Ledneva V.S.,Voronezh State University |
Ul'yanova L.V.,Voronezh State University |
Talykova M.I.,Voronezh State University |
Burdina N.S.,Voronezh State University |
And 5 more authors.
Voprosy Prakticheskoi Pediatrii | Year: 2016
The objective. A comparative monitoring of sputum of two groups of children with cystic fibrosis to ensure rational therapy for exacerbation of brochopulmonary process. Patients and methods. From 2006 to 2015, 654 samples of sputum were examined, which were obtained from 34 children of group 1 as compared with results of testing 423 samples of sputum and throat swabs of 41 patients of group 2. The children's age was 1 month to 10 years. Group 1-34 children with cystic fibrosis (CF) with mixed and a predominantly pulmonary form of disease, aged 1 month to 6 years, in whom CF was diagnosed by the findings of neonatal screening. Group 2-41 patients with CF with mixed and a predominantly pulmonary form aged 6 to 23 years, who were on medical records before introduction of neonatal screening for CF in the region. Results. In patients of group 2 diagnosis was made at the age of 1 to 3 years, and adequate therapy began later than in patients of group 1 (p < 0.01). In group 1, during the first year of life staphylococcus aureus was inoculated in 9 (26%) patients, alphahemolytic streptococcus-in 10 (29%), blue pus bacillus infection in monoculture-in 1 (2.9%) and was recorded as transient carriage at the age of 1 year, which significantly differs from the microlandscape of patients in group 2: by the age of 1 year the frequency of inoculation of blue puss bacillus infection amounted to 38% (15 patients), staphylococcus aureus-42% (17 patients) (p < 0.05). Chronic colonization of blue puss bacillus infection significantly more rarely occurred in patients of group 1 (17 and 37% in groups 1 and 2, respectively, p < 0.01). Conclusion. Analysis of the microbial spectrum of sputum in patients with cystic fibrosis has shown that chronic blue puss bacillus infection was more frequently diagnosed in patients with a severe variant of disease. Patients with CF diagnosed under the neonatal screening, there were significantly less cases of inoculation of this pathogen, which is indicative of a later colonization of the bronchial secretion by aggressive, therapy-resistant pathogens in patients in case of early diagnosis and adequate therapy of disease.