ANTIBIOTIC RESISTANCE OF SOME REPRESENTATIVES OF THE OROPHARYNGEAL MICROBIOTA IN CHILDREN WITH WEB-INFECTION

Abstract

Primary WEB-infection causes the development of infectious mononucleosis in approximately ¼ patients if the infection occurs in adolescence. WEB causes widespread infections.

Materials and methods. By prior consent of the parents 28 patients with WEB-infection aged 5 to 16 years were examined. On the basis of a complex of clinical and laboratory examinations all patients had moderate WEB-infection, typical form. Microbiological examination of oropharyngeal swabs was performed by the classical bacteriological method, the examination of antibiotic susceptibility of isolates was carried out by the Kirby-Bauer technique.

Results and discussion. β-hemolytic Streptococcus spp. were dominated in opripharyngeal microbiocenosis (64.3 %) of strains and this group includes a lot of streptococcal species causing disease in humans. The appearance of Enterobacter spp., E. coli and an increase in the number of Candida is an indicator of a decrease in the level of colonization resistance of this habitat. Detection of S. aureus in 35.7 % of patients indicates a violation of the structure of the normal microbiocenosis of the oropharynx, which is a consequence of unreasonable prescribing massive antibiotic therapy. The examination of antibiotic susceptibility of staphylococci and streptococci showed the presense of antibiotic resistance of 52.6 % of streptococci isolated strains and 25.0 % of staphylococci to azithromycin. Besides 20.0 % of streptococci were resistant to ceftriaxone and 40.0 % to cephalexin. Nonrational use of antibiotics leads to the development of antibiotic resistance of the oropharyngeal normoflora in children and worsens the prognosis of treatment of bacterial infections caused by opportunistic pathogens.

Conclusions. 1. In the microbiome of the oropharynx of children with WEB infection, β-hemolytic Streptococcus spp. (64.3 %) prevailed. The appearance of Enterobacter spp., E. coli and an increase in the number of fungi of the genus Candida is an indicator of a decrease in the level of colonization resistance of this habitat. Detection of S. aureus in 35.7 % of patients indicates a violation of the structure of the normal microbiocenosis of the oropharynx, which is a consequence of unreasonable appointment of massive antibiotic therapy. The study of antibiotic susceptibility of staphylococci and streptococci showed resistance in 52.6 % of isolated strains of streptococci and 25.0 % of staphylococci to azithromycin. In addition, 20.0 % of streptococci were resistant to ceftriaxone and 40.0 % to cephalexin.

2. In case of WEB infection in children, the prescription of antibiotics is indicated only in the case of activation of bacterial flora and after preliminary determination of the sensitivity of the most common representatives of this microbiome to antibiotics. Uncontrolled and unreasonable use of antibiotics leads to the development of antibiotic resistance of the oropharyngeal normoflora in children and worsens the prognosis for the treatment of bacterial infections caused by opportunistic pathogens in the future.