RESULTS OF THE USE OF COMBINED PROBIOTIC THERAPY FOR THE CORRECTION OF INTESTINAL MICROBIOCENOSIS DISORDERS IN PATIENTS WITH MULTIDRUG-RESISTANT TUBERCULOSIS OF THE PATHOGEN

Abstract

Introduction. About 90% of TB patients have side effects of anti-TB therapy in the form of gastrointestinal disorders. Currently, the role of disorders of the intestinal microbiocenosis in the formation of dyspepsia has been proven. In turn, dyspeptic syndrome leads to a decrease in patient adherence to treatment, which affects the effectiveness of tuberculosis treatment. The most dangerous in this regard are second-line anti-tuberculosis drugs used in the treatment of drug-resistant tuberculosis. Long-term use of these drugs requires the development and implementation of algorithms for the correction of microecological disorders of the intestine. The aim of the study was to evaluate the microbiological results of using a combined probiotic in persons with tuberculosis and multidrug-resistant pathogen in the course of anti-tuberculosis therapy. Material and methods. A prospective linear study included 30 patients with respiratory tuberculosis and multidrug-resistant pathogen. The study consisted in a two-stage study of the microbiocenosis of the intestinal biotope of these patients by a quantitative bacteriological method before and after combined probiotic therapy with a further comparison of the number of microorganisms. Statistical data processing was performed using the IBM SPSS program. Qualitative signs are represented by absolute and relative frequencies, expressed as a percentage, with 95% confidence intervals calculated for them by the Wilson method (rel.% [95% CI]). Quantitative data are presented in the work in the format of the median and interquartile range (Me (25th; 75th). For variables related to the ordinal scale and nonparametric quantitative variables, the Mann-Whitney U test was used to compare the two groups of observations. the compared groups were considered statistically significant with a statistical significance of less than 0.05. Results and discussion. The use of combined probiotic therapy in patients with multidrug-resistant tuberculosis did not compensate for the deficiency of obligate microorganisms - Bifidobacterium spp., Lactobacillus spp. However, in the process of probiotic therapy noted a decrease in the concentration of Enterococcus spp., E. Coli lac-, E. Coli hly +, Streptococcus spp., as well as a decrease in the titers and species structure of fungi of the genus Candida. A clinical example showing the microbiological and clinical efficacy of probiotic therapy in a patient with co-infection TB / HIV. Despite the changes received, the average population indicators for the region have not been achieved. Conclusion. It was found that the use of combined probiotic therapy in patients with multidrug-resistant tuberculosis led to a decrease in the pool of opportunistic microorganisms in the intestinal lumen and had a positive clinical effect in a patient with TB / HIV co-infection.