Improving the effectiveness of antimicrobial therapy in the treatment of children with severe purulent-inflammatory diseases through biofilm formation inhibition and consideration of biorhythmic properties of microorganisms

Davydenko V. B., Mishyna M. M., Miasoiedov V. V., Pashchenko Yu. V., Shtyker S. Yu., Davydenko N. V.

Kharkiv National Medical University, Ukraine

The article presents the results of clinical and experimental studies of biofilms and biorhythmic characteristics of pathogens and their exposure to ultrasound and ozone.

The objective of the research — to study the features of modern pathogenic microbes, causative agents of purulent-inflammatory diseases in children in order to improve antimicrobial therapy.

Materials and methods. The work is based on experimental microbiological studies of biofilm formation, biorhythmic properties of pathogens and their exposure to ultrasound and ozone.

Results and discussion. Studies have shown a high ability of pathogenic microbes to biofilm formation as one of the main factors of their polyresistance. Devastating effects on biofilm of low-intensity ultrasound in combination with ozone has been proved. Daily biorhythms in the activity of pathogens in terms of pathogenicity factors production were identified. Schemes to increase the efficiency of antimicrobial therapy for purulent-inflammatory diseases in children were developed.

Conclusions. 1. The researches identified the daily dynamics of production of pathogenicity factors of clinical strains of S.aureus and E.coli and showed a high enzymatic activity and the formation of dense biofilms with further production of planktonic cells at 9:00, 12:00, 15:00 and 21:00. Peaks of reduced production of aggression enzymes were recorded at 6:00 and 18:00. 2. It is shown that the majority of isolates in the form of planktonic cells had multiple antibiotic resistance (89.2–97.8% of cases), which is the result of broad and not always rational use of antibiotics. 3. It was found that under the influence of ultrasonic radiation on factors of pathogenicity of clinical strains of E.coli and S.aureus, activity of aggression enzyme, ability to biofilm formation and production of planktonic cells are inhibited. 4. The possibility of combined use of ultrasonic radiation and ozone to treat the inflammation in purulent inflammatory diseases in children is justified that promotes the inhibition of planktonic cells production and the ability to form secondary biofilms by multiresistant strains of S.aureus and E.coli and causes complete bacteriolysis in the area of ultrasound and ozone effect. 5. The researches became an objective basis for the introduction into the clinical practice of modern therapeutic interventions, such as ultrasound treatment of inflammation foci and ozone therapy in acute destructive pneumonia, common forms of peritonitis and acute hematogenous osteomyelitis in children. 6. Identified biorhythmic patterns of pathogenic microorganism activity that are adequate response to the action of antimicrobial agents make it possible to develop flexible antimicrobial strategy. The development of such a strategy requires further in-depth studies in this area.

Key words: purulent inflammatory diseases, biofilm, biorhythms, ultrasound, ozone.

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