肺炎条件菌群的生态学分析

N. Kovalenko, T. M. Zamazii, I. V. Novikova, G. Taranenko
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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. \nObjective: 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. \nMaterials 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. \nAn 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. \nResults 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. 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引用次数: 1

摘要

现状:呼吸道的脓性炎症性疾病更多是由内源性微生物群引起的(在不同触发因素的影响下)。决定抗生素选择的适当性,从而决定疾病有益结果的因素之一是感染病原体的微生物谱。目前,关于各种疾病中人类微生物群组成的变化及其在包括呼吸系统疾病在内的各种疾病发病机制中的作用的信息越来越多。目的:研究非医院肺炎菌群的种类组成及不同种类在菌群结构中的参与程度。材料与方法:对336例肺炎患者的各种临床材料进行细菌学研究。微生物学检查包括病原分离、形态鉴定、培养鉴定和生化鉴定。采用恒常指数、Berger-Parker优势度指数等指标,研究临床材料微生物区系的结构和功能特征,对其进行生态学分析。结果与讨论:在肺炎患者菌群微生态指标的研究中,揭示了鼻咽部内源性微生物在肺部生物病变中的分布,并通过恒常性指标和Berger-Parker优势度指标证实了这一点。感染因子病原谱中以念珠菌属真菌和翠绿菌群链球菌为主,定植水平较高。分离出的微生物既有单培养的,也有伴生的,其中含有2 ~ 5种。念珠菌属细菌和真菌的组合最常见,占80.7%(152/187)。这些关联不仅包括本地细菌,还包括非特异性生境,如肺炎克雷伯菌、铜绿假单胞菌、大肠杆菌、阴沟假单胞菌、产气假单胞菌、粪假单胞菌、粪假单胞菌、寻常假单胞菌、神奇假单胞菌、干燥假单胞菌和鲍蒙假单胞菌。结论:所获得的资料表明,肺炎患者的肺部被鼻咽部微生物群的代表菌群积极定植,并出现一定的微生物病定性和定量变化。这表现在短暂和随机的机会性微生物的出现,对减少的背景下,控制的本地微生物群的鼻咽。在其他分离的机会微生物中,念珠菌属真菌和翠绿菌组的链球菌占主导地位,其特点是定植水平高。
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ECOLOGICAL ANALYSIS OF OPPORTUNISTIC MICROFLORA IN PNEUMONIA
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.
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