Peculiarities of microbic landscape at NSAID-induced gastropathy in patients with diabetes mellitus
Journal Title: Сучасна гастроентерологія - Year 2018, Vol 0, Issue 3
Abstract
Objective — to investigate the frequency and nature of microbial lesions of the mucous membrane of the upper gastrointestinal tract in patients with NSAID-induced gastropathy against the background of diabetes mellitus (DM). Materials and methods. The study involved 108 patients with NSAID-induced gastropathy (48 % men, n = 52; 53 % women, n = 56), who were in- or outpatients of the clinic of the Kharkiv National Medical University. The mean age was 42.5 ± 4.5 years. The main group consisted of 51 (47 %) DM patients, the comparison group included 57 (53 %) patients without DM. Both groups were age- and gender-matched. The microbiological study (including Helicobacter and fungal infection) of the material (obtained during EGDS (biopsy) from the stomach antrum and/or zones around the ulcer was carried out; the fungi and bacterial sensibility to chemotherapeutic agents was determined. Results. The patients with H. pylori-associated gastropathies significantly prevailed in the main group (р < 0.05). In 70 (64.2 %) examined patients the microbial composition was characterized by the predominance of combinations of bacteria and Candida fungi. Biofilms were found in all patients of the main group. At defects greater than 1.0 cm, probability of joining of the fungal infection increased (OR 7.0, 95 % CI 2.67 — 18.33; р < 0.0001). Investigation of sensibility of the obtained biofilms to the effects of chemotherapeutic agents showed that amphotericin B and nystatin had greatest antimycotic activity. The types of bacteria obtained from patients were more sensitive to cephalosporin antibiotics and azithromycin. Conclusions. In patients with NSAID-induced gastropathy against the background of diabetes mellitus the risk of contamination of the mucous membrane of the upper parts of gastrointestinal tract by associations of bacteria and fungi reliably rises. Biofilms provoke an increased resistance of microorganisms to antifungal drugs and antibiotics. In patients with diabetes mellitus, the targeted research on dysbiosis in the upper parts of gastrointestinal mucosa should be performed. The determination of the chemosensitivity of each of the obtained microorganisms is also required.
Authors and Affiliations
L. M. Bobro, T. V. Golovko
Keywords
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- EP ID EP298596
- DOI 10.30978/MG-2018-3-37
- Views 125
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