Why is the growth of conditionally pathogenic flora dangerous? The danger posed by representatives of opportunistic flora

A. Principles of rational nutrition to normalize the weight of a conditionally healthy person without pronounced food addiction 1. No prohibited foods. We advise our clients to remove the prohibitions in relation to any products or their combinations. In our opinion

An example of physical activity for apparently healthy overweight people For weight loss, aerobic exercise is important, since the hydrolysis (breakdown) of fats in mitochondria occurs in the presence of oxygen. Aerobic exercise increases oxygen consumption,

The prevalence of cystitis in Russia is very high - 35 million cases are recorded annually. The disease can appear at any age.

In 25% of women of childbearing age, inflammation of the bladder is recorded in one form or another.

Men get sick much less often. However, after 65 years, the number of sick men and women becomes almost the same. This is due not only to the structure of the genitourinary system.

The course of the disease and the features of its treatment depend on the type of infection causing cystitis.

What infections cause cystitis?

The disease is caused by conditionally pathogenic flora, which is constantly in the human body.

The source of pathogens are the intestines, rectum, skin of the anogenital region and the vagina.

During an influenza epidemic, hemorrhagic cystitis occurs. Also, the disease is caused by adenovirus, herpes virus and parainfluenza.

With the onset of sexual activity, there is a risk of contracting urogenital infections. In young people, sexually transmitted infections are often the cause of cystitis.

Uncomplicated inflammation of the bladder is caused by a single microorganism; during chronic illness, several pathogens are found.

Conditionally pathogenic microflora (UPF)

Microorganisms are constantly present in the human body.

Conditionally pathogenic bacteria live on the skin, in the digestive tract and genitourinary system, i.e., in those organs that are directly related to the external environment. Microflora is necessary for their normal functioning.

Besides UPF possess antagonistic action in relation to pathogenic flora. Thus, the body is protected from excessive reproduction of pathogenic bacteria.

In a healthy body, opportunistic flora does not cause pathology. But with a decrease in general immunity or under the influence of external factors, bacteria begin to multiply actively. When their number exceeds the maximum allowable, they become pathogenic and can cause various infections.

Conditionally pathogenic flora of the digestive tract

In the gastrointestinal tract, bacteria promote digestion, synthesize vitamins, and participate in the processes of immunity formation.

Gram-negative (E. coli, Proteus, Klebsiella, Enterobacter) or Gram-positive bacteria (Streptococcus, Staphylococcus, Enterococcus) lead to the development of cystitis.

Staphylococcus aureus

In 2005, domestic scientists conducted a study of UTIAR III. According to this study, in 86% of cases, acute inflammation of the bladder is caused by E. coli, 6% by Klebsiella spp., 1.8% by Proteus spp., 1.6% by Staphulicocus saprophitus, 1.2% by Pseudomnas aeruginosa, etc. .

Thus, the first place among opportunistic intestinal bacteria that cause acute uncomplicated cystitis is occupied by Escherichia coli. In second place is Klebsiella, and the third in frequency is saprophytic staphylococcus aureus.

Infection of the bladder usually occurs gradually and, first of all, the pathogen enters the urethra. , causes, as well as the process of infection - this is useful to know.

You will find herbal recipes for chronic cystitis.

Symptoms of acute cystitis in women - frequent urination, pain symptom in the abdomen cause severe discomfort. This topic is all about the diagnosis and treatment of the inflammatory process. Preventive measures to avoid the development of the disease.

The microflora of the genital organs

The main representatives of the normal microflora of the vagina that can cause inflammation of the bladder are fungi of the genus Candida and ureaplasma.

Yeast-like fungi r. Candida causes candidiasis (thrush) in women. Cystitis develops as a complication of severe vaginal candidiasis.

In people with weakened immune systems, fungi spread through the blood to all organs. General candidiasis develops.

This occurs in patients with diabetes mellitus, after operations and long-term use of antibiotics, during radiation therapy, during treatment with steroid hormones. These people develop candidal cystitis.

Candidiasis cystitis can be suspected if more than 1000 colonies of fungi are found in 1 ml of urine.

Ureaplasma uealiticum belongs to mycoplasmas and are virus-like microorganisms. The peculiarity of ureaplasmas lies in the fact that they are able to attach to leukocytes, disrupt their functioning and reduce the inflammatory protective reaction. This leads to a severe course of cystitis. Often such cystitis is prone to a long relapsing course. Sometimes they go unnoticed.

Ureaplasma itself, inflammation causes extremely rarely, it manifests its pathogenic properties in combination with chlamydia or other pathogenic bacteria.

Sexually Transmitted Infections (STIs)

In women of childbearing age and sexually active men, a urogenital infection is often the cause of cystitis.

The most important is chlamydial infection. About 10% of people are infected with Chlamydia trachomatis.

Chlamydia does not have specific manifestations, it is usually detected with existing complications - chronic diseases of the genitourinary system.

Chlamydia are able to exist inside the cells of the human body in the form of atypical forms. This circumstance complicates treatment and leads to frequent relapses. After treatment, stable immunity is not formed.

Respiratory viruses

Among the viruses that can lead to cystitis, there are adenovirus, influenza virus, parainfluenza, herpes virus.

In most cases, viral cystitis resolves without special medical treatment within a few weeks.

However, against the background of viral inflammation of the bladder, bacterial cystitis often develops.

The genitourinary system is particularly susceptible to various infections. - the causes and factors of this symptom, as well as additional symptoms of diseases.

Causes and symptoms of the inflammatory process in chronic cystitis in men - read.

How does a bladder infection occur?

The entry of pathogenic microorganisms into the urinary system occurs in several ways:

• If the rules of personal hygiene are not observed, the UPF of the intestine and vagina enters the bladder in an ascending way.
• Viral infections, Candida fungi penetrate into it through the blood. This path is called hematogenous.
• The descending pathway is said to be when pathogens enter the bladder from the kidneys. This occurs with pyelitis of various etiologies.
• Very rarely, a contact path is observed, in which the infection from neighboring organs passes to the bladder. This is observed with purulent fusion of its walls.

In 86%, the cause of inflammation of the bladder is Escherichia coli. The entry of microorganisms into the bladder occurs when hygiene rules are not followed and immunity is reduced.

streptococcal infection

Don't forget about sexually transmitted infections. To prevent infection of cystitis, casual sexual contact should be avoided.

All inflammation occurs against the background of a decrease in immunity. Therefore, it is necessary to carry out hardening, take multivitamins, observe the daily regimen and eat right.

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Ancient inhabitants of the planet

Bacteria appeared on our planet more than three and a half billion years ago. They survived two ice ages in the history of the planet and continue to successfully evolve today. The classification includes more than a million species of bacteria that live almost everywhere. They are divided into many different groups, but the most interesting for us are enterobacteria. What it is, it is easy to explain - these are our neighbors who share our body and food with us.

Enterobacter family

Representatives of the huge Enterobacteriaceae family live both in the external environment and in the body of animals and humans. In the context of this article, we will consider the genus Enterobacter (pathogenic and opportunistic enterobacteria), which includes 15 species of bacteria. These living creatures are facultative anaerobes (they can do without oxygen) and are considered colimorphic (the environment for enterobacteria is the lower sections of the gastrointestinal tract of all warm-blooded animals and humans).

Features of the structure and life

In appearance, these are sticks with flagella, which serve to move the bacteria. These proteobacteria do not form spores and reproduce by simple division. In the soil and aquatic environment, they are able to remain viable for many months. From disinfectants, they die within a few minutes, and at high temperatures - within an hour. Conditionally pathogenic enterobacteria are natural inhabitants of the intestines of animals. They play an important role in formate fermentation of food products. But among them there are pathogenic and conditionally pathogenic representatives for humans. All of them are gram-negative enterobacteria. What it is will be discussed later.

General information about conditionally pathogenic flora (UPF)

The opportunistic flora includes lactose-negative enterobacteria, clostridia, various cocci, etc. The essence of these microbes is reflected in the name of the group: “opportunistic pathogens”. Normally, they do not cause disturbances. Many of them can even be useful to the body to a certain extent. But when the norm is exceeded and / or the immune defense is ineffective, they can cause serious diseases. Competing with beneficial bacteria, opportunistic flora can become part of the intestinal microbial film and cause functional disorders, inflammatory and allergic diseases.

It is possible that opportunistic flora enters the bloodstream through the intestinal wall and spreads throughout the body (translocation), which is especially dangerous for young children and people with severe immunodeficiencies, in whom these microorganisms can cause various diseases, including life-threatening ones. .

In addition to obligate pathogenic enterobacteria, acute intestinal infections (AII) can be caused by other members of the Enterobacteriaceae family. In the international lexicon, they are usually referred to as opportunists. In the USSR, the term "opportunistic pathogens" became widespread. Also known clostridial OKA. Intestinal infections caused by opportunistic enterobacteria (OPE) are not as widespread as those caused by pathogenic enterobacteria. They are mainly diagnosed and recorded during food outbreaks and as nosocomial infections.

A certain idea of ​​the frequency of spread of the considered infections was obtained as a result of specially performed in 1984-1985. on the instructions of the Russian Ministry of Health for research, in which patients were examined for a wide range of bacterial and some viral intestinal infections. Among the etiologically deciphered acute intestinal infections in children, infections caused by opportunistic enterobacteria accounted for only 4.1%, while in most cases they were due to Klebsiella. This is more than 6 times lower than the proportion of intestinal escherichiosis and shigellosis.

As another source of information on the incidence of acute intestinal infections caused by opportunistic enterobacteria, one can cite the analysis of outbreaks of this etiology registered in the USSR in 1985-1987. During this period, 23 AII outbreaks occurred in the country, the causative agents of which were Klebsiella, Proteus, Enterobacter or Citrobacter; during them 971 people fell ill. At the same time, 13 outbreaks with 684 cases were registered, in which opportunistic enterobacteria were the etiological cause in association with other microorganisms. The proportion of outbreaks of AII caused by UPE was significantly lower than that caused by Shigella or Salmonella. Thus, in 1986 in the USSR, out of the total number of AII outbreaks (154) caused by any representatives of the Enterobacteriaceae family, outbreaks of Shigella etiology accounted for 58.7%, Salmonella etiology - 23.8%, and those caused by opportunistic enterobacteria - only 10.4 %, i.e., almost 6 and 2.5 times less, respectively.

Clostridial acute intestinal infections in the USSR and abroad are more often registered as foodborne diseases. In the USA in 1979, out of the total number of foodborne outbreaks with an established etiology, outbreaks caused by only one type of Clostridium accounted for 18.7% and in 1982 - 15.7%, and in the UK in the period 1970-1979. their share was even higher; 39.4%. In the United States, Clostridium is the third leading cause of foodborne AII (after Salmonella and Staphylococcus aureus).

Opportunistic enterobacteria are also natural inhabitants of the intestines of many animals, including agricultural ones.

Conditionally pathogenic enterobacteria are widespread in nature; their constant presence in the water of open reservoirs, especially Proteus, Enterobacteria and Klebsiella, has been proven. The latter are more common in the plant world than others; they were isolated from potato tubers, lettuce leaves and other plants, from flowers, grains, seeds, sawdust, as well as from soil and wastewater. The vastness of the ecological sphere of Klebsiella is associated with the significant stability of their capsule forms, capable of withstanding various biological and physico-chemical influences, including the effects of disinfectants and high temperatures. This leads to the frequent contamination by Klebsiella of household items, food products, as well as objects of the intrahospital environment.

How to "read" the analysis for dysbacteriosis?

In the form of each analysis for dysbacteriosis there are indicators of microflora, which we will decipher.

Pathogenic enterobacteria

Usually this indicator in the analysis form comes first. This group of microorganisms includes such bacteria that cause acute intestinal infection (Salmonella, Shigella - causative agents of dysentery, causative agents of typhoid fever). The detection of these microorganisms is no longer an indicator of dysbacteriosis, but an indicator of a serious infectious bowel disease.

bifidobacteria

These are the main representatives of the normal intestinal microflora, the number of which in the intestine should be 95 - 99%. Bifidobacteria perform the important job of breaking down, digesting and absorbing various food components, such as carbohydrates; they themselves synthesize vitamins, and also contribute to their absorption from food; with the participation of bifidobacteria, iron, calcium and other important trace elements are absorbed in the intestine; bifidobacteria stimulate the motility of the intestinal wall and contribute to the normal emptying of the intestine; bifidobacteria neutralize various toxic substances that enter the intestine from the outside or are formed as a result of the vital activity of putrefactive microorganisms. The analysis form indicates the titer of bifidobacteria, which must be at least 10 7 - 10 9 . A significant decrease in the number of bifidobacteria is always a sign of severe dysbacteriosis.

Lactobacilli (lactobacilli, lactic acid bacteria, lactic acid streptococci)

The second representative (5% in the total of intestinal microorganisms) and the most important representative of the normal flora. Lactobacilli or lactic acid microbes, as their name suggests, produce lactic acid, an essential component for normal bowel function. Lactobacilli provide anti-allergic protection, promote normal bowel movements, produce highly active lactase, an enzyme that breaks down milk sugar (lactose). In the analysis, their number should be at least 10 6 - 10 7 . Deficiency of lactobacilli can lead to the development of allergic diseases, constipation, lactase deficiency.

Escherichia coli with normal enzymatic activity (escherichia)

It should be noted that the bacteria of the normal intestinal flora live by attaching to the intestinal wall and forming a film that covers the intestine from the inside. Through this film, all absorption in the intestine occurs. Bacteria of normal intestinal microflora together provide 50-80% of all digestion, and also perform protective (including anti-allergic) functions, neutralize the action of foreign and putrefactive bacteria, promote bowel movement, provide adaptation to nutrition and to external influences.

Escherichia coli with reduced enzymatic activity

This is an inferior E. coli, which does not pose any harm, but does not perform its beneficial functions. The presence of this indicator in the analysis is a sign of incipient dysbacteriosis, as well as a decrease in the total number of Escherichia coli can be an indirect sign of the presence of worms or protozoa in the intestine.

Some assays describe bacteroids whose role is unclear, but known to be non-harmful bacteria, usually their number is of no practical importance.

All other indicators of microflora are conditionally pathogenic flora. The very term “opportunistic pathogenic” denotes the essence of these microbes. They become pathogenic (violating the normal functions of the intestine) under certain conditions: an increase in their absolute number or percentage of normal flora, with the ineffectiveness of protective mechanisms or a decrease in the function of the immune system.

Conditionally pathogenic flora - these are lactose-negative enterobacteria (Klebsiella, Proteus, citrobacters, enterobacters, hafnia, serrations), hemolyzing Escherichia coli and various cocci (enterococci, epidermal or saprophytic staphylococci, Staphylococcus aureus). In addition, opportunistic pathogens include clostridia, which are not sown in all laboratories.

Conditionally pathogenic flora is introduced, competing with beneficial bacteria, into the microbial film of the intestine, colonizes the intestinal wall and causes disruption of the entire gastrointestinal tract. Intestinal dysbacteriosis with a high content of opportunistic flora may be accompanied by allergic skin reactions, stool disorders (constipation, diarrhea, greens and mucus in the feces), abdominal pain, bloating, regurgitation, vomiting. In this case, usually the body temperature does not rise.

Coccal forms in the total amount of microbes

The most harmless representatives of conditionally pathogenic flora are enterococci. They are most often found in the intestines of healthy people, their number up to 25% does not pose a threat to health. If the amount exceeds 25% (more than 10 7), this is most often associated with a decrease in normal flora. In rare cases, an increase in the number of enterococci is the main cause of dysfunction associated with dysbacteriosis.

Epidermal (or saprophytic) staphylococcus aureus (S. epidermidis, S. saprophyticus)

These types of staphylococci can cause disturbances, but their number up to 25% is acceptable. Even among the relatively harmless cocci named above, more pathogenic cocci can occur, which is indicated in this position. If a total cocci is, for example, 16%, and the percentage of hemolytic cocci is 50%, which means that half of the 16% are more harmful cocci, and their percentage in relation to the normal flora is 8%.

Staphylococcus aureus (S. aureus)

One of the most unpleasant (along with hemolyzing Escherichia coli, Proteus and Klebsiella) representatives of conditionally pathogenic flora. Even small amounts of it can cause pronounced clinical manifestations, especially in children during the first months of life. Therefore, usually in the norms given in the analysis form, it is indicated that it should not be (in fact, quantities not exceeding 10 3 are permissible).

The pathogenicity of Staphylococcus aureus directly depends on the state of the normal flora: the more bifidobacteria, lactobacilli and normal E. coli, the less harm from staphylococcus. Its presence in the intestines can lead to allergic reactions, pustular skin rashes, and intestinal dysfunction. Staphylococci are common environmental microbes, in particular, they live in large numbers on the skin and mucous membranes of the upper respiratory tract.

They can pass to the baby through breast milk. Weakened children are most susceptible to infection with staphylococci (problem pregnancy, prematurity, caesarean section, artificial feeding, use of antibiotics - risk factors for weakening the immune system). It is important to understand that staphylococci, like other opportunistic bacteria, manifest themselves under certain conditions, the main of which is a weakening of the immune system, therefore, immunocorrective therapy is important in the treatment of dysbacteriosis associated with staphylococcus aureus.

Hemolysing Escherichia coli

It is a representative of lactose-negative enterobacteria, but stands out separately due to its prevalence and significance. Normally, it should be absent. Almost everything said about Staphylococcus aureus applies to this microbe. That is, it can cause allergic and intestinal problems, is very common in the environment (although it is almost never found in breast milk), causes problems in weakened children, and requires immunocorrection.

It should be noted that the term "hemolysing" does not mean that there is any effect on the blood. Conditionally pathogenic flora in dysbacteriosis should not overcome the intestinal wall and enter the bloodstream. This is possible only with extremely pronounced forms of dysbacteriosis in children with severe immunodeficiencies, which, as a rule, pose a threat to life. Fortunately, such conditions are rare.

lactose-negative enterobacteria

A large group of opportunistic bacteria of a greater or lesser degree of pathogenicity. Their number should not exceed 5% (or in credits: 10 3 - 10 6 - a moderate increase, more than 10 6 - a significant increase). The most unpleasant bacteria from this group are Proteus (most often associated with constipation) and Klebsiella (they are direct antagonists (competitors) of lactobacilli, which leads to the development of allergies and constipation, as well as manifestations of lactase deficiency).

Mushrooms of the genus Candida

Permissible presence up to 10 4 . An increase in this parameter may be after the use of antibiotics. If the number of fungi is increased, and the amount of normal intestinal flora is sharply reduced, while candidiasis (thrush) of the visible mucous membranes (oral cavity, genitals) is noted - these are manifestations of systemic candidiasis, that is, there is an infection with intestinal fungi. If the number of fungi in the analysis for dysbacteriosis is increased, but there is no decrease in the normal intestinal flora, this indicates that the fungi live on the skin around the anus, and not in the intestines, in this case external therapy using antifungal ointments or creams is sufficient.

Clostridia

Due to technical difficulties and little practical importance, not all laboratories determine it. Permissible quantity up to 10 7 . They usually show pathogenicity in combination with other opportunistic flora, rarely cause problems in isolation (most often - liquefaction of the stool, diarrhea). Their number depends on the function of local intestinal immunity.

Other microorganisms

This parameter describes rare species of bacteria, the most dangerous of which is Pseudomonas aerugenosa (Pseudomonas aerugenosa). Most often, the microorganisms described in this position of analysis are of no practical importance.

How to quickly recover from an infection?

The treatment regimen for poisoning is made by a doctor individually for each patient.

To recover faster from an intestinal infection, they usually use:

• means replenishing the reserves of liquid and ions;
• enterosorbents;
• enzyme preparations.

Step 1. We replenish the loss of electrolytes

The main danger in case of poisoning is the development of dehydration. To prevent this, even during the recovery period, it is recommended to drink more fluids and take special drugs that compensate for the loss of vital potassium and sodium ions. One of these drugs is Regidron.

Powder Regidron is diluted in 1 liter. boiled water at room temperature. Drink the resulting solution should be 1-2 tbsp. l. every 10-15 minutes until diarrhea and vomiting completely stop. If there is no medicine at hand, you can prepare a simple saline solution yourself. Take:

Dissolve sugar, salt and soda in 1 liter of boiled water and take according to the scheme above.

Step 2. Remove toxins from the body

Sorbents are drugs that act in the intestines like a sponge, collecting toxins and removing them from the body. The most popular sorbent is activated carbon. You can use it or choose more modern drugs:

Step 3. Helping digestion

Enzyme preparations are designed to digest food that enters the body. They help to "unload" the inflamed intestines in the first days after poisoning. It is worth taking them in the case when the appetite has recovered, and the patient returns to his usual diet. The use of enzymes in the complex treatment of poisoning allows you to quickly get in shape.