[ANTIBIOTICS SENSITIVITY OF STAPHYLOCOCCUS AUREUS, PSEUDOMONAS AERUGINOSA AND BACTERIA OF BURKHOLDERIA CEPACIA COMPLEX, PERSISTING IN LUNGS OF PATIENTS WITH MUCOVISCIDOSIS (MV)].

AIM: Study the spectrum of resistance to antibiotics and its variability of Staphylococcus aureus, Pseudomonas aeruginosa and Burkholderia cepacia complex (BCC), persisting in lungs of MV patients. MATERIALS AND METHODS: 312 strains of S. aureus, 213 strains of P. aeruginosa, 186 strains of BCC were studied. Monitoring of antibiotics sensitivity was carried out in strains, isolated from 30 patients with chronic S. aureus infection, from 22 patients with chronic BCC infection and from 21 patients with chronic pseudomonas infection. Interval of monitoring was from 14 days to 5 years 7 months. RESULTS: Study of S. aureus, P. aeruginosa and BCC strains has shown, that 35 and 33.3% of cases of staphylococcus infection, 37 and 46% of pseudomonas infection in children and adults, respectively, 100% of BCC infections were determined by multi-resistant clones. Study of genotypically identical strains, isolated from a single patient at different stages, has shown a change in antibiotics sensitivity as a result of persistence. CONCLUSION: Persisent infection of lungs in patients with MV is determined: by exchanging clones with varying antibiotics sensitivity or prolonged circulation of a single clone with a high degree of phenotypical and genotypical variability, that determine alteration of seeding of sensitive and resistant strains from the same patient during monitoring. This confirms the necessity of study of antibiotics sensitivity of strains for prescription of antibacterial therapy.

[Use of high-frequency chest wall oscillation in an exacerbation of chronic pyo-obstructive bronchitis in adult patients with cystic fibrosis].

AIM: To evaluate the efficiency of high-frequency chest wall oscillation in the treatment of an exacerbation of chronic pyo- obstructive bronchitis in adult patients with cystic fibrosis (CF). SUBJECTS AND METHODS: A simple open-label comparative study enrolled 31 patients with CF. C-reactive protein (CRP), spirometric indicators (forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow), hemoglobin oxygen saturation, anthropometric data, six-minute walk test, and dyspnea rating by the MRC scale were assessed before treatment and on the last day of hospitalization. All the patients received conventional drug therapy; the study group patients (n=15) had the latter in combination with vibration-compression therapy for 15 minutes twice daily at a vibration frequency of 9-12 Hz and at an amplitude of 6-9 bars; the treatment cycle lasted 12-14 days. RESULTS: Both groups showed significant changes in spirometric and pulsometric readings, 6-minute walk test results, and MRC score. Body mass index increased and CRP decreased in the majority of patients in both groups. There were significant group differences in functional and anthropometric changes: 10.0 ± 4.6 and 6.9 ± 3.6% for FEV1 (p = 0.04) and 9.5 ± 4.8 and 5.9 ± 3.8% for FVC (p = 0.03) in the study and control groups, respectively. CONCLUSION: Incorporation of vibration-compression therapy (Vest vibro drainage) into the combination treatment of adult patients with CF results in significantly improved bronchial patency and more effective abolishment of an exacerbation.