(CMV) antigens, the expression of specific cytotoxic lymphocytes on infected lung cells leads to damage to the
alveoli.
Taking into account the constantly changing sensitivity of pathogens of bacterial infections to antibiotics,
the growing resistance of pathogens requires a constant analysis of the composition and sensitivity of
microflora. In this regard, the study of the etiological structure and antibiotic resistance of major pathogens is
necessary for timely adequate antibiotic prophylaxis and empirical antibiotic therapy [6-8].
The aim of study was to identify the spectrum of pathogens and its resistance over time in patients with
infectious complications after kidney transplantation.
MATERIAL AND METHODS
The foundation of the study was the results of the examination and treatment of 105 patients after
heterotopic related TP for the period 2010-2017. Of these, 101 patients were operated on in our center.
Pulmonary complications with the development of bilateral interstitial pneumonia were observed in 7 patients
in the immediate postoperative period, in 4 patients in the late, during the observation period from 1 month to 4
years.
Four more patients operated in clinics in India and Pakistan were hospitalized to our center with a clinic
for acute lung injury syndrome in one case against acute and in three chronic kidney transplant rejection,
pyelonephritis and bacterial pneumonia with further development of sepsis were also diagnosed.
The materials for analysis were: urine (236 samples), blood (195 samples), discharge from drainages (220
samples), sputum (217 samples), material of broncho-alveolar lavage (56 samples), and tracheal wash (220
samples). Traditional methods for isolating and identifying microorganisms and determining their sensitivity
to antimicrobial agents by the disk diffusion method were used. The species specificity of the isolated
microorganisms was determined using standard methods using identification media (production ‘‘HiMedia’’,
India). Investigated the effectiveness of cephalosporins, aminoglycosides, fluoroquinolones, tetracyclines,
carbapenems, glycopeptides, inhibitor-protected antibiotics.
In event of bronchopulmonary infection in the complex of conventional therapy, the new antimicrobial
biotechnological medication FarGALS was used, which is characterized by a pronounced antiseptic and local
anti-inflammatory effect. The antimicrobial activity of the FarGALS with respect to the isolated strains was
determined by diffusion into agar. Accounting for the results was to measure the diameters of the zones of
inhibition of the growth of test cultures around the wells. With zones up to 10 mm, cultures were considered
stable, with zones of 11-14 mm being moderately resistant, with zones of 15 mm and above being sensitive.
FarGALS has a broad spectrum of antimicrobial activity (active against gram-positive and gram-negative,
aerobic and anaerobic, nesporoobrazuyushchy and spore-forming bacteria, etc., fungi of the genus Candida). In
addition, the presence of antibodies against CMV in the serum was determined and the presence of CMV DNA
was detected by a quantitative polymerase chain reaction method. Polymerase chain reaction (PCR),
quantitative determination showed 3,5x106ME / ml in the blood. As well as dynamic control of C-reactive
protein.
Ethical approval
The review board and ethics committee of RSSPMCS named after acad. V.Vakhidov approved the study
protocol and informed consents were taken from all the participants.
RESULTS AND DISCUSSION
The number of microbiological positive samples is reduced from 85% to 47%. A total of 236 cultures were
isolated, of which gram-positive - 20%, gram-negative - 46%, fungi of the Candida river - 34%. From gram-
positive: Staphylococcus aureus and Enterococcus spp. met in 4.0-2.0% of cases, from gram-negative -
Pseudomonas aerugenosa 20–13.6%, Klebsiella pneumonia 43.2–8.7%, E. coli 11–23.0%, Acinetobacter spp. - 8-
39%. Strains Acinetobacter spp. excreted mainly from the trachea (patients on prolonged mechanical
ventilation) - 77%. Among the samples of tracheobronchial aspirate in 25% of cases - were allocated, associated,
most of the microbial associations included fungi. The results of the study of samples of biological media are
represented in table 1. Most of all we studied the drain bag biological media (7.3-19%).
To cite this paper: Ibadov R A, Ibragimov S Kh, Shaniyeva Z A, Matkarimov Z T, Ibadov R R. 2019. Etiological circumstances and pathogenic aspects of
pulmonary infectious complications in recipients of kidney transplant. J. Life Sci. Biomed. 9(3): 64-67; www.jlsb.science-line.com
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