Monitoring of the microflora of the paranasal sinuses as a method of early prevention of colonization of the lower respiratory tract of clinically significant strains of microorganisms in patients with cystic fibrosis

Numerous works of foreign authors show the relationship between microorganisms that colonize the upper and lower respiratory tract in patients with cystic fibrosis. However, no such studies have been conducted in the Russian Federation. The article presents the results of the evaluation of the species composition of microorganisms isolated from parallel cultures of nasal lavage fluid and lower respiratory tract of patients with cystic fibrosis. The aim of the study was to determine the qualitative and quantitative species composition of the nasal lavage fluid microflora and to assess the correlation of microorganisms isolated from the paranasal sinuses and lower respiratory tract. The material for the study was 61 nasal wash samples obtained from 44 patients with cystic fibrosis of the Samara region. Collection and sowing of primary material for culture media was carried out in accordance with the patent of the Russian Federation “method of collection and primary sowing of nasal lavage fluid from patients with cystic fibrosis for microbiological examination”. Identification of the isolated strains was performed using MALDI-TOF - mass spectrometry. As a result of the study, 333 strains of microorganisms were isolated. Of these, 54 strains isolated from 33 patients have proven clinical value in cystic fibrosis. The structure of clinically significant strains included such representatives as Staphylococcus aureus, Burkholderia cenocepacia, Pseudomonas aeruginosa, Achromobacter xylosoxydans. Analysis of the results showed that the structure of bacterial pathogens isolated from nasal lavage correlates with the composition of the microflora of the lower respiratory tract. The study revealed 8 patients at risk for infection with strains of proven clinical significance in cystic fibrosis from the upper respiratory tract. Thus, paranasal sinuses can be a source of lower respiratory tract infection in patients with cystic fibrosis. Regular microbiological examination of the microflora from nasal lavage fluid allows to identify clinically significant microorganisms at an early stage and can be considered as a way of early prevention of the formation of chronic bacterial infection of the lower respiratory tract in cystic fibrosis.