic E. faecium strains on clinical and laboratory parameters in children with non-smooth forms of campylobacteriosis .. Materials and methods: In the period from 2018 to 2020. In DNCIB FMBA, a comprehensive single-center prospective dynamic open observational study of 34 children with an uneven course of campylobacteriosis was carried out. For therapeutic purposes, patients were prescribed an autoprobiotic (group A; n = 15) or a probiotic strain E. faecium (group P; n = 19). Clinical and laboratory parameters and indicators of the intestinal microbiocenosis composition were assessed by real-time PCR. Results: Studies of the effect of two different approaches to prescribing probiotic strains of enterococcus to children with a protracted course of campylobacteriosis - a conditionally “reference” industrial strain E. faecium L3 and autoprobiotic strains with a comparable frequency (88.9% and 93.3% of cases, respectively) revealed their significant positive impact on the course of protracted forms of campylobacteriosis, which was expressed by the disappearance of abdominal pain syndrome, normalization of the frequency and consistency of stools, relief of hemocolitis in the absence of undesirable side effects. Analysis of the dynamics of coprograms before and after taking autoprobiotics and probiotic E. faecium L3 also did not reveal significant differences: there was an equivalent positive dynamics in the form of improvement in most of the macroscopic and microscopic characteristics of the stool. The study of the composition of the intestinal microbiota showed that after the course of administration of autoprobiotic strains of E. faecium, there was a significant increase in the content of butyrate-producing indigenous representative - F. prausnitzii, which promotes the repair of the intestinal mucosa. The studies also showed that the course use of autoprobiotic strains of enterococcus contributed to a decrease in the frequency of convalescent release of campylobacter, which suggests a sanitizing effect of autoprobiotics and does not exclude a similar effect in relation to other bacterial pathogens of intestinal infections in children.

Relevance. Vaccine prophylaxis is the most cost-effective and affordable means of controlling infectious diseases. At the same time, there is a great regional diversity in the number of people who refuse vaccination. In our country, according to several large studies, there is a relatively low adherence to vaccination compared to other European countries. It is common to have doubts and questions about immunization in adult patients or parents who vaccinate their children. A decrease in vaccination coverage of the population can lead to an increase in the incidence of infections preventable by immunization. At the same time, measures to promote vaccination used by preventive health care systems in various countries are insufficient. This increases the likelihood for doctors of various specialties to meet in their daily activities with patients' questions and concerns about vaccination.The purpose of this work was to highlight the practical aspects of building a dialogue with patients who have doubts about vaccination. Conclusions. Successful communication is based on the doctor's ability to build a confidential dialogue based on confidence in the decency and goodwill of all its participants. Based on the study, the following conclusions can be drawn. An alarming trend in recent years is the increasing number of patients who doubt the effectiveness of vaccination. For hesitant patients, the doctor is one of the most important sources of information about vaccines. The doctor's ability to clearly and confidently build a dialogue about vaccination helps to dispel the patient's doubts and is the most effective means of increasing adherence to immunization of the population.

The features of gut microbiota in metabolic syndrome (MS) and ways to correct it using autoprobiotics, based on indigenous bacteria obtained from fecal samples of the host, remain unexplored. The aim of the study was to investigate the effectiveness of an indigenous consortium (IC) of fecal bacteria in treatment of patients with MS. The study was carried out on 36 patients with MS, manifested with abdominal obesity, eating disorders, dyslipidemia, and hypertension. The control group was formed by 20 healthy volunteers. Samples of IC and gut microbiota content were examined by qPCR and metagenome (16S rRNA) analysis before and after therapy. The decrease in anthropometric parameters of obesity, liver enzyme level correction, reduction in C reactive protein and triglyceride concentrations were revealed after IC usage. The decrease in genera Bifidobacterium, Enterobacter, Paraprevotella, and Prevotella, as well as an increase in Bacteroides fragilis and Oscillospira spp. populations were shown after consumption of IC. A negative correlation between the quantity of B. fragilis and the anthropometric parameters of obesity (r = −0.48) and C reactive protein level (r = −0.36) in serum was established. Thus, IC can be considered as a potential functional personified product for the therapy of MS.