ВОЗРАСТНЫЕ ОСОБЕННОСТИ БОЛЬНЫХ ТУБЕРКУЛЕЗОМ  С МНОЖЕСТВЕННОЙ И ШИРОКОЙ ЛЕКАРСТВЕННОЙ УСТОЙЧИВОСТЬЮ , "Вестник ЦНИИТ"

Rusakova, Larisa; Стерликов, С. А.

doi:10.7868/s2587667820060345

Cited by 1 publication

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“…Сохранение и коррекция кишечного микробиома у пациентов с туберкулезом приобретает все большую значимость, в связи с необходимостью улучшения качества и продолжительности жизни больных при длительной многокомпонентной противотуберкулезной терапии, обусловливающей стойкие нарушения микробиоты [16]. Дисбаланс в микробиоме сопровождается появлением гастроинтестинального синдрома, формированием резистентности возбудителей на фоне мальабсорбции и снижением комплаентности пациентов к лечению [14,27].…”

Section: Introductionunclassified

“…В настоящее время имеются ограниченные данные по использованию бактерийных иммунобиологических препаратов на фоне этиотропной терапии у пациентов с туберкулезом, вызванным штаммами микобактерий с множественной лекарственной устойчивостью (МЛУ) [16]. Поэтому сложно говорить о длительности и количестве курсов пробиотикотерапии для туберкулезных пациентов, о характере влияния комбинированной терапии на тяжесть заболевания и эффективность противотуберкулезных препаратов в отношении резистентных возбудителей.…”

Section: Introductionunclassified

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Microbiological evaluation of probiotic therapy in patients with pulmonary tuberculosis

Otdushkina,

Zakharova,

Kholodov

et al. 2023

Russian Journal of Infection and Immunity

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Patients with pulmonary tuberculosis and multiple pathogen resistance (MDR) develop persistent disorders of the intestinal microbiome during prolonged multicomponent chemotherapy requiring correction. However, there is limited data on the use of bacterial drugs in patients with tuberculosis followed by assessing their effectiveness. The aim of the study was to evaluate changes in the intestinal microbiome after a course of probiotics along with anti-tuberculosis chemotherapy in patients with MDR tuberculosis. Materials and methods. The design a prospective small-cohort study (n = 30). Patients with pulmonary tuberculosis received anti-tuberculosis drugs according to the IV or V regimen, the median of the doses taken was 34.5 (30; 57.5); gastrointestinal syndrome was recorded in all study subjects. Probiotic therapy was applied by using a preparation containing Bifidobacterium bifidum and B. animalis and Lactobacillus casei, L. plantarum, L. delbrueckii subsp.bulgaricus, L. acidophilus. The course of therapy comprised 21 days,1 capsule twice a day. Before and 7 days after probiotics therapy, studies on composition of the intestinal microbiota were carried out, the frequency of virulence factors Enterococcus spp., Staphylococcus spp., Candida spp. was examined; fatty acid composition and activity of enterococcal organic acid production were studied. Results. After a course of probiotics, a significant increase in lactobacillus titers was recorded from 5.2 (4.0; 6.0) to 6.1 (6.0; 8.0) lg CFU/g (p = 0.05). The frequency of mucosal colonization by Candida fungi and lactose-negative Escherichia decreased by 2-fold (p = 0.001) and 3-fold (p = 0.05), respectively. The frequency of detected virulent strains significantly decreased: hemolysin-producing staphylococci by 9 times (p = 0.009), enterococci with gelatinase activity by 6 times. E. faecalis membrane oleic acid level significantly increased (C9-C18:1) (p = 0.03). In E. faecium, cis-7-palmitoleic acid (C7-C16:1) and oleic (C9-C18:1) fatty acid level increased by 2-fold (p = 0.05), and for linoleic acid (C18:2) by 4 time (p = 0.04) accompanied by elevated acid formation by 1.5 times. Conclusion. A single course of probiotic therapy in patients with pulmonary tuberculosis leads to qualitative microbiome changes, which are characterized by decreased levels of conditionally pathogenic microorganisms with virulent properties and altered composition of the enterococcal cell membrane accompanied by their increased biochemical activity.

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Section: Introductionunclassified