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

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.