[Microbial intestinal biocenosis in lingering and complicated course of community pneumonia].

AIM: To characterize species and quantitative composition of intestinal microflora in lingering and complicated course of community pneumonia (CP). MATERIAL AND METHODS. The trial enrolled 130 CP patients and 30 healthy controls. Severe and moderate CP was diagnosed in 118 patients, mild CP--in 12 patients. In 36 (27.6%) patients the disease stayed long. Among the complications (47.7%) there were respiratory insufficiency of degree I-II (n = 29), exudative pleurisy (n = 7), toxic shock (n = 6), abscess of the lung (n = 5), acute vascular failure (n = 5), chronic renal failure (n = 5), DIC syndrome (n = 3), myocarditis (n = 2). Intestinal microflora was studied quantitatively and qualitatively using domestic materials. RESULTS: Dysbacteriosis often accompanies CP--42.3% in acute period, 18.8% in convalescence. Dysbacteriosis was more severe in severe CP. Compared to healthy controls, CP patients' intestine contains low content of bifidobacteria (100-fold), nonpathogenic enterococci and escherichia with normal enzymatic activity (10-fold and more). The number of saprophytic and epidermal staphylococci is very high- a 100-fold rise. In lingering pneumonia 2-3 times more often than in mild acute CP feces contain escherichia with low enzymatic activity, lactose-negative, staphylococci. Patients with pneumonia complications had dysbacteriosis of degree I, II, III and IV in 19.4, 30.4, 8.1 and 6.5% cases, respectively. CONCLUSION: Long-term administration of antibiotics in patients with lingering and complicated CP destroys balance of intestinal microflora and thus influences the course of CP. This dictates the necessity to conduct fecal microflora analysis in patients with CP irrespective of intestinal diseases.

[The characterization of the intestinal microflora in patients with extrahospital pneumonia].

One hundred and sixty patients, including 130 patients with extrahospital pneumonia (EHP), were examined. The control group consisted of 30 practically healthy subjects. All the EHP patients (86 males and 44 females aged 18 to 70 years) underwent complex clinicolaboratory examination. The results of ECG and chest radiography were taken into consideration in addition to complaints, disease history, and objective parameters to characterize the degree of EHP and the phase of the process. The qualitative and quantitative compositions of the intestinal microflora were studied according to recommendations of USSR Public Health Ministry (1987) using Russian nutrient media and reagents. The degree of dysbacteriosis was determined according to the classification by I. B. Kuvayeva et al. (1991), supported by other researchers. Some qualitative and quantitative changes in the obligatory and facultative intestinal microflora were found in 42.3% of EHP patients. Intestinal dysbacteriosis was revealed in 8.3% of patients with mild EHP, in 34.8% of patients with moderate EHP, 52.8% of patients with severe EHP, 86.1% of patients with protracted EHP, and 64.5% of patients with complicated EHP. Thus, EHP in most patients was accompanied by more or less severe intestinal microflora disturbances, which frequently were of latent character. The degree of dysbacteriosis tended to grow along with the severity of the disease.