SPECTRUM OF NON-SPECIFIC MICROFLORA IN PULMONARY TUBERCULOSIS PATIENTS IN THE REGIONS OF SIBERIA AND THE FAR EAST

Introduction. Disruption of the lung microbiota in tuberculosis patients contributes to the aggravation of the course of the underlying disease, increased processes of alteration and exudation in the lesions, and a decrease in the treatment efficacy. Depending on the parameters of the external environment and the characteristics of the tuberculous process, the nature of the nonspecific microflora may change. Current data on monitoring the prevalence of nonspecific microflora are important for choosing a correct chemotherapy regimen. Aim: to study the spectrum of nonspecific microflora in inpatients admitted from the regions of Siberia and the Far East with different clinical forms of pulmonary tuberculosis. Materials and Methods. Microbiological studies of sputum samples from 520 pulmonary tuberculosis patients were analyzed, who were at the inpatient stage of treatment in the period of 2021-2022, using generally accepted bacteriological methods. The statistical significance of differences was assessed using the Chi- square test and considered significant at p ≤ 0.05. Results and Discussion. Of the 520 patients in the study, there were 472 patients from the regions of Siberia, 48 people from the regions of the Far East (Novosibirsk Oblast, Omsk, Republic of Tyva, Republic of Khakassia and Altai Territory, Amur Region, Kamchatka Territory, and Republic of Yakutia). In total, in sputum cultures of the pulmonary tuberculosis patients under study, bacterial flora was detected in 52% of cases, while fungal flora was found in 48% of cases; there were mainly Saccharomycetaceae, Enterobacteriaceae, and Staphylococcaceae, to a lesser extent there were Pseudomonadaceae and Yersiniaceae. The nonspecific microflora families and species composition of were similar in the regions of both districts. Conclusions. In the sputum of patients from the regions of the Siberian and Far Eastern Federal Districts, predominantly fungal microflora (C. albicans) was detected because of long-term antibiotic therapy. Bacterial microflora was more often represented by gram-negative species, such as H. parainfluenzae, Kl. pneumoniae, E. coli, etc. In this sample of patients, there was no significant difference between the regions of the Siberian and Far Eastern Federal Districts in the composition and ratio of families and species of nonspecific microflora. With drug-resistant strains of Mycobacterium tuberculosis, the growth of nonspecific microflora increased almost twice and, on the contrary, decreased almost 3 times for the families of Alcaligenaceae and Streptococcaceae. Bacterial nonspecific microflora mainly showed sensitivity to broad-spectrum antibiotics, nonspecific in the treatment of tuberculosis. S. aureus and Kl. pneumoniae remained susceptible to fluoroquinolones and amikacin, respectively. In all tuberculosis forms, fungal microflora prevailed. In fibrous-cavernous and infiltrative forms and in tuberculoma, bacteria of the Pseudomonadaceae family were cultured significantly more frequently (p<0.05) than in disseminated tuberculosis.