ECOLOGICAL ANALYSIS OF OPPORTUNISTIC MICROFLORA IN PNEUMONIA. Actuality: Purulent-inflammatory diseases of the respiratory tract are more often induced (under the influence of different triggers) by endogenous microflora. One of the factors that determine the appropriateness of the choice of antibiotics and, therefore, the beneficial outcome of the disease is the microbial spectrum of causative agents of infection. At the present time, there is increasing information on changes in the composition of human microbiota at various diseases and its role in the pathogenesis of various disorders, including respiratory diseases. Objective: Studying the species composition of the microflora in non-hospital pneumonia and the determination of the participation of different species in the structure of microbiocenosis. Materials and methods: Bacteriological research of various clinical materials from 336 patients with pneumonia is conducted. Microbiological examination included an isolation of pathogens, identification by morphological, cultural and biochemical properties. An ecological analysis of the microflora of clinical material was carried out by studying its structure and functional characteristics using indicators such as the index of constancy, the Berger-Parker domination index. Results and discussion: During the study of micro-ecological indicators of microflora of patients with pneumonia, the distribution of endogenous microorganisms of nasopharynx in the biocenosis of lungs was revealed, which was confirmed by the indices of constancy and the dominance of Berger-Parker. In the etiological spectrum of infectious factors, fungi of the genus Candida and streptococci of viridans group, which had a high colonization level, were prevailed. Microorganisms were isolated in both a monocultural and associative form, which contained two to five species. Combinations of bacteria and fungi of the genus Candida were the most common, which were registered at 80.7 % (152/187). The associations included not only autochthonous bacteria but also non-specific habitats such as K. pneumoniae, P. aeruginosa, E. coli, E. cloacae, E. aerogenes, E. faecalis, E. faecium, P. vulgaris, P. mirabilis, C. xerosis and A. baumonii. Conclusion: The obtained data have shown that the lungs of patients with pneumonia are actively colonized by the representatives of the microflora of the nasopharynx with certain qualitative and quantitative changes of microbiocenosis. This is manifested in the emergence of transient and random opportunistic microorganisms against the background of reduced domination of the autochthonous

Objective: to study the dynamics of the detection of resistance to antibiotics of the infectious agents of the ENT organs in 2011 and 2016. Material and methods. The study of the sensitivity of microflora to antibiotics was performed by the diffusion method in agar (standard disk method) in accordance with the Order of the Ministry of Health of Ukraine No. 167 dated 05.04.2007. Results. The study has found growth of the resistance of the bacterial flora isolated from the ENT organs to some fluoroquinolones (norfloxacin, ciprofloxacin, levofloxacin), aminopenicillins (ampicillin, amoxicillin), macrolides (azithromycin) maintaining its sensitivity to meropenem, tygecycline and cephalosporins, especially to cephoperazone, ceftriaxone, and cephepime. Conclusion. Active antibiotic therapy over the past five years has led to a sharp decrease in the sensitivity of the pathogens of ENT infectious diseases to traditional drugs used for empirical therapy. It is necessary to monitor the sensitivity of microorganisms to antibiotics in each region in order to determine the tendency of resistance of the leading etiological agents to antibiotics.

В ходе исследования выявлено, что ведущая роль в этиологии инфекционных заболеваний верхних и нижних дыхательных путей принадлежала Streptococcus viridans и грибам рода Candida. Удельный вес грибов рода Candida составлял 28,8 % у больных фарингитами, 22,6 % — у больных бронхитами и 37,4 % — у больных пневмонией, которые в 77–85,6 % случаев были представлены ассоциациями с бактериями. Отмечался высокий уровень резистентности грибов рода Candida к триазольным антимикотикам.