DYSBACTERIOSIS

From Big Medical Encyclopedia

DYSBACTERIOSIS (grech, dys-+ bacteria] + - osis; synonym disbioz) — disturbance of labile equilibrium of the microflora normal occupying unsterile cavities and integuments of the person and animals and forming natural associations of microorganisms.

Biol, D.'s essence is defined by character of qualitative and quantitative changes in species composition of associations («a microbic landscape»). Is more often characterized by sharp reduction of total quantity of microbes, up to total disappearance of separate species of normal microflora, along with periodic or long domination of the types normal presented by the minimum quantity of individuals, sometimes and at all not revealed by standard methods bacterial. researches.

In D.'s formation antagonistic relationship of representatives of natural associations is important. Usually temporary fluctuations in number of certain representatives of microbic flora are leveled in the natural way. In the presence of the conditions promoting the bigger speed of reproduction of certain representatives of associations or owing to accumulation of the specific substances suppressing growth of other microbes (see. Bakteriotsinogeniya ) there are sharp disturbances of the quantitative ratios and structure of microflora leading to development of.

At D. one of the main functions of normal intestinal microflora — its antagonistic activity concerning pathogenic and putrifactive microorganisms, and also vitaminoobrazuyushchy and enzymatic functions is sharply broken that promotes decrease in resistance of an organism.

It is most sharply expressed more stoutly than others D. developing in intestines of the person and animals against the background of weakening of nonspecific protective forces and the general tone of a macroorganism is studied. Especially often it is observed at children after the postponed diseases, disturbances of food or at weakness the general physical. development. In these conditions there is a preferential reproduction of conditionally pathogenic microorganisms who are constantly living in a human body and animals, and it is possible, and the types of these representatives newly forming. Representatives of the sort Escherichia at whom wide shtammovy distinctions — from positively full-fledged commensals to pathogenic, causing severe forms of toxic dyspepsia in children are observed often treat the last (see. Colibacillus ).

Prevailing at D. often there are microorganisms, resistant to widely applied antibiotics or medicinal substances, capable to extend in population of closely related associations. In the same conditions can get preferential distribution and putrefactive microbes (the sorts Proteus, etc.); the coccal forms causing purulent inflammatory processes; the bacteria of the sort Pseudomonas which are often causing postoperative complications; fungal microflora, is more often with dominance of Candida.

A specific place is held by naturally arising D. at long stay of people in extreme conditions: the Antarctic expeditions, space flights, scuba divings, and also under the influence of ionizing radiation.

Schematically D.'s development can be presented in the form of the following phases. The first phase — considerable reduction of number of normal symbionts in natural places of their usual dwelling. The second phase — disappearance of some symbionts and increase in contents of others, and also representatives of the microflora which normal is found in very scanty quantity or which is not found at all. The third phase — emergence autoflor in cavities, bodies and fabrics in which it usually does not meet: e.g., the emergence of colibacillus in bilious ways, a bubble or barmy fungi in urine, coccal forms in blood, etc. which is followed by change of toxigenicity, virulence and pathogenicity of either certain representatives of normal symbionts, or their associations.

Distinguish the compensated (latent) form D. when the macroorganism does not react seen patol, process on disturbance of balance of microflora; the subcompensated form D. when there are local inflammatory processes occupying strictly limited or more or less widespread sites (e.g., stomatitis, perleches, enteritis, a hyperemia of mucous membranes, plaques on mucous membranes, etc.); dekompensirovanny form D., at a cut sharp falling of resistance of an organism leads to generalization of process with formation of the metastatic centers in various parenchymatous bodies with intoxication and an outcome in sepsis.

D.'s emergence and the related autoinfection is influenced by two major factors: a) the irrational use of antibacterial drugs (in particular, antibiotics) involving death of a considerable part of the normal symbionts sensitive to drug, and rough reproduction of flora, resistant to it; b) the allergic reactions connected with a sensitization of a macro-organism antibiotics (drug disease) or other allergens. Value and a sensitization of a macroorganism strains of the microbes which gained resistance to antibiotics has probably.

Most often the following forms D. meet: fungal (kandidamikozny), staphylococcal, caused by representatives sorts Proteus, the sorts Escherichia, a pyocyanic stick, and also various associations of the called microorganisms.

Treatment

the Philosophy of treatment of D. consists in rational purpose of antibacterial agents and treatment of a basic disease (diseases went. - kish. path, liver, gall bladder, pancreas, hypotrophies, etc.). Stop introduction to the patient of antibacterial agents which could serve as D.'s reason; appoint the desensibilizing and stimulating therapy (antihistaminic drugs, drugs of calcium, polyvitamins; transfusions of blood, hormonal drugs, bacteriophages, specific anti-staphylococcal and anti-pyocyanic serums, specific gamma-globulins, anatoxins and vaccines). Prescription of antibiotics is admissible only concerning the activators playing the dominating role at given patol, process (e.g., nystatin and levorinum at a candidiasis, erythromycin at staphylococcal and polymyxin at pyocyanic D., Negramum of nitrofuran drugs at D. caused by representatives of the sort Proteus).

For normalization of an indestinal flora, especially after enteral use of antibiotics, those antibacterial drugs which do not influence colibacillus and other symbionts of intestines are recommended (e.g., Enteroseptolum). Normalization of composition of intestinal microflora can be also reached by use of bacteritic drugs which part viable full-fledged microflora — lactic-acid bacteriums, the colibacillus dominating in a normal biocenosis of healthy people is. These drugs antagonistic are active concerning pathogenic (e.g., causative agents of dysentery) and conditionally pathogenic colibacilli. Treat such drugs: kolibakterin, bifidumbacterium, laktobakterin, bifikol. At all types of intestinal D. administration of fermental drugs is shown. However D.'s treatment cannot be standard and efficient at its different forms and phases.

Prevention — rational purpose of antibacterial agents at treatment of a basic disease (a stomach disease, intestines, a liver, etc.), a gigabyte. actions, fortifying therapy and good nutrition of the weakened children and patients.


Bibliography: Gorelchenkova V. G. and Germans. V. Sostoyaniye of microflora of a large and small bowel at diverticulums of a large intestine, in book: Urgent vopr, gastroenterol., under the editorship of A.S. Loginov, century 7, page 341, M., 1974; Lebedeva M. N., Goncharov G. I. and Lizko N. N. Modern aspects of norm and pathology of intestinal microflora, Zhurn, mikr., epid, and immun., No. 9, page 36, 1974; Marko O. P. and Korneva T. K. About intestinal dysbacteriosis, Owls. medical, No. 5, page 88, 1974; The Pathogeny, clinic and treatment of intestinal infections, under the editorship of A. F. Bilibin, page 31, M., 1965, bibliogr.; Peretts L. G. Znacheniye of normal microflora for a human body, M., 1955, bibliogr.; Plane-lyes X. X. and Kharitonova A. M. By-effects at an antibioticotherapia of bacterial infections, M., 1965; The Guide to infectious diseases, under the editorship of A. F. Bilibin and G. P. Rudnev, page 557, M., 1967.

A. F. Bilibin.

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