Features of the microbial landscape of the upper respiratory tract in children with microaspiration syndrome with damage to the central nervous system
Background. Pathology of the respiratory system ranks first in the structure of the morbidity in children of all age groups. One of the factors leading to the protracted course of bronchitis or recurrent broncho-obstructive syndrome is microaspiration. Children with neurological disorders have a high risk of both acute and chronic microaspiration. The purpose is to study the characteristics of respiratory pathology and the microbial landscape of the upper respiratory tract in children with microaspiration syndrome on the background of damage to the central nervous system (CNS). Materials and methods. A comprehensive survey was conducted in 30 children aged 1 month to 12 years (the average age of patients was 4.60 ± 0.03 years) with CNS pathology. The main group consisted of 18 children with perinatal CNS damage who had prolonged and recurrent bronchitis in the past medical history, the comparison group — 12 respiratory asymptomatic children with perinatal CNS damage. The study included a detailed medical history, an objective examination of children and laboratory and instrumental methods. The microbial spectrum of the upper respiratory tract was investigated in all patients by deep smear from the oropharynx. For statistical processing of the results obtained, the program Statistica 13.0 was used. Results. It was found that microaspiration syndrome occurs mainly in children with severe combined pathology of CNS. Respiratory pathology in these patients is characterized by recurrent bronchitis (the average frequency per year is 5.9 ± 0.4), its early manifestation (the average age of bronchitis onset is 4.4 ± 0.5 months) and a protracted course (average duration of bronchitis is 1.5 ± 0.1 months). The peculiarity of the microbial landscape of the upper respiratory tract in children with microaspiration syndrome against the background of central nervous system damage is the dominance of intestinal opportunistic microflora (Klebsiella pneumoniae, Proteus vulgaris, Proteus mirabilis) and also Pseudomonas aeruginosa and Candida. Conclusions. The obtained results are of practical importance for the selection of the starting antibacterial drug for the treatment of prolonged bacterial bronchitis in children with microaspiration syndrome on the background of CNS damage.
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