THE STRUCTURE OF ANTIBIOTIC THERAPY OF RESPIRATORY TRACT INFECTIONS IN PATIENTS WITH TYPE II DIABETES AND THE STATE OF THE OROPHARYNGEAL MICROBIOME
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i3.13917Keywords:
antibiotics, diabetes, respiratory infections, microbiomeAbstract
SUMMARY. The aim – to find out the frequency and structure of antibiotic therapy for acute respiratory syndrome in patients with diabetes mellitus, at the outpatient and inpatient stages of treatment, to identify changes in the oropharyngeal microbiome in these patients.
Material and Methods. The complex of clinical and laboratory studies for the examination of patients with DM included a questionnaire about the frequency of prescribing antibiotics, an analysis of the disease histories of inpatients, and a bacteriological examination of swabs from the oropharynx of 25 outpatients and 39 patients with DM. Material from the oropharynx was examined by a standard bacteriological method.
Results. Predominance of the prescription of macrolides and cephalosporins at the outpatient stage with mostly oral intake, and twice as often the use of cephalosporins parenterally in the hospital, the influence of antibiotic therapy on the state of the oropharyngeal microbiome in patients who had an acute coronary syndrome against the background of type II diabetes were revealed: almost the same amount of S. aureus in inpatient (12.82 %) and outpatient (12.00 %) patients with diabetes, which indicates chronic carriage; detection of S. pneumoniae is four times more frequent in hospitalized patients, and in 7.69 % of patients K. pneumoniae. The sowing of fungi of the genus Candida is twice as frequent among those examined in the hospital – 46.15 %. More frequent detection of E. coli in outpatient settings.
Conclusions. At the outpatient stage, patients with type II diabetes received antibiotics orally in 68.0 % of cases. Staying in a hospital for respiratory pathology in patients with diabetes on the background of taking antibiotics is an additional risk factor for contamination with hospital strains of microorganisms and more often contributes to the development of dysbiotic changes in the oropharynx with the development of candidiasis. Changes in the microbiome of the oropharynx in this category of patients can be both a reason for taking antibiotics and a consequence of antibiotic therapy.
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