Features of the composition of the microbiome of the respiratory tract and intestine in children against the background of chronic adenoiditis

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Abstract
Among the main pathologies of childhood, respiratory tract lesions dominate, with a significant proportion of this category of diseases being chronic inflammatory processes localized mainly in the pharyngeal tonsil (adenoids) and palatine tonsils. Due to the prevalence of these pathologies, it is necessary to develop new approaches to the treatment and rehabilitation of patients. The aim of the study was to conduct a study of the microbiome of the upper respiratory tract and gastrointestinal tract in paediatric patients with chronic adenoiditis for a comparative analysis of the clinical effectiveness of various treatment approaches. Material and methods . We checked out 150 kids aged 3-6 years with chronic inflammation in their nasopharynx. We split the patients into 3 comparable groups based on the treatment and rehabilitation measures carried out. Group 1 included patients who underwent surgery under general anesthesia. Children in groups 2 and 3 received nasopharyngeal irrigation with a probiotic solution for 30 days after surgery or without surgery, respectively. All children underwent bacteriological testing of the oral and nasopharyngeal microbiome, as well as qualitative and quantitative analysis of the luminal intestinal microflora. Results and discussion . In groups 2 and 3, after treatment, the number of cultures positive for Streptococcus salivarius (by 20 and 28 %, respectively), S. mitis (by 14 and 18 %, respectively) in washings from the mouth and nasopharynx statistically significantly increased, in group 3 − cultures containing Neisseria spp. and S. oralis (by 38 and 20 %, respectively). In groups 2 and 3, a decrease in the number of transient and accessory microflora, including Staphylococcus aureus and S. pyogenes , was detected. The composition of the intestinal microbiome significantly improved: in groups 2 and 3 normal microflora was determined in 94.0 % of patients in group 2 (before treatment – only in 8 %) and in 96.0 % of children in group 3 (before treatment – in 16 %). Conclusions. The data obtained indicate the significant effectiveness of probiotic therapy in the postoperative period, as well as in combination with conventional conservative treatment methods for the correction of the microflora of the upper respiratory tract and intestinal biocenosis in children with chronic infectious and inflammatory processes of the nasopharynx.

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