Characteristics of the anaerobic microbiota of the respiratory tract of children with cystic fibrosis

The study of the potential role of anaerobic bacteria in CF and their involvement in the pathophysiology of CF is important for understanding the influence of anaerobic flora on the damage to the bronchopulmonary system in cystic fibrosis. Objective: to determine the anaerobic diversity of the respiratory tract microbiota and its role in CF, to determine the resistance of anaerobic bacterial strains to antibacterial drugs. Materials and methods Sputum samples from 65 pediatric patients with cystic fibrosis were examined for anaerobic flora, a total of 86 samples of discharge from the lower respiratory tract were taken. Group 1 without anaerobic flora culture amounted to 56/86.2% of people, group 2 with anaerobic flora culture - 9/13.84% of people. To assess the effect of anaerobic flora on lung function, two groups of patients were identified - a group with Pseudomonas aeruginosa culture - 31/47.7% patients and a group of patients with Pseudomonas aeruginosa culture and anaerobic flora - 9/13.84%. Results: long-term persistence of anaerobic flora in severe patients and re-infection with anaerobic bacteria, including new species, were shown. Fusobacterium necrophorum isolated from one patient with cystic fibrosis had complete resistance to 7 antibacterial drugs, and sensitivity in increased concentrations to 4 antibacterial drugs, including metronidazole. The addition of anaerobic flora significantly aggravates the course of the chronic bronchopulmonary process, which is shown in the study with statistically significant differences in nutritional status indicators - patients with anaerobic flora culture had worse indicators M ± SD BMI per 21.5 ± 15.49 compared to the group of patients without anaerobic flora culture 35.43 ± 27.96 (p2-3 = 0.03), FEV1 57.60 ± 24.99, without AnM culture 82.69 ± 23.24 (p2.3 = 0.036), FVC 67.40 ± 15.63, in the group without AnM culture 87.62 ± 23.71 (p2.3 = 0.049), and including when comparing groups with an increase in P. aeruginosa and the group with the growth of P. aeruginosa in association with anaerobic flora - FEV1 57.60% ± 24.99 of the expected value in the group with the growth of anaerobes and 77.44 ± 22.89% of the expected value in the group with the growth of only P. aeruginosa (p = 0.033), FVC - 67.40 ± 15.63% of the expected value versus 85.43 ± 18.66% of the expected value, respectively (p = 0.041). Conclusion. The addition of anaerobic flora significantly aggravates the course of the chronic bronchopulmonary process, the possible long-term persistence of anaerobic flora in severe patients is shown, it is necessary to examine patients with CF during an exacerbation for the presence of anaerobic flora. It is necessary to include antimicrobial drugs with activity against anaerobic bacteria in the treatment of exacerbations in the absence of an effect from antimicrobial therapy.