Personalized symbionic therapy of campylobacteriosis protracted course in children

Abstract

Campylobacteriosis is one of the most common bacterial intestinal infections with high risks of severe and prolonged infection in childhood. The growing incidence of campylobacteriosis, the variety of clinical forms of the disease, the difficulties of timely diagnosis of the infection against the background of a high level of resistance of the microorganism to a number of antibacterial drugs determine the need to optimize the rational tactics of treating this infectious disease. One of the possible ways to overcome these difficulties is to further expand the use of probiotics and autoprobiotics. Aim: to reveal the features of the influence of autoprobiotic and probiotic E. faecium strains on clinical and laboratory parameters in children with non-smooth forms of campylobacteriosis .. Materials and methods: In the period from 2018 to 2020. In DNCIB FMBA, a comprehensive single-center prospective dynamic open observational study of 34 children with an uneven course of campylobacteriosis was carried out. For therapeutic purposes, patients were prescribed an autoprobiotic (group A; n = 15) or a probiotic strain E. faecium (group P; n = 19). Clinical and laboratory parameters and indicators of the intestinal microbiocenosis composition were assessed by real-time PCR. Results: Studies of the effect of two different approaches to prescribing probiotic strains of enterococcus to children with a protracted course of campylobacteriosis - a conditionally “reference” industrial strain E. faecium L3 and autoprobiotic strains with a comparable frequency (88.9% and 93.3% of cases, respectively) revealed their significant positive impact on the course of protracted forms of campylobacteriosis, which was expressed by the disappearance of abdominal pain syndrome, normalization of the frequency and consistency of stools, relief of hemocolitis in the absence of undesirable side effects. Analysis of the dynamics of coprograms before and after taking autoprobiotics and probiotic E. faecium L3 also did not reveal significant differences: there was an equivalent positive dynamics in the form of improvement in most of the macroscopic and microscopic characteristics of the stool. The study of the composition of the intestinal microbiota showed that after the course of administration of autoprobiotic strains of E. faecium, there was a significant increase in the content of butyrate-producing indigenous representative - F. prausnitzii, which promotes the repair of the intestinal mucosa. The studies also showed that the course use of autoprobiotic strains of enterococcus contributed to a decrease in the frequency of convalescent release of campylobacter, which suggests a sanitizing effect of autoprobiotics and does not exclude a similar effect in relation to other bacterial pathogens of intestinal infections in children.

Liver Damage in Campylobacteriosis in Children (Clinical Case)

“…Campylobacter jejuni и Campylobacter coli -два наиболее распространенных вида кампилобактерий, входящих наравне с сальмонеллами в число двух ведущих причин острых кишечных инфекций [1]. Важное значение в заболеваемости играют и другие виды: Campylobacter upsaliensis, Campylobacter lari и Campylobacter fetus, которые могут вызывать серьезные системные инфекции во всех возрастных группах, особенно у пациентов с ослабленным иммунитетом [6].…”

“…Исследования на здоровых добровольцах, а также данные наблюдений за вспышками показали, что количество бактерий, необходимое для развития кампилобактериоза у людей, может составлять не более 500 микроорганизмов [7,8]. Пациенты со сниженной кислотностью желудка, в том числе получающие ингибиторы протонной помпы [9] и дети [6], могут подвергаться более высокому риску заражения Campylobacter spp. Инфекция обычно распространяется в дистальном отделе подвздошной и толстой кишки и первоначально вызывает осмотическую диарею.…”

“…Clinical Case и крови), болью в животе, лихорадкой, тошнотой и рвотой [6,18,19]. У детей клинические проявления кампилобактериоза могут также имитировать картину острого аппендицита и инвагинации кишечника [19].…”