ФоРМиРоВание БиоПлЁнок оППоРТУниСТиЧеСкиМи МикРооРганиЗМаМиМалафеева Э.В., гульнева М

The paper gives the data available in the literature on the role of opportunistic microorganisms (OMs) in rheumatic diseases (RDs). OMs are anticipated to be involved as triggers initiating the development of chronic inflammation. Along with this, OMs in autoimmune diseases may play a defensive role through the interaction with Toll-like receptors and the activation of T cells that have suppressor activity. The possible involvement of OMs in the pathogenesis of RDs provides support not only the isolation of microorganisms, but also the detection of antibacterial antibodies of different classes. Of great importance are OMs in the etiology of comorbid infections, the risk of which is due to both the presence of autoimmune RDs and the necessity of using the drugs having immunosuppressive activity. The active clinical introduction of biological agents is followed by a rise in the rate and severity of different infections, including those caused by OMs. Having a marked biological and environmental plasticity, OMs are able to persist long when there are changes in the immune defense of patients with RDs. There is evidence for the higher adhesive properties and persistent potential of the microorganisms that colonize the body of patients with RDs. In the latter, OMs that are distinguished by pronounced antibiotic polyresistance are isolated, making the treatment and prevention of opportunistic infections more difficult in rheumatology. The results of the papers analyzed in the review suggest that the study of OMs in RDs is of practical importance.

A study of quality of life in patients with rheumatoid arthritis development of varying degrees of violations of the microflora of the large intestine and found that the development of disorders of the intestinal microflora is accompanied by a significant change in the quality of life of patients. In patients with varying degrees of violations of microbial gut microbiota observed decline in physical and psychological components of health. The lowest values of quality of life in patients fitted with the II degree of microbiological violations microbiota of the large intestine.

The study was carried out concerning capability of 194 strains of opportunistic microorganisms to form bio-films. It is established that bacteria ecizing organism of patients with rheumatic diseases have capacity to form microbial bio-films. The formation of bio-films is manifested with the same rate as in agents of inflammatory processes. At that, Escherichia coli, Staphylococcus haemolyticus and bacteria of genus Proteus isolated under rheumatic diseases have significantly higher capability to form biofilms that matters for development of comorbide infections.

Specific features of colonic microbiocenosis were investigated in 64 patients presenting with osteoarthritis. They were divided into 4 groups including patients with the normal body weights and those with grade I, II, and III obesity respectively. The qualitative and quantitative analysis of intestinal microflora was performed by the bacteriological method. It was shown that obesity was associated with an increased frequency of isolation of enterococci despite their decreased content. Simultaneously, variations in the diversity of opportunistic microorganisms were documented. Alterations in the qualitative and quantitative composition of intestinal microbiocenosis in the patients with osteoarthrosis depended on the degree of obesity. Grade III obesity was associated with the most pronounced decrease in the occurrence of bacteroids, entercococci, and lactose-positive coliform bacteria. It is concluded that the development of dysbiosis in the large intestine should be taken into consideration in the choice of combined therapeutic strategy for the treatment of the patients with osteoarthritis and concomitant obesity of different severity.

Выполнено изучение наличия и уровня антител к условно-патогенным бактериям в сыворотке крови больных ревматическими заболеваниями. Определение IgG антител к бактериальным антигенам проведено иммуноферментным методом (ИФА). У больных с ревматическими заболеваниями установлено увеличение частоты обнаружения и уровня IgG антител к бактериальным антигенам условно-патогенных микроорганизмов. Достоверно чаще выявлялись антитела к антигенам микроорганизмов с более выраженными признаками патогенности.

Изучен персистентный потенциал 157 штаммов микроорганизмов, 83 штамма выделены у больных ревматическими заболеваниями. Выявлено повышение распространения антилизоцимной активности условно-патогенных микроорганизмов, колонизирующих организм больных ревматическими заболеваниями. Штаммы стафилококков и кишечных бактерий, выделенные у больных ревматическими заболеваниями, отличались высокой антилизоцимнои активностью, а культуры S. epidermidis и E. coli характеризовались выраженной антилактоферриновой активностью.

The purpose of the investigation was to study the quantitative and qualitative composition of colon microflora in system connective tissue diseases and system vasculites. The authors studied colon microflora in patients with systemic lupus erythematosus, systemic scleroderma, nodular polyarteritis, and hemorrhagic vasculitis. The structure of symbiotic interrelations between microorganisms participating in the formation of colon microbiocenosis was determined. Colon microflora was found to be disordered in terms of its qualitative and quantitative composition. The predomination of anaerobic microorganisms was decreased, while the role of conditionally pathogenic bacteria was increased. The number of lactobacteria was significantly lowered; bifidobacteria and bacteroids were found frequently, while their number was substantially lowered as well. Conditionally pathogenic microorganisms and bacteria with hemolytic activity acquired high significance in the forming of the colon microbiocenosis of the patients. The frequency of the isolation and the density of colon colonization with staphylococci and conditionally pathogenic enterobacteria were significantly increased. General trends and peculiarities of changes in the quantitative and qualitative composition of colon microflora in some rheumatic diseases were determined. The data on the peculiarities of the colon microbiocenosis in these patients may be used to substantiate methods of complex therapy including correction of dysbiotic disturbances.

The authors studied the course of the disease in the postoperative period in 308 patients with carcinoma of the rectum. The literature data and personal experience made it possible to reveal the high frequency of purulent complications among this category of patients. In view of this, the values of humoral and cellular metabolism were studied in some patients with uncomplicated forms of rectal carcinoma. Special attention was given for the first time to the peculiarities of local defence reactions of the peritoneum.

Изучен персистентный потенциал 157 штаммов микроорганизмов, 83 штамма выделены у больных ревматическими заболеваниями. Выявлено повышение распространения антилизоцимной активности ус-ловно-патогенных микроорганизмов, колонизирующих организм больных ревматическими заболеваниями. Штаммы стафилококков и кишечных бактерий, выделенные у больных ревматическими заболеваниями, от-личались высокой антилизоцимнои активностью, а культуры S. epidermidis и E. coli характеризовались вы-раженной антилактоферриновой активностью.Ключевые слова