THE METABOLIC ACTIVITY OF THE MICROFLORA OF THE OROPHARYNX IN CHILDREN WITH BRONCHITIS AND COMMUNITY-ACQUIRED PNEUMONIA

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Background: Given a steady increase in the number of children with recurrent  respiratory tract infections, to develop methods of their rehabilitation, it is necessary to evaluate  factors of nonspecific resistance. Aim: To study metabolic activity of oropharyngeal microflora in children  with recurrent bronchitis and community-acquired pneumonia, based on determination of spectrum  of shortchain fatty acids (SCFA). Materials and methods: This prospective  study included  60 children with recurrent  respiratory  tract  infections  aged  from 3 to 7 years, hospitalized  for inpatient  treatment of bronchitis  (n = 30) and pneumonia (n = 30). The oropharyngeal microflora was assessed by classical bacteriological  method (in mucosal smears); SCFA levels in non-stimulated saliva were measured by gas liquid chromatography. Results: There was no significant difference  in qualitative  and  quantitative composition  of the oropharyngeal microflora between children  with  bronchitis  and  pneumonia. However, assessment of metabolic  functions showed some significant differences. Children with   bronchitis  showed  signs of microflora hyperactivation  with total  SCFA production up  to  118.4% (mean) from that of the reference range, with predominant activation of aerobic bacteria (anaerobic index 66.8%). In children with pneumonia, microflora was suppressed (68.13% of the normal range, the difference with the bronchitis group being significant, p < 0.05), with predominance of strictly anaerobic  bacteria (anaerobic index 110.35% from the normal range, p < 0.05). Children with recurrent respiratory tract infections had the following common characteristics: prevalence  of bacterial proteolysis (70% of patients) and butyric acid deficiency (63% from the normal level in bronchitis and 33%, in pneumonia, p > 0.05). Conclusion: The data obtained could be used to make a decision on the necessity of antibacterial therapy.

About the authors

E. A. Medvedeva

Moscow Regional Research and Clinical Institute

Author for correspondence.
Email: evgeniya0103med@yandex.ru
Medvedeva Evgeniya A. – Research Fellow, Children's Infections Disease Department Russian Federation

E. R. Meskina

Moscow Regional Research and Clinical Institute

Email: evgeniya0103med@yandex.ru
Meskina Elena R. – MD, PhD, Professor, Head of Department of Pediatric Infections Russian Federation

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Copyright (c) 2016 Medvedeva E.A., Meskina E.R.

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