Analysis of the Microorganism’s Sensitivity in Patients with Chronic Adenoiditis to Pharmacotherapy with Antibacterial Drugs

Abstract

Introduction: The prevalence of chronic pathology of the pharyngeal lymphatic system in preschool children reaches 45% and is mainly manifested by hypertrophy of adenoid vegetations, which in half of cases are combined with chronic inflammation, which, with repeated periods of exacerbation, leads to the development of severe chronic pathology of the upper respiratory tract. The role of microorganisms toleranceto pharmacological agents is widely proven in formation of chronic inflammatory disorders and demand correction of therapeutic schemes. Research tasks: The aim of this research was to study the microbial landscape of oropharynx in children who received surgical for adenoiditis and determine the sensitivity of the identified microorganisms to the pharmacotherapy with antibiotics. Material and Methods: We conducted a study of 1577 children aged from 1 year to 17 years and 11 months who received inpatient treatment at the otorhinolaryngological Department of the OO “Scientific and clinical multidisciplinary center named after Z. I. Kruglaya” in the city of Oryol in the period from 2015 to 2017 for hypertrophy of adenoid vegetations. The patients were divided into three groups based on the years of the study. The study of the oropharyngeal microbial association was performed by preparing a smear followed by Gram staining and bacterioscopy. Determination of the sensitivity of microorganisms to antibacterial drugs was performed by discdiffusion method. Results: We found in patients oropharynx microbial landscape with hypertrophy of chronic vegetation in dynamics over the period from 2015 to 2017, an increase in the number of opportunistic saprophytic flora was detected, which was observed against the background of a clear increase in the number of patients with this pathology an increase in the number of cases associated with saprophytic MRCA flora, represented mainly by Staphylococcus aureus, leads to a decrease in the effectiveness of conservative treatment of chronic adenoiditis, which is expressed in an increase in the number of adenotomies. Conclusion: The study revealed negative consequences of uncontrolled use of antibiotic therapy at the pre-hospital stage and irrational schemes of chemotherapy in hospital units, which is manifested in the growing resistance of microorganisms to both “old” antibacterial drugs and a decrease in sensitivity to pharmacotherapy with the latest generation of antibiotics and requires active revision of the schemes of antibiotic therapy and prevention.