Atopic dermatitis (AtD) is a multifactorial inflammatory skin disease characterized by itching, chronic recurrent course and age-related features of lesions. AtD pathogenesis has not been fully elucidated yet. An important factor for AtD emergence and progression is the imbalance in symbiotic microbiota. The research publications provide a few studies about a role for oropharyngeal microorganisms in AtD immunopathogenesis. The aim of the study is to analyze biological diversity of oropharyngeal microbial communities in varying AtD severity. 97 male patients, aged from 16 to 19 years, with different AtD severity were included in the study. Culture study of oropharyngeal discharge was also performed. Biological material was seeded on the expanded list of growth media and incubated for 5 days at the 37°С. To assess the biological diversity of the oropharyngeal microbiota, the coefficient of constancy (C) was used, in order to classify individual microorganisms as permanent, additional or transient. Statistical data processing was performed using the Stat Tech software (version 4.0.0, Stattech LLC, Russia). While examining biological diversity of the oropharyngeal microbiota in AtD patients, 58 microbial species were isolated and identified. After statistical analysis the significant differences in frequency of isolation, depending on different AtD severity were observed for microbes such asStreptococcus vestibularisandRothia dentocariosa. WhenR. dentocariosais isolated from the oropharynx, the chances of AtD exacerbation emergence decreased by 6 times, whereas in case ofS. vestibularis, on the contrary, it increased by 5 times. Therefore, identification of transitions of individual microbes from transient to additional and permanent microbiota and vice versa, depending on the AtD stage and severity, allows to analyze an influence of specific microorganisms in AtD pathological processes and to establish definite new microbiological predictors of AtD exacerbation and remission.
Background:Young farm animals are susceptible to opportunistic infections which may cause economic losses due to mortality and poor weight gain. The development of antimicrobial resistance and the desire to improve therapy efficacy and safety are the reasons to seek for new antibacterial drugs ensuring rapid recovery with minimum adverse events. Aim:To estimate the efficacy of DOKSI AVZ 500 in respiratory pathologies in young pigs. Methods:The study was conducted in 65-70-day-old Yorkshire piglets with signs of bacterial respiratory pathologies. The animals were treated with the test drug for 3 or 5 days. The reference group received TETRAMAX 500 which is similar to the test drug in terms of chemical structure, mechanism of action, and activity spectrum. The animal's status was assessed using clinical examination, clinical blood count, and bacteriological tests. Results:Both test and reference drugs were well tolerated and ensured the animal recovery within about 4 days. The recovery was accompanied by normalization of hematological parameters and flora composition. The bacterium associated with the disease development, Streptococcus suis, was virtually completely eliminated in all groups. No adverse events were noted. After the treatment, all the animals readily gained weight and live market quality. Conclusion:DOKSI AVZ 500 was a highly efficient therapy for respiratory pathologies caused by the resident opportunistic flora in piglets. It has also shown noninferiority vs. TETRAMAX 500 in terms of all the health-related parameters and thus can be recommended for introduction in veterinary practice in pig farms.
In recent years, with the rapid development of molecular biology, genomics, high-performance sequencing technology and bioinformatic analysis technology, there has been an active study of a previously overlooked “organ” – the intestinal microbiota (GM). It is known that the microbiota of the human gastrointestinal tract plays a key role in metabolic, physiological, immunological and digestive processes. Microbial composition and colonization, in turn, depend on factors such as the neonatal delivery method, breastfeeding, nutrition, antibiotic treatment and environmental exposure at an early age. Also, one of the factors influencing the maintenance of homeostasis is the relationship between bacterial species or communities of species inside and outside the microbiome. Dysbiosis is the key to understanding the etiology of various diseases. Although the pathogenesis of IBD has not been fully studied, in patients with this pathology, inflammation of the gastrointestinal tract is a common sign of intestinal dysbiosis. Currently, there is a lot of evidence that intestinal dysbiosis leads to a violation of immune tolerance, which can cause or complicate the course of IBD. Thus, research is needed to clarify the role of microbiota in the pathogenesis of diseases. Based on changes in the intestinal microbiota, new diagnostic tools and possible treatment methods can be developed.
Until recently, HIV infection does not lose its relevance. In 2022, 630 000 people died and 1.3 million people became infected with the human immunodeficiency virus (HIV). HIV-positive persons develop more infectious diseases than healthy people do; the causative agents are mainly opportunistic microorganisms. Streptococcus pneumoniae is the main causative agent of infection in the lungs in HIV-infected persons. In order to prevent the development of severe pneumococcal infections and to overcome antibiotic resistance, vaccines have been developed. There are polysaccharide (PPV) and conjugate (PCV) vaccines. According to clinical recommendations, vaccination of previously unvaccinated HIV-infected patients is carried out regardless of T-helper cell level. However, no data were found on the effect of PCV13 on immunological memory cells. The purpose of this study is to assess an effect of PCV13 vaccination on the immune system in HIV-infected subjects. Materials and methods. The study included 200 patients with HIV infection, which were divided into two groups: I — received a dose of PCV13 (n = 100) and control group (n = 100). During the first visit, immunological and microbiological studies were carried out. On the second visit, a PCV13 was injected into the deltoid muscle. The third visit was made a year later, where immunological and microbiological studies were repeated. Participants were divided into 4 subgroups depending on CD4+ T cell level. The microbial study was done using a swab collected from the back of the throat. Results. During the immunological examination at visit 1, abnormalities were detected in all examined populations and immune cell subsets. At 12 months post-vaccination, the median levels of CD3+CD4+ and CD45RO+ T lymphocytes in the immunized group were higher than pre-vaccination levels compared to control group, in which the values changed insignificantly. Our data confirm the immunological effectiveness of PCV13 administration in HIV-infected patients. In patients with peripheral blood CD19+ lymphocyte deficiency, had increased microbial detection rate (p = 0.003). Conclusion. As a result, due to the high risk of pneumococcal pneumonia, HIV-infected patients should be immunized with a 13-valent pneumococcal conjugate vaccine.
The study involved 100 patients with inflammatory bowel disease: 65 patients with ulcerative colitis and 35 patients with Crohn's disease. The control group consisted of 50 participants. The mean age of the patients was 43.7±18.4 years. The diagnosis of UC or CD was established on the basis of clinical, laboratory, endoscopic, and histopathological results in accordance with the IBD diagnostic criteria. All participants underwent blood serum tests: IgA and IgG ASCA, p-ANCA by ELISA. Results. P-ANCA was significantly more common in the group of the patients with UC. 60 % of the patients tested positive for at least one antigen. The highest prevalence of p-ANCA was observed against lactoferrin, elastase, and proteinase 3. The occurrence of antibodies to ASCA was observed in 80 % of the patients with CD and in 15 % of the patients with UC. The proportion of the patients with a positive test result for IgA ASCA markers (72 %), IgG ASCA (57 %), and IgG / IgA ASCA (60 %) was significantly higher in the CD group than in the patients with UC and the control group (P<0.001). In the CD group, the proportion of the patients who tested positive for IgA ASCA was significantly higher in those after surgery compared to those who did not have surgical interventions. Conclusions. The most informative serological marker for UC verification used for differential diagnosis with CD are p-ANCA. The study revealed significantly more frequent localization of lesions within the colon and prevalence among young people in the patients with CD and with a positive ASCA result. A combination of ANCA and ASCA tests appears to be a good option for IBD laboratory diagnosis.
Fusobacterium nucleatum is a component of the oral microflora, and in clinical practice it is associated primarily with periodontal diseases. Since 2011, the scientific community has confirmed the association of F. nucleatum with colorectal cancer (CRC) by seeding it from tumor tissue samples. Research has led to the discovery of mechanisms by which this bacterium may contribute to the development, metastasis of CRC and chemoresistance. With the help of its adhesion proteins (FadA and Fap2) F. nucleatum specifically attaches to colorectal carcinoma cells. Following invasion, F. nucleatum induces inflammation, activates β-catenin signaling, and creates a favorable microenvironment for tumor growth and development. Recently, the role of F. nucleatum in other types of oncological pathology, such as oral cavity cancer, head and neck cancer, gastric cancer, esophageal cancer, pancreatic cancer, cervical cancer and breast cancer, has been confirmed. Understanding the mechanisms of association of F. nucleatum with oncological diseases will help to find new approaches in the treatment, prevention and diagnosis of cancer. Thus, further studies of the correlation between F. nucleatum and carcinogenesis are needed, using a multidisciplinary approach and physicians from other specialties.
The development of new methods for diagnosing infectious diseases, such as polymerase chain reaction, sequencing, and mass spectrometry, has made it possible to expand our understanding of the microflora of the human body in general and of the respiratory tract in particular. The most common microorganisms in lungs include Proteobacteria (Pseudomonas spp., Haemophilus spp.), Bacteriodetes (Prevotella spp., Porphyromonas spp.) and Firmicutes (Veillonella spp., Streptococcus spp.). Pathological processes in the lower respiratory tract change the microbiome. Consequently, Moraxella, Haemophilus, and Acinetobacter microorganisms are found in patients with chronic obstructive pulmonary disease. The main causative agents of community-acquired pneumonia include Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Klebsiella pneumoniae and other enterobacteria. Atypical causative agents of pneumonia include Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila. The wide prevalence of S. pneumoniae in the population confirms the need for vaccines to prevent the development of invasive and noninvasive forms of infection. The aim of the study was to analyze literature data on the structure of the normal microflora of the lung and to investigate its role in the development of pathological conditions. Conclusion . A growing body of research confirms the important role of the normal microflora of the respiratory tract. Vaccination against diseases of the bronchopulmonary system may reduce the incidence and mortality of pneumonia. However, the problem of community-acquired pneumonia is still relevant. In particular, the changes in the structure of the pathogens of this disease is of great interest. Vaccination against respiratory pathogens in combination with uncontrolled use of antibiotics during the pandemic of the new coronavirus infection could contribute to a change in the structure of both the lower respiratory microflora in general and the pathogens of bacterial community-acquired pneumonia in particular. The detection of a change in the predominant pathogen calls for revising etiotropic treatment and organizing planned prophylaxis if the appropriate vaccines are available.
The rapid spread of a new coronavirus infection in the country actualizes the conduct of bacteriological studies of clinical material obtained from the respiratory tract of patients with COVID-19. During the experiments, 230 sputum samples and 260 autopsy lung samples from patients with COVID-19 were analyzed. 946 high-risk strains were isolated and identified by MALDI-ToF mass spectrometry on a Microflex LT instrument (Bruker®). According to the results of bacteriological cultures of sputum, a predominance of gram-positive ones was revealed, amounting to 50.5% (222 strains) of the total number of isolated pathogens. However, falling into this group is manifested by natural representatives of the microflora of the human mucous membranes from the genera Streptococcus, Rothia and Lactobacillus (109 strains in total), which can be manifested by the detection of improper sputum collection, causing contamination by the substance of intense salivation and nasopharyngeal discharge. In turn, the “classic” gram-positive causative agents of pneumonia were detected much less frequently: S. aureus in 5 cases, S. pneumoniae in 6 patients. The causative agents in the order Enterobacterales are represented by 42 strains, among which the most likely species are K.pneumoniae (27 strains). In the group of non-fermenting gram-negative bacteria, A. baumanii (29 strains) prevailed, and P. aeruginosa was also identified in 2 cases. When analyzing the results of a microbiological study of autopsy material (lungs) of patients with COVID-19, significant differences in the qualitative and quantitative composition of the microflora were revealed, compared with sputum. In the group of gram-positive bacteria, 15 strains of the natural microflora of the mucous membranes were identified, while sensitive species dominated among gram-negative pathogens: K. pneumoniae (102 strains), A. baumanii (75 strains), P. aeruginosa (11 strains). Regular microbiological monitoring is essential for antibiotic therapy and prevention of secondary bacterial infection. In the event of a fatal outcome, the results of microbiological analysis of autopsy material can determine the cause of death of the patient.
Nigella sativa L. is a promising plant object, herbal medicinal raw materials of which can be comprehensively used for the development of drugs with an antimicrobial activity.The aim of the study was to screen and compare the antimicrobial activity of water-ethanolic extractions from the Nigella sativa L. herbs with a eucalyptus tincture of as a reference preparation.Materials and methods. Chromatograms of the extracts were obtained by thin layer chromatography in the system of chloroform – ethanol – water (26:16:3). The detection of adsorption zones was carried out in daylight, in the UV light at λ=254 nm and λ=365 nm, as well as by treatment with reagents – a 3% alcohol solution of aluminum chloride and a solution of diazobenzosulfonic acid in a 20% sodium carbonate solution. The next step was to determine the minimum inhibitory concentration by the method of double serial dilutions in Mueller-Hinton nutrient broth (Bio-Rad, USA). As test cultures, the strains of the American Type Culture Collection (ATCC) microorganisms were used: Staphylococcus aureus (ATCC 29213), Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27853), as well as Candida albicans (a clinical strain). Simultaneously, an experiment to establish a “negative” control was carried out. For the comparative evaluation of the studied samples activity, its activity was compared with the reference preparation with a proven antimicrobial activity – a eucalyptus tincture.Results. For all water-ethanolic extractions and the Nigella sativa L. herb tincture, the adsorption zones characteristic of flavonoids with Rf1 = 0.28, Rf2 = 0.15, Rf3 = 0.11 were revealed, and under the action of an alcoholic solution of aluminum chloride, the fluorescence of the adsorption zones was also enhanced, which indicates the phenolic nature of these compounds.In the course of the study, it was found out that all water-ethanolic extractions from the Nigella sativa L. herbs have the greatest antimicrobial effect against the Pseudomonas aeruginosa strain. When compared with the reference preparation – a eucalyptus tincture, it was notified that the specified tincture of the Nigella sativa L. herbs has an advantage in the antimicrobial activity over the strain of Pseudomonas aeruginosa – the action at the 16-fold dilution vs the 4-fold dilution. The action on the Escherichia coli and Candida albicans strains is comparable for the both tinctures.Conclusion. The obtained results of phytochemical and microbiological analyses will be used as a rationale for the introduction of antimicrobial preparations based on the Nigella sativa herbs in medical and pharmaceutical practice.
Chronic obstructive pulmonary disease (COPD) is a serious problem for global health. Infectious agents play a main role in the development of COPD exacerbations. Bacterial colonization of the lower respiratory tract is common in patients with stable COPD. The role of microbiota and host immune response to potential pathogens is not well studied. Microbiota composition disorders in respiratory tract are found in patients with COPD and associated with maladaptive changes in the immune system of the lungs and increased level of inflammation. This review investigates role of microbiota in the pathogenesis of COPD and its impact on the course of the disease. Some important issues such as pneumococcal vaccination and antimicrobial resistance of respiratory pathogens are also discussed.
The estimation of diagnostic value of humoral immunity indices in dust lung diseases is given and the tests for determining the individual sensitivity of persons to the effect of industrial aerosols of various fibrogenity degree are chosen. It is established that disorders of humoral immunity and inspecific resistance of the organism in dust lung pathology depend on the disease type and are determining for developing infectious complications. It is recommended to determine the factors of humoral immunity and inspecific resistance in workers being in contact with high concentrations of industrial aerosols and in patients with dust lung diseases for the exact estimation of risk of developing infectious complications.
Infectious complications in the respiratory tract caused by microorganisms from the Burkholderia cepacia complex are the main cause of death among patients with cystic fibrosis. Natural and acquired resistance mechanisms allow Burkholderia cepacia complex pathogens to adapt to the conditions of regular antibiotic therapy, which necessitates the use of antibacterial drugs with an alternative mechanism of action. Studies on the importance of iron as an essential factor in the metabolism of bacteria and methods of its acquisition from the environment contributed to the development of a new antibiotic from a number of cephalosporins – cefiderocol. In the structure of cefiderocol, a fragment is formed that imitates siderophores – chelating molecules that ensure the transport of iron ions into the internal environment of the microorganism. A unique mechanism, described in the scientific literature as a “Trojan horse”, allows antibiotic molecules conjugated with siderophores to effectively penetrate into the bacterial cell, exerting a bactericidal effect. Thus, cefiderocol can be used to treat infectious complications in the lungs of patients with cystic fibrosis caused by bacteria from the Burkholderia cepacia complex, including multidrug-resistant strains. In addition, the spectrum of activity of cefiderocol allows the use of this antibiotic in the treatment of infections caused by nosocomial gram-negative bacteria such as Enterobacterales, Acinetobacter, Pseudomonas and Stenotrophomonas.
Bronchial asthma is a serious public health issue. It is important to reduce the frequency of attacks for BA patients. Vaccination for pneumococcal infection is an important complementary tool that can improve the clinical pattern of bronchial asthma. The study involved 102 patients with bronchial asthma, who were monitored over 4 years. The patients were divided into 4 groups based on the vaccination scheme used for pneumococcal infection: PCV13, PPV23, PPV23/PCV13, PCV13/PPV23. Sequential vaccination with pneumococcal conjugate and polysaccharide vaccines leads to a decrease in the isolation of pneumococcus from sputum in BA patients, which has a pronounced positive effect on the clinical pattern of this disease, namely, it leads to a decrease in the frequency of attacks, the requirement for courses of antibacterial chemotherapy and hospitalizations, and therefore this vaccination protocol should be included in the standards of BA patient management.
Non-tuberculous mycobacteria (NTM) include more than 190 species and subspecies. Some NTM species can cause human diseases of the lungs or extrapulmonary infections. The guidelines focus on pulmonary mycobacteriosis in adult patients without cystic fibrosis or HIV infection caused by the most common NTMs, such as Mycobacterium avium complex, Mycobacterium kansasii, and Mycobacterium xenopi among slow-growing NTMs and Mycobacterium abscessus complex among fast-growing species. Experts of American Thoracic Society (ATS), European Respiratory Society (ERS), European Society for Clinical Microbiology and Infectious Diseases (ESCMID), and American Society for Infectious Diseases (IDSA) contributed to the development of the guidelines. A total of 31 evidence-based recommendations are provided for the diagnosis and treatment of NTM-induced lung infections.
Обоснование. Одним из приоритетных направлений в улучшении качества лечебно-профилактических мероприятий у взрослого населения с различными патологиями является вакцинация против пневмококковой инфекции. Эффективность вакцинации находится в прямой зависимости от способности индивидуума к формированию адекватного специфического иммунитета. Цель исследования — оценить уровень поствакцинальных антител к капсульным полисахаридам S. pneumoniae у взрослых больных бронхиальной астмой (БА) и хронической обструктивной болезнью легких (ХОБЛ) после введения 13-валентной конъюгированной пневмококковой вакцины (ПКВ13). Методы. Методом ИФА проведено определение уровня IgG -антител к 12 капсульным полисахаридам (КПС) серотипов 1, 3, 4, 6 A , 6 B , 7 F , 9 V , 14, 18 C , 19 A , 19 F , 23 F S. pneumoniae, входящим в состав ПКВ13, и 2 серотипам (9N, 15В), не входящим в него, с использованием исследовательских тест-систем, разработанных на базе ФГБНУ «НИИ вакцин и сывороток им. И.И. Мечникова». Группы взрослых больных — 32 пациента, страдающих БА, и 33 пациента с ХОБЛ, которые получали основное лечение согласно принятым международным стандартам. Группа сравнения — 20 здоровых, не имеющих сопутствующих заболеваний. У больных вакцинация проводилась вне острого периода заболевания с использованием ПКВ13. Результаты. Вакцинация ПКВ13 пациентов с БА и ХОБЛ не приводит к развитию обострений основного заболевания, при этом редко могут развиться необычные явления в поствакцинальном периоде, предусмотренные инструкцией к препарату. Сравнительный анализ изменений уровней поствакцинальных антител, проведенный через 6 нед, относительно исходного уровня IgG -антител к капсульным полисахаридам S. pneumoniae у взрослых больных и здоровых привитых ПКВ13 показал одинаковое нарастание специфических антител к 12 серотипам пневмококка. Различие выявлено только в отношении IgG -антител к смеси полисахаридов, входящих в состав вакцины ПКВ13, которые у пациентов с БА и ХОБЛ в поствакцинальном периоде регистрировались в более высоких титрах ( p < 0,001), чем у здоровых лиц. Заключение. Вакцинация ПКВ13 больных с БА и ХОБЛ безопасна и сопровождается синтезом IgG -антител к капсульным полисахаридам серотипов S . pneumoniae .
Atopic dermatitis is one of the most common diseases (20‒40% among skin diseases) that occur in both genders worldwide and in different age groups. The problem urgency is caused by an increase in morbidity, a chronic relapsing course that often leads to a decrease in the quality of life and disability, low efficiency of traditional treatment methods, and limited access to contemporary effective targeted therapy. The clinical guidelines, which aimed to optimize care for patients with atopic dermatitis, contain up-to-date information on epidemiology, etiological factors, mechanisms of development and pathogenesis, aspects of the clinical presentation and disease course, current diagnostic methods (including allergological examination methods), as well as approaches to treatment (including traditional methods and modern targeted therapy). The indications for allergen-specific immunotherapy are determined, and the aspects of its implementation are described. The procedure for the provision of medical care, prevention, and follow-up monitoring is outlined. Clinical practice guidelines for atopic dermatitis are intended for practitioners of all specialties, students, teachers of medical schools, residents, graduate students, and researchers.
Recently, more and more scientific works have been devoted to non-tuberculous mycobacteria, both by domestic and foreign researchers. One of the main reasons for this is the increase in patients with immunosuppression of various origins, improvement of the quality of laboratory and instrumental diagnostics of mycobacteriosis. This article focuses on the representatives of the M. fortuitum group, as the main pathogens among the group of fast-growing mycobacteria. The data on the modern classification based on the use of molecular genetic studies are indicated. The M. fortuitum group includes: Mycobacterium fortuitum, M. peregrinum, M. senegalense, M. porcinum, M. houstonense, M. neworleansense, M. boenickei, M. conceptionense, M. septicum, M. alvei. According to the new data, mycobacteria were divided into 5 clades (Abscessus-Chelonae, Fortuitum-Vaccae, Terrae, Triviale, Tuberculosis-Simiae), and based on molecular genetic studies, new genera in the Mycobacteriaceae family were isolated: Mycolicibacter spp., Mycolicibacillus spp., Mycolicibacillus spp., Mycobacteroides spp., Mycolicibacterium spp. In accordance with the new classification, representatives of the Mycobacterium fortuitum group belong to the genus Mycolicibacterium. The main epidemiological features of the main sources of the spread of mycobacteria, factors and ways of their transmission are indicated. Due to their wide distribution in the environment, representatives of the M. fortuitum group are capable of causing diseases of the pulmonary and extrapulmonary localization. The distinctive features of pathogenicity factors, due to which the course of the disease is determined, are noted. The article also indicates the main difficulties and features of determining the sensitivity to antimicrobial chemotherapy drugs, provides data on the main features of antibiotic resistance of M.fortuitum group. In preparing the review, literature sources obtained from international and domestic databases were used: Scopus, Web of Science, Springer, RSCI.