The structure of the incidence of acute intestinal infections in children of the Southern Aral Sea region and bioimmune correction of intestinal microbiocenosis in shigellosis

Abstract

BACKGROUND: The microbiome of the gastrointestinal tract ensures colonization resistance of the intestinal epithelium, produces enzymes, and participates in nutrient metabolism. Changes in its composition lead to pathological conditions of the intestines.AIM: To determine the structure of the incidence of acute intestinal infections in children living in the Southern Aral Sea region and to characterize the effect of bioimmune correction of changes in the intestinal microbiome in children with shigellosis.

MATERIAL AND METHODS: In the period from 06.07.2020 to 05.10.2020, 179 children with intestinal infections aged 2 to 7 years living in an environmentally unfavorable zone of Southern Uzbekistan were examined. The children were divided into two groups: the first (32 children) received basic therapy (pathogenetic therapy, antibiotic therapy, diet), the second (11 children) received basic therapy with bioimmune correction with bifidobacteria bifidum (bifidumbacterin PL) and thymus peptides of sheep embryos and newborn lambs (immunomodulin). To characterize the microbiome, the material was screened on differential diagnostic media, identifying obligate, facultative and opportunistic microflora. To assess the statistical significance of differences between data groups, the Student's t test was used, taking p ≤0.05 as a significant level.

RESULTS: Shigellosis was diagnosed in 43 sick children (24% of those examined), escherichiosis was diagnosed in 34 (19%), salmonellosis was diagnosed in 30 (16.3%), and diarrhea of other bacterial etiology was diagnosed in 23 (13%) patients. In all variants, changes in the intestinal microbiome were detected. Etiotropic therapy led to an improvement in the general condition of patients, but did not affect dysbiotic changes in the intestines and did not contribute to the restoration of the microbiome. Bioimmune correction of dysbiosis in shigellosis in 11 patients using preparations of bifidobacteria bifidum and fetal thymic peptides led to the restoration of intestinal microflora to normal values: the number of lactose-negative E. coli significantly decreased by more than 5 orders of magnitude (p=0.037), fungi of the genus Candida (p=0.030) and enterococci (p=0.019) by 3 orders of magnitude, and staphylococci by 2 orders of magnitude (p=0.048).

CONCLUSION: The use of preparations of bifidobacteria bifidum and fetal thymus peptides as bioimmunocorrectors is a promising therapeutic strategy for shigellosis in children.

Keywords

intestinal microbiota / dysbiosis / bioimmune correction / bifidumbacterin PL / immunomodulin

References

[1] Crighton E, Barwin L, Small I, Upshur R. What have we learned? A review of the literature on children’s health and the environment in the Aral Sea area. Int J Public Health. 2011;56(2):125–138. DOI: 10.1007/s00038-010-0201-0.

[2] Turdybekova YG, Dosmagambetova RS, Zhanabayeva SU, Bublik GV, Kubayev AB, Ibraibekov ZG, Kopobayeva IL, Kultanov BZh. The Health status of the reproductive system in women living in the Aral Sea region. Open Access Maced J Med Sci. 2015;3(3):474–477. DOI: 10.3889/oamjms.2015.078.

[3] Tannock GW. Medical importance of the normal microflora. New York, NY: Springer; 1999. р. 3–22. DOI: 10.1007/978-1-4757-3021-0.

[4] Yesufa S, Ngaa N, Zelenikhin P, Sokolova E, Gataullin I, Ilinskaya O. Dysbiosis of cultivable aerobic microbiota tightly associated with colon cancer epithelial cells. Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2015;6(5):1658–1663.

[5] Javadzadeh VN. Probiotics and simbiotics applied of disboised of intestinal comparable characteristic factors of clinic laboratory of patients. Azerbaijan Medical Journal. 2013;1:45–48.

[6] Eremushkina YM. Principles of acute intestinal infections treatment. Russkiy meditsinkiy zhurnal. 2006;(1):61–66. (In Russ.)

[7] Ерёмушкина Я.М. Принципы лечения острых кишечных инфекций. Русский медицинский журнал. 2006;(1):61–66.

[8] Ploskireva AA, Gorelov AV. Tactics of probiotic therapy in acute enteric infections in children. Clinical practice in pediatrics. 2015;10(2):40–46. (In Russ.) EDN: TVTQOP.

[9] Плоскирева А.А., Горелов А.В. Тактика пробиотической терапии при острых кишечных инфекциях у детей. Вопросы практической педиатрии. 2015;10(2):40–46. EDN: TVTQOP.

[10] WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers. Geneva: World Health Organization; 2005. р. 20–31.

[11] Garib FY, Garib VF. Immunomodulin. Tashkent: Med. Iit. by Abu Ali Ibn; 2000. 240 p.

[12] Ministry of Health of the Republic of Uzbekistan. Registration number No. 27, 2023. State Register of medicines, medical devices and medical equipment approved for use in medical practice in the Republic of Uzbekistan 21–25. https://uzpharm-control.uz/uploads/pages/state-register-of-medicines-and-medical-products/files/REESTR-25-05-02-2021.pdf (access date: 17.05.2023). (In Russ.)

[13] Министерство здравоохранения Республики Узбекистан. Рег. номер №27, 2023 г. Государственный реестр лекарственных средств, изделий медицинского назначения и медицинской техники, разрешённых к применению в медицинской практике в Республике Узбекистан 21–25 гг. https://uzpharm-control.uz/uploads/pages/state-register-of-medicines-and-medical-products/files/REESTR-25-05-02-2021.pdf (дата обращения: 17.05.2023).

[14] Bifidumbacterin dry PL. Dosage and administration. https://apteka.uz/all/org/good/%7B02ee8d8f-70fc-4996-8331-5855afabf29b%7D#instruction (access date: 17.05.2023). (In Russ.)

[15] Бифидумбактерин сухой PL. Способ применения и дозы. https://apteka.uz/all/org/good/%7B02ee8d8f-70fc-4996-8331-5855afabf29b%7D#instruction (дата обращения: 17.05.2023).

[16] Immunomodulin. Dosage. https://apteka.uz/product/immunomodulin (access date: 17.05.2023). (In Russ.)

[17] Иммуномодулин. Дозировка. https://apteka.uz/product/immunomodulin (дата обращения: 17.05.2023).

[18] Metodicheskie rekomendatsii. Mikrobiologicheskaya diagnostika disbakterioza kishechnika. (Guidelines. Microbiological diagnosis of intestinal dysbacteriosis.) M.: Izdatel'stvo nauchno-issledovatel'skogo instituta epidemiologii i mikrobiologii im NF Gamalei; 2007. 74 p. (In Russ.)

[19] Методические рекомендации. Микробиологическая диагностика дисбактериоза кишечника. М.: Издательство научно-исследовательского института эпидемиологии и микробиологии им. Н.Ф. Гамалеи; 2007. 74 с.

[20] Modesto M. The Bifidobacteria and related organisms. Isolation, cultivation, and storage of Bifidobacteria. London: Elsevier Inc; 2018. р. 67–98. DOI: 10.1016/b978-0-12-805060-6.00004-1.

[21] Pozdeev OK. Meditsinskaya mikrobiologiya. Uchebnoe posobie. (Medical microbiology. Textbook.) Ed. VI Pokrovsky. 4th ed. M.: GEOTAR-Media; 2010. 768 p. (In Russ.)

[22] Поздеев О.К. Медицинская микробиология. Учебное пособие. Под ред. В.И. Покровского. 4-е изд. М.: ГЭОТАР-Медиа; 2010. 768 с.

[23] Nuraliev NA, Sadullaev OK, Saidov BO. Sposob kul'tirovaniya bifidobakteriy dlya mikrobiologicheskoy diagnostiki i korrektsii disbakterioza kishechnika. Ratsional'noe predlozhenie №10 ot 25.01.96. Vydano Khorezmskoy oblastnoy klinicheskoy bol'nitsey No. 1. (Method for cultivating bifidobacteria for microbiological diagnosis and correction of intestinal dysbacteriosis. Rational proposal No. 10 dated January 25, 1996.) Issued by Khorezm Regional Clinical Hospital No. 1. (In Russ.)

[24] Нуралиев Н.А., Садуллаев О.К., Саидов Б.О. Способ культирования бифидобактерий для микробиологической диагностики и коррекции дисбактериоза кишечника. Рациональное предложение №10 от 25.01.96. Выдано Хорезмской областной клинической больницей №1.

[25] Li Y, Xia S, Jiang X, Feng C, Gong S, Ma J, Fang Z, Yin J, Yin Y. Gut microbiota and diarrhea: An updated review. Front Cell Infect Microbiol. 2021;11:625210. DOI: 10.3389/fcimb.2021.625210.

[26] Baker S, The HC. Recent insights into Shigella. Curr Opin Infect Dis. 2018;31(5):449–454. DOI: 10.1097/QCO.0000000000000475.

[27] Chung TH, Le SH. Dynamic of the human gut microbiome under infectious diarrhea. Curr Opin Microbiol. 2022;66:79–85. DOI: 10.1016/j.mib.2022.01.006.

[28] Glotova AP, Mironova OM, Zaytseva LYu. The structure of dysbiotic disorders in children with salmonellosis, and how to correct them. Modern problems of science and education. 2019;(5):99–107. (In Russ.)

[29] Глотова А.П., Миронова О.М., Зайцева Л.Ю. Структура дисбиотических нарушений у детей, перенёсших острую кишечную инфекцию, и способы их коррекции. Современные проблемы науки и образования. 2019;(5):99–107.

[30] Novokshonov AA, Sokolova NV, Galeeva EV, Krapivina IV, Portnykh OYu. Probiotic Bifiform — an alternative to etiotropic antibiotic and chemotherapy for acute intestinal infections in children. Children infections. 2003;(3):36–40. (In Russ.)

[31] Новокшонов А.А., Соколова Н.В., Галеева Е.В., Крапивина И.В., Портных О.Ю. Пробиотик Бифиформ — альтернатива этиотропной антибиотико- и химиотерапии острых кишечных инфекций у детей. Детские инфекции. 2003;(3):36–40.

RIGHTS & PERMISSIONS

Eco-Vector