Management of patients with ulcerative colitis with account of microbiological examination of bioptate of colon wall

Abstract

Ulcerative colitis (UC) is a common disease with the evident tendency to annual increase in incidence. The disease mostly affects young individuals of active working age. The peak of incidence of the disease is observed at the age of 20-29 and 50-55 years.

The aim of study was optimization of diagnostics and management of patients with ulcerative colitis by correction of antibacterial therapy on the basis of the data of microbiological examination of the microflora of the wall of colon.

Materials and Methods. 35 Patients with ulcerative colitis from 28 to 61 years of age with the average age 37.6 years who underwent outpatient and stationary treatment in colonoproctology and gastroenterology departments of SamSMU clinics in the period from January to May 2017 were examined. Of them, 18 were males (48.6%) and 17 females (51.4%).

Results. Significant species diversity of microflora was identified that requires exact species identification and development of standard procedures for isolation of microorganisms from bioptates of patients with ulcerative colitis with the aim of administration of antibacterial treatment. In analysis of sensitivity of the isolated strains to antibiotics 45% of the isolated microorganisms were found to have signs of resistance to 1-2 groups of medical drugs, and 33% showed signs of resistance to 3 and more groups. Only 22% of strains were found to be sensitive to all tested preparations. Eradication of such flora presents certain difficulties, and in our opinion, requires administration of combined therapy after examination of bioptate.

Conclusions. All patients with ulcerative colitis require examination of the microbial composition of the intestinal wall for optimization of diagnostics and treatment. 10⁵-10⁶ titer of microorganisms, their wide species diversity may support inflammation in the colon and prevent relief. It is necessary to continue study of microbiological composition of the colonic wall in the comparative aspect for optimization of diagnostics and management of patients with ulcerative colitis.

Keywords

ulcerative colitis / microflora / biopsy / antibiotic therapy

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RIGHTS & PERMISSIONS

Davydova O.E., Andreev P.S., Katorkin S.E., Lyamin A.V., Kiseleva I.V., Lichman L.A., Bistrov S.A.