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.
References
Kuznetsov, S., Vovk, T., Olkhovska, O., & Tatarkina, A. (2019). Dyferentsiina diahnostyka hostrykh respiratornykh virusnykh infektsii u ditei : metod. vkaz. dlia studentiv 5–6-kh kursiv ta likariv-interniv [Differential diagnosis of acute respiratory viral infections in children: method. order for 5th-6th year students and intern doctors]. Kharkiv: KhNMU [in Ukrainian].
Kovalevska, I., Ruban, O., & Yevtushenko, O. (2019). Doslidzhennia asortymentu medychnykh preparativ dlia likuvannia tsukrovovho diabetu na medychnomu rynku Ukrainy [Study of the assortment of medical drugs for the treatment of diabetes on the medical market of Ukraine]. Farmatsevtychnyi zhurnal – Pharmaceutical Journal, 2, 13-23 [in Ukrainian].
Savychuk, N. (2021). Mikrobiom porozhnyny rota ta yoho rol u pidtrymani zahalnoho i stomatolohichnoho zdorovia [Microbiome of the oral cavity and its role in maintaining general and dental health]. Medychna hazeta «Zdorovia Ukrainy 21 storichchia» – Medical Newspaper "Health of Ukraine of the 21st century", 4, 57 [in Ukrainian].
Nuotio, J., Niiranen, T., & Laitinen, T.T. (2022). Use of antibiotics and risk of type 2 diabetes, overweight and obesity: the Cardiovascular Risk in Young Finns Study and the national FINRISK study. BMC Endocr. Disord., 22, 284. DOI: 10.1186/s12902-022-01197-y.
Klimniuk, S., Yasniy, V., & Yasniy, O. (2021). Vplyv antybiotykoterapii na mikrofloru riznykh biotopiv u patsiientiv, khvorykh na tsukrovyi diabet [The effect of antibiotic therapy on the microflora of different biotopes in patients with diabetes]. Zdobutky klinichnoi i eksperymentalnoi medytsyny – Advances in Clinical and Experimental Medicine, 2, 83-86. DOI: 10.11603/1811-2471.2021.v.i2.12206 [in Ukrainian].
Park, S.J., Park, Y.J., & Chang, J. (2021). Association between antibiotics use and diabetes incidence in a nationally representative retrospective cohort among Koreans. Scientific Reports, 11, 21681. DOI: 10.1038/s41598-021-01125-5.
Romanyuk, L., Klumnyuk, S., Mykhailyshyn, H., Volch, I., & Kravets, N. (2022). Retrospective Analysis of Antibiotic Therapy and Sensitivity to Antifungals of Fungi of the Genus Candida, Secreted from Patients with Viral-Bacterial Pneumonia Associated with COVID-19. Mikrobiol. Z., 1, 15-19.
Downer, S., Berkowitz, S.A., Harlan, T.S., Olstad, D.L., & Mozaffarian, D. (2020). Food is medicine: actions to integrate food and nutrition into healthcare. Food for Thought, 369. DOI: 10.1136/bmj.m2482.
(2022). Standart medychnoi dopomohy «Ratsionalne zastosuvannia antybakterialnykh i antyfunhalnykh preparativ z likuvalnoiu ta profilaktychnoiu metoiu» Nakaz MOZ Ukrainy № 823 vid 18.05.2022 – Standard of medical care "Rational use of antibacterial and antifungal drugs for therapeutic and preventive purposes" Order of the Ministry of Health of Ukraine No. 823 dated 18.05.2022. Retrieved from: https://www.dec.gov.ua/wp-content/uploads/2022/05/ 2022_823_smd_rac_antybact.pdf [in Ukrainian].
