[Microbial intestinal biocenosis in lingering and complicated course of community pneumonia]

Abstract

Aim: To characterize species and quantitative composition of intestinal microflora in lingering and complicated course of community pneumonia (CP). MATERIAL AND METHODS. The trial enrolled 130 CP patients and 30 healthy controls. Severe and moderate CP was diagnosed in 118 patients, mild CP--in 12 patients. In 36 (27.6%) patients the disease stayed long. Among the complications (47.7%) there were respiratory insufficiency of degree I-II (n = 29), exudative pleurisy (n = 7), toxic shock (n = 6), abscess of the lung (n = 5), acute vascular failure (n = 5), chronic renal failure (n = 5), DIC syndrome (n = 3), myocarditis (n = 2). Intestinal microflora was studied quantitatively and qualitatively using domestic materials.

Results: Dysbacteriosis often accompanies CP--42.3% in acute period, 18.8% in convalescence. Dysbacteriosis was more severe in severe CP. Compared to healthy controls, CP patients' intestine contains low content of bifidobacteria (100-fold), nonpathogenic enterococci and escherichia with normal enzymatic activity (10-fold and more). The number of saprophytic and epidermal staphylococci is very high- a 100-fold rise. In lingering pneumonia 2-3 times more often than in mild acute CP feces contain escherichia with low enzymatic activity, lactose-negative, staphylococci. Patients with pneumonia complications had dysbacteriosis of degree I, II, III and IV in 19.4, 30.4, 8.1 and 6.5% cases, respectively.

Conclusion: Long-term administration of antibiotics in patients with lingering and complicated CP destroys balance of intestinal microflora and thus influences the course of CP. This dictates the necessity to conduct fecal microflora analysis in patients with CP irrespective of intestinal diseases.