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"Child`s Health" 1 (52) 2014

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Characteristic of colon microbiocenosis at preschool children suffering community-acquired pneumonia associated with iron deficiency anemia

Authors: Smiyan O. I., Vasylyshyn Kh. I., Binda T. P., Kozlova K. G. – The Sumy State University, Ukraine

Categories: Pediatrics/Neonatology

Sections: Clinical researches

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Keywords

community-acquired pneumonia, bowel microbiota, children.

An important physiological role in the body of the child has a normal intestinal microflora, which in connection with person’s microorganism is regarded as a kind of extracorporeal organ. According to several authors, 88.6 % of children with acute respiratory diseases reveal disbiotic changes of intestinal micro flora. Among patients with pneumonia revealing frequency of the third level dysbiosis is 44.4 %, and besides quantitative violations there occurs also a high-quality disintegration of components of micro ecological system. .

Objective: To investigate the qualitative and quantitative changes in micro biota of the colon at preschool children, patients with community-acquired pneumonia (CAP) associated with iron deficiency anemia (IDA).

Materials and methods:

We examined 48 children between the ages of one and three years old about the CAP who were treated in the infection department number 1 of Sumy Region St. Zenaida’s Children's Hospital for the period from 2011 to 2013. The patients were divided into two groups. Group I included 25 children with CP without IDA. Group II included 23 patients with CAP associated with IDA of light degree. The control group included 18 healthy children of appropriate age and gender.

Studying the peculiarities of micro flora composition was performed according the method developed by R.V. Epstein-Litvak (1977), and was based on a quantitative count of bacteria , which are displayed in a 1gr.dissolved feces ,sowed on selective culture medium.

Studies were carried out during the acute illness (for 1 day admission to hospital) and the period of early recovery and cancellation etiotrop treatment (10–14 days).

Results and Discussion

The studies revealed significant changes in the quantitative and qualitative composition of the colon micro flora at children with CAP.

When analyzing disbiotic changes of the colon at children with CP without IDA at the beginning of the disease was found a significant decrease in the number of bifida (p < 0.001) and lactobacilli (P < 0.001), Escherichia coli (p< 0.001) and an increase of containing the UPI (p < 0.01), staphylococci (p < 0.001), and fungi of the genus Candida (p < 0.001) compared to the control group.

Similar changes in micro-ecology of the colon at the beginning of hospitalization were observed at children with CP with IDA. At patients with CAP with IDA compared with the data of healthy children were identified significant reduction in the amount of bifida bacteria (p < 0.001), Lactobacillus (p < 0.001), Escherichia coli (p < 0.001) increase in TPC (p < 0.001), Staphylococcus (p < 0.001), and fungi of the genus Candida (p < 0.001).

When comparing the colon micro flora at children of groups I and II at the beginning of the disease, it was found that patients with CAP with IDA had a significant decrease in the intensity of colonization by bifida bacteria (p < 0.05), lactic acid bacteria (p < 0.05) and a significant increasing the number of TPC (p < 0.05) against the relevant indicators at children with NP without IDA.

Estimating changes in the composition of intestinal micro flora at children with CP in both groups after standard treatment showed no positive dynamics. Thus, at children in group I the number of bifida bacteria, lactobacilli, Escherichia coli, UPM, Staphylococcus and Candida fungi did not change significantly (p > 0.05).

At children with CP with IDA after treatment the number of lactic acid bacteria, Escherichia coli, TPC, staphylococcus and fungi of the genus Candida has not changed relatively to the acute period, while containing of bifida bacteria was significantly reduced (p < 0.05).

At the end of treatment indicators such as total number of bacteria and bifida bacteria at children of group II compared with patients in group I were significantly lower (p < 0.05 ), and the titer of UPM – significantly higher ( p < 0.05).

Thus, significant changes of qualitative and quantitative composition of the colon micro flora at children with CAP conditioned by decrease in the detection rate of the indigenous micro flora and increased contamination of given pathogenic and conditionally – pathogenic microorganisms.

Conclusions:

1. The changes of the intestinal micro flora of children with community-acquired pneumonia in the acute phase was characterized by reduction in the number of bifida bacteria – and lactobacilli, intestinal bacillus and increasing the titer of yeast fungi, staphylococci and other representatives of the conditional – pathogenic organisms.

2. The revealing degree of misbalance of the colon biocoenosis depended on the presence of concomitant iron deficiency anemia. More significant changes in the micro flora found themselves at children with community-acquired pneumonia associated with iron deficiency anemia.

3. After conducting standard treatment at children with community-acquired pneumonia, a decrease of bifid bacteria – and lactobacilli title, intestinal bacillus and increasing the number of yeast fungi, staphylococci and other representatives of the conditional – pathogenic organisms. At the same time, during convalescence the number of bifid bacteria and intestinal bacillus at the children of group II was significantly reduced, and the number of UPM significant increase compared with those in group I patients.

4. Disturbance of the colon micro-ecology at children with community-acquired pneumonia associated with iron deficiency anemia can be the basis for inclusion in the complex of pathogenic probiotic therapy aimed at correcting the disturbance.


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