Clinical significance of lung microbiota and efficiency of the inhaled antibacterial therapy of cystic fibrosis in children

The objective: to study clinical and microbiological features of the injuries of the respiratory organs and to assess the effectiveness of elimination therapy in chronic sinus infection in children in the regional center for cystic fibrosis. The specialists of Omsk center for cystic fibrosis made a retrospective analysis of 48 case histories and assessed clinical and functional parameters depending on the age and microbiological status of the respiratory tract. They presented a comparative assessment of the effectiveness of the original and generic tobramycin inhalation.

The results. An association of microorganisms was identified in the majority of bacterial cultures of cystic fibrosis patients’ sputum (66.7%). Among the clinically relevant pathogens there were Staphylococcus aureus (18.9%) and Pseudomonas aeruginosa (16.6%) with the significant prevalence of non-mucoid forms. From 2011 to 2016 the amount of Pseudomonas aeruginosa strains, sensitive to all usable antibiotics, decreased, especially significant sensitivity decline was registered to amikacin – 21.35% and сiprofloxacin – 26.1%. The children infected by Pseudomonas  aeruginosa had more deviations of lung function measured by the computed bronchophonography and spirometry, they more often had changes at chest computed tomography than patients free of Pseudomonas aeruginosa infection. Usage of generic tobramycin instead of original tobramycin didn’t lead to the elevation of respiratory syndrome exacerbation rates, didn’t increase requirement in the intravenous antibacterial treatment and didn’t influence to the degree of microbial colonization of sputum. The conclusion. There was noted an increase in the resistance of Pseudomonas aeruginosa to anti-pseudomuscular drugs, which justifies the introduction of highly concentrated inhaled forms of antibiotics. Replacing the original inhaled tobramycin with a generic drug did not cause a deterioration in the clinical and functional status of the patients and did not change their microbiological status.

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